Platelet preservation during coronary bypass surgery with bubble and membrane oxygenators: effect of albumin priming

Abstract

Sixty-three patients admitted for routine coronary bypass operations were randomized to cardiopulmonary bypass (CPB) with a membrane oxygenator (Capiox- CA) or a bubbler (Polystan or William Harvey- WH), and in the Polystan group to prime with or without albumin (P+ or P-). Platelets were counted and blood loss from the mediastinal drains during the first 12 postoperative hours was measured. The reduction in platelet numbers from baseline to closure of the sternum was significantly larger in the P- group (121 x 10⁹/l, median) than in the CA group (55 x 10⁹/l) (p <0.001), with intermediate reductions in the P+ (87 x 10⁹/l) and WH (90 x 10⁹/l) groups. The reduced platelet loss in the P+ group compared with P- was accompanied by a significant reduction in early postoperative chest tube drainage (480 versus 728 ml). Thus, precirculation of the CPB circuit with prime containing a low dose of albumin was a simple and inexpensive means of increasing platelet function with a bubble oxygenator.