Why Centrifugal?

Roller pumps push blood along, creating turbulence that can damage it and create debris by spalling particles from the tubing. Impeller pump blades push through the blood, causing areas of damaging turbulence. Centrifugal pumps, by contrast, promote laminar flow, which improves blood- and air-handling capabilities and decreases blood trauma.

 

How Bio-Pump Works

The nonocclusive design of the Bio-Pump™ centrifugal blood pump helps decrease blood trauma associated with extracorporeal circulatory support during cardiopulmonary bypass. It uses the constrained forced-vortex pumping principle, in which a series of smooth-surfaced rotating cones pull the blood into the vortex created by the rotation. As the blood flows toward the pump outlet, the air-handling vortex energy created by the cones transfers to the blood in the form of pressure and velocity.

The Evidence

From early on, the design of centrifugal pumps was found to offer advantages for improved clinical outcomes*.

Early Evidence-Based Returns

  • Reduced hemolysis and postoperative chest tube drainage1
  • Significant improvement with respect to platelet count, decreased complement activation and reduced microbubble transmission2
  • Improved platelet retention on CPB, “most notable on cases longer than 120 minutes and patients older than 70”3

Use in Complex Procedures

  • A centrifugal pump "should be usd in complex procedures to avoid severe postperfusion syndrome"4
  • Pediatrics: Reduced blood trauma, platelet activation and inflammatory response. Improved renal response, resulting in shorter vent, ICU and overall LOS5

Improved Neurological Outcomes

  • 1000 patients undergoing “routine” cardiac surgery6
    • Reduction in chest tube drainage
    • Fewer transfusions
    • Significantly lower incidence of neurological complications
  • Retrospective analysis (4000 patients)7
    • Non randomized – clear bias of using the centrifugal pump on longer, more complex cases
    • Significantly lower neurological deficits (1.5 vs 2.6%)

Why Now More Than Ever

Both older patients and those undergoing longer procedures are being placed at “an elevated risk of multi-organ dysfunction.”8

  • Older patients
  • Longer, more complex procedures
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Footnote

*

Evidence is related to centrifugal blood pumps in general and is not specific to Bio-Pump. 

References

1

Lynch et al. Centrifugal Blood Pumping for Open Heart Surgery; Minnesota Medicine, 1978; 61:536-537

2

Wheeldon et al. Vortex Pumping for Routine Cardiac Surgery; Perfusion, 1990; 5(2):135-43

3

Parault, B, Conrad, S. The Effect of Extracorporeal Circulation Time and Patient Age on Platelet Retention During Cardiopulmonary Bypass: A Comparison of Roller and Centrifugal Pumps; JECT; 1991, 23:34-38

4

Jakob HG, et al. Routine extracorporeal circulation with acentrifugal or roller pump; ASAIO Trans. 1991 Jul-Sep;37(3):M487-9

5

Morgan et al. Superiority of centrifugal pump over rollerpump in paediatric cardiac surgery: prospective randomized trial; EJCTS; 1998; 13:526-532

6

Klein et al. Centrifugal Pumping During Routine Open Heart Surgery; Artificial Organs 1998; 22:326-226

7

Parolari A, et al. Adult cardiac surgery outcomes: role of the pump type; EJCTS; 2000; 18:575-582

8

Tomasso et al. Hepatic and renal effects of cardiopulmonary bypass; Best Practice & Research Clinical Anaesthesiology; 2015; 29: 151-161

Caution: Federal Law (USA) restricts the device to sale by or on the order of a physician. For complete listing of indications, contraindications, precautions and warnings, please refer to the Instructions For Use which accompany each product. For distribution only in markets where the Bio-Pump and Bio-Console have been approved. 

Bio-Pump, Bio-Console and AffinityTM CP are trademarks of Medtronic, Inc.