Reducing the prime cardiopulmonary bypass volume during paediatric cardiac surgery.

Autor:	Mathieu L; Department of Pediatric and Congenital Cardiovascular surgery, Haut-Lévêque Hospital, Surgical Centre, Bordeaux University Hospital, Pessac, France., Brunetti C; Department of Pediatric and Congenital Cardiovascular surgery, Timone Hopital, Aix Marseille University Hospital, Marseille, France., Detchepare J; Department of Pediatric and Congenital Cardiovascular surgery, Haut-Lévêque Hospital, Surgical Centre, Bordeaux University Hospital, Pessac, France., Flambard M; Department of Pediatric and Congenital Cardiovascular surgery, Haut-Lévêque Hospital, Surgical Centre, Bordeaux University Hospital, Pessac, France., Germain C; Research and Innovation Unit in Healthcare and Humanities (URISH), Bordeaux- University Hospital, Bordeaux, France., Langouet E; Department of Cardiovascular Anesthesia and Critical Care, CHU Bordeaux, Bordeaux, France., Tafer N; Department of Cardiovascular Anesthesia and Critical Care, CHU Bordeaux, Bordeaux, France., Roubertie F; Department of Pediatric and Congenital Cardiovascular surgery, Haut-Lévêque Hospital, Surgical Centre, Bordeaux University Hospital, Pessac, France.; IHU Liryc, Electrophysiology and Heart Modeling Institute, Pessac, France., Ouattara A; Department of Cardiovascular Anesthesia and Critical Care, CHU Bordeaux, Bordeaux, France.; Univ. Bordeaux, INSERM, U1034, Biology of Cardiovascular Diseases, Pessac, France.
Jazyk:	angličtina
Zdroj:	Perfusion [Perfusion] 2024 Nov 01, pp. 2676591241296319. Date of Electronic Publication: 2024 Nov 01.
DOI:	10.1177/02676591241296319
Abstrakt:	Introduction: Despite technological advances, the use of homologous blood to prime the cardiopulmonary bypass (CPB) circuits of infants under 10 kg remains common. However, such rapid massive transfusion may increase post-CPB morbidity. Method: We retrospectively included consecutive patients weighing 2.3-10 kg who underwent cardiac surgery under CPB. Patients were divided into two groups based on their priming volumes: low priming volume (LPV) (below the median volume) or high priming volume (HPV) (the median volume or above). Results: The study included 208 patients, of whom 104 had priming volumes below the median [37.9 (28.4-51.7) mL/kg] and 104 had at least the median volume. We recorded positive correlations between the priming volume, on the one hand, and the peak creatinine and CRP levels within 5 days postoperatively, the duration of intensive care unit (ICU) stay, and the mechanical ventilation time, on the other. A relationship was also observed between a higher median priming volume and the need for renal replacement therapy in the ICU and mediastinitis. Conclusion: Although the differences in priming volume between the twogroups were small, they significantly influenced the postoperative complications. Perfusionists should seek to limit the priming volume to reduce the post-CPB inflammatory response, the duration of ICU stay, and possibly the risk of mediastinitis. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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