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Does the use of a centrifugal pump offer any additional benefit for patients having open heart surgery?

^a Department of Cardiothoracic Surgery, North Staffordshire Royal Infirmary, Stoke on Trent, UK
^b Department of Cardiothoracic Surgery, James Cook University Hospital, Middlesbrough, UK
^c Department of Cardiothoracic Surgery, Blackpool Victoria Hospital, UK

*Corresponding author. Tel./fax: +44-780-1548122.

E-mail address: joeldunning{at}doctors.org.uk (J. Dunning).

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether a centrifugal pump is better than a roller pump in patients undergoing cardiac surgery. Altogether 93 papers were identified using the below mentioned search, of which 15 papers presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group, relevant outcomes and weaknesses were tabulated. We conclude that there is no evidence for the benefit of a centrifugal pump over a roller pump in elective coronary artery bypass grafting in respect of blood loss, clinical outcomes or neurological problems. The two largest studies, a large RCT of 1000 patients and a cohort study of 4000 patients, both demonstrated a halving in the incidence of neurological events with numbers needed to treat of 37 and 91. However, the remaining much smaller RCTs and cohort studies that we assessed failed to show significant differences in either clinical or biochemical markers.

Key Words: Evidence-based medicine; Thoracic surgery; Cardiopulmonary bypass; Centrifugal pump; Extracorporeal circulation; Roller pump

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