Effect of Retrograde Autologous Blood Priming of Cardiopulmonary Bypass on Hemodynamic Parameters and Pulmonary Mechanics in Pediatric Cardiac Surgery: A Randomized Clinical Study
Cardiothoracic Surgery Department, Ain Shams University Faculty of Medicine, Ain Shams University Hospitals, Cairo, Egypt. Electronic address: hamdi_singab@hotmail.com. Cardiothoracic Surgery Department, Ain Shams University Faculty of Medicine, Ain Shams University Hospitals, Cairo, Egypt. Anesthesia and Intensive Care Department, Ain Shams University Faculty of Medicine, Ain Shams University Hospitals, Cairo, Egypt.
Seminars in thoracic and cardiovascular surgery. 2020
The present study aimed to assess the impact of retrograde autologous priming (RAP) on hemodynamics and pulmonary mechanics in children subjected to cardiothoracic surgery. This prospective randomized study analyzed the clinical records of 124 children with Rachs-1 left to right lesions subjected to cardiac surgery. They comprised 64 patients in RAP group and 60 patients in the conventional priming group.
The preoperative, intraoperative and postoperative data of the studied patients were reported. The outcome measures included hematocrit value, blood gases, lung mechanics parameters, transfusion needs, ICU stay, postoperative complications and mortality. Preoperatively, there were no significant differences between the studied groups regarding the demographic data, underlying lesions, laboratory data, blood gases and pulmonary mechanics parameters. Intraoperatively, RAP group patients had significantly lower amount of blood loss, less frequent need to packed RBCs transfusion and better hematocrit values when compared with the control group. Postoperatively, RAP group patients had significantly higher Hct % at ICU arrival, significantly better pulmonary mechanics parameters and significantly shorter duration on mechanical ventilation. Retrograde autologous priming in children older than 12 months subjected to cardiac surgery for Rachs-1 left to right lesions is associated with less transfusion needs and better pulmonary mechanics.
