Istituto di Fisiologia Clinica     
Farneti P. A., Sbrana S., Spiller D., Cerillo A. G., Santarelli F., Di Dario D., Del Sarto P. A., Glauber M. Reduction of blood coagulation and monocyte-platelet interaction following the use of a minimal extracorporeal circulation system (Synergy) in coronary artery bypass grafting (CABG). In: Perfusion, vol. 23 (1) pp. 49 - 56. Prakash P. Punjabi (ed.). SAGE Publications, 2008.
Cardiovascular surgery with cardiopulmonary bypass (CPB) induces activation of blood coagulation and systemic inflammation involved in post-operative complications. Our study evaluated the impact of the minimal extracorporeal circulation (mini-CPB) system (Synergy®, Sorin Group) on these functional aspects. Twenty patients were randomly assigned to standard CPB (n=10) or to Synergy (n=10). Platelet expression of PAC-1, and monocyte/granulocyte-platelet conjugates were evaluated by flow cytometry. A leukocyte-platelet adhesion index was calculated after cell number normalization. ELISAs were performed to measure IL-6 and TNF-α, thrombinantithrombin III complexes (TAT), prothrombin fragments (F1+2), β-thromboglobulin (β-TG) and sP-selectin (sCD62P). Blood samples were drawn at the time of anesthesia (T1), at the end of CPB (T2), and at 4 (T3) and 24 hours (T4) after weaning from CPB. All patients were similar for clinical characteristics. When compared to standard CPB, the Synergy showed lower levels of the monocyte-platelet adhesion index at T2 (0.023 ± 0.005 vs 0.063 ± 0.013, P = 0.0092) and T4 (0.031 ± 0.003 vs 0.055 ± 0.005, P = 0.0017), TAT complexes at T2 (27.175 ± 5.967 vs 86.592 ± 5.415, P = 0.0005) and T3 (26.977 ± 2.468 vs 45.146 ± 4.365, P = 0.0041), F1+2 fragments at T2 (2.222 ± 0.226 vs 4.249 ± 0.292, P = 0.0009), and sP-selectin at T3 (115.17 ± 19.623 vs 169.554 ± 19.709, P = 0.0703) and T4 (108.542 ± 6.429 vs 140.799 ± 14.771, P = 0.0833). In summary,the Synergy exhibited a lower post-operative activationof blood coagulation, together with a reduced interaction between circulating monocytes and platelets.
URL: http://www.sagepublications.com
DOI: 10.1177/0267659108091336
Subject coronary artery bypass grafting
minimal extracorporeal circulation
coagulation system
flow cytometry

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