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Mediators of Inflammation
Volume 2009, Article ID 707042, 7 pages
http://dx.doi.org/10.1155/2009/707042
Review Article

The Inflammatory Response to Miniaturised Extracorporeal Circulation: A Review of the Literature

Department of Cardiothoracic Surgery, Wessex Cardiac Institute, Southampton General Hospital, Southampton, SO16 6YD, UK

Received 26 July 2009; Accepted 3 November 2009

Academic Editor: Philipp Lepper

Copyright © 2009 Hunaid A. Vohra et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Conventional cardiopulmonary bypass can trigger a systemic inflammatory response syndrome similar to sepsis. Aetiological factors include surgical trauma, reperfusion injury, and, most importantly, contact of the blood with the synthetic surfaces of the heart-lung machine. Recently, a new cardiopulmonary bypass system, mini-extracorporeal circulation (MECC), has been developed and has shown promising early results in terms of reducing this inflammatory response. It has no venous reservoir, a reduced priming volume, and less blood-synthetic interface. This review focuses on the inflammatory and clinical outcomes of using MECC and compares these to conventional cardio-pulmonary bypass (CCPB). MECC has been shown to reduce postoperative cytokines levels and other markers of inflammation. In addition, MECC reduces organ damage, postoperative complications and the need for blood transfusion. MECC is a safe and viable perfusion option and in certain circumstances it is superior to CCPB.