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The effect of bloodless pump prime on cerebral oxygenation in paediatric patients
Author(s) -
Han S. H.,
Kim C. S.,
Kim S. D.,
Bahk J. H.,
Park Y. S.
Publication year - 2004
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.0001-5172.2004.00374.x
Subject(s) - medicine , cardiopulmonary bypass , anesthesia , oxygenation , oxygen saturation , blood transfusion , surgery , oxygen , chemistry , organic chemistry
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 (rSO 2 ) value measured by near‐infrared spectroscopy was compared between the two groups. Results:  In both groups, rSO 2 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 rSO 2 in Group C (49.0 ± 5.4% vs. 59.2 ± 7.0%; P <  0.01). During rewarming, rSO 2 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 rSO 2 than with blood‐containing prime at the starting period of CPB and the rewarming period.

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