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The effect of bloodless pump prime on cerebral oxygenation in paediatric patients

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Abstract:

Background: 

In paediatric patients, crystalloid prime for cardiopulmonary bypass (CPB) causes further haemodilution in comparison with blood-containing prime. Thus it may affect the cerebral oxygen supply/demand balance. The purpose of the study was to compare the effect of bloodless pump prime with that of blood-containing prime on cerebral oxygenation in children. Methods: 

Thirty-six paediatric patients scheduled for elective repair of atrial or ventricular septal defect were enrolled. In Group C (n = 18), the CPB circuit was primed only with crystalloid. In Group B (n = 18), red blood cells were added to achieve a haematocrit (Hct) of 20% during CPB. The regional cerebral oxygen saturation (rSO2) value measured by near-infrared spectroscopy was compared between the two groups. Results: 

In both groups, rSO2 decreased below baseline at the start of CPB and during rewarming (P < 0.001, for both groups during each period). At the start of CPB, haemodilution was greater in Group C than in Group B (Hct 16.1 ± 0.7% vs. 20.7 ± 0.5%; P < 0.01), and there was a greater reduction in rSO2 in Group C (49.0 ± 5.4% vs. 59.2 ± 7.0%; P < 0.01). During rewarming, rSO2 was significantly lower in Group C than in Group B (57.8 ± 5.3% vs. 62.8 ± 6.2%; P < 0.01). Conclusions: 

In paediatric patients, the haemodilution associated with crystalloid priming causes a greater reduction in rSO2 than with blood-containing prime at the starting period of CPB and the rewarming period.

Keywords: Bloodless priming; cardiopulmonary bypass; cerebral oxygenation; paediatrics

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.0001-5172.2004.00374.x

Affiliations: 1: Department of Anaesthesiology, Seoul National University, Bundang Hospital, 2: Department of Anesthesiology, Seoul Municipal Boramae Hospital, and 3: Department of Mathematics, Hanyang University, College of Natural Science, Seoul, Korea

Publication date: May 1, 2004

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