Perfusato autólogo retrógrado no circuito de circulação extracorpórea em pacientes adultos

Reges, Ricardo; Vicente, Walter Villela de Andrade; Rodrigues, Alfredo José; Basseto, Solange; Alves, Lafaiete; Filho, Adilson Scorzoni; Ferreira, César Augusto; Évora, Paulo Roberto Barbosa

doi:10.5935/1678-9741.20110052

Cited by 15 publications

(6 citation statements)

References 18 publications

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“…At the same time, priming of conventional crystal solution in CPB will inevitably cause serious hemodilution and reduction of plasma colloid osmotic pressure, which will produce adverse effects ( 1 - 4 ). It has been demonstrated that the applications of retrograde autologous priming (RAP) in adult rheumatic heart disease and cardiac surgeries for coronary heart diseases can improve the hematocrit (Hct) level, reduce postoperative chest drainage volume and allogeneic blood transfusion, indicating that RAP is a safe and cost-effective blood conservation technique ( 5 - 8 ). The application of RAP in pediatric CPB can reduce priming volume, and keep a high Hct level during trans-instrument process ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical applications of retrograde autologous priming in cardiopulmonary bypass in pediatric cardiac surgery

Nie

Jiao

et al. 2016

Braz J Med Biol Res

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Retrograde autologous priming (RAP) has been routinely applied in cardiac pediatric cardiopulmonary bypass (CPB). However, this technique is performed in pediatric patients weighing more than 20 kg, and research about its application in pediatric patients weighing less than 20 kg is still scarce. This study explored the clinical application of RAP in CPB in pediatric patients undergoing cardiac surgery. Sixty pediatric patients scheduled for cardiac surgery were randomly divided into control and experimental groups. The experimental group was treated with CPB using RAP, while the control group was treated with conventional CPB (priming with suspended red blood cells, plasma and albumin). The hematocrit (Hct) and lactate (Lac) levels at different perioperative time-points, mechanical ventilation time, hospitalization duration, and intraoperative and postoperative blood usage were recorded. Results showed that Hct levels at 15 min after CPB beginning (T2) and at CPB end (T3), and number of intraoperative blood transfusions were significantly lower in the experimental group (P<0.05). There were no significant differences in CPB time, aortic blocking time, T2-Lac value or T3-Lac between the two groups (P>0.05). Postoperatively, there were no significant differences in Hct (2 h after surgery), mechanical ventilation time, intensive care unit time, or postoperative blood transfusion between two groups (P>0.05). RAP can effectively reduce the hemodilution when using less or not using any banked blood, while meeting the intraoperative perfusion conditions, and decreasing the perioperative blood transfusion volume in pediatric patients.

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Section: Introductionmentioning

confidence: 99%

Clinical applications of retrograde autologous priming in cardiopulmonary bypass in pediatric cardiac surgery

Nie

Jiao

et al. 2016

Braz J Med Biol Res

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“…Three studies, 25 , 26 , 27 of which one randomized trial, did not find any significant difference in PRBC transfusions between the RAP and conventional CPB group. Moreover, the three studies that found no effect of RAP all use higher priming volumes in both the RAP and control groups compared to the studies that found a significant benefit of RAP.…”

Section: Individual Studiesmentioning

confidence: 90%

“…When taking a closer look at these three studies, it becomes apparent that the study by Reges et al 25 is a prospective but small-scale pilot study. The small sample size (n = 27 in the RAP group) may be the reason the authors could not identify a significant difference between the RAP and non-RAP group.…”

Section: Discussionmentioning

confidence: 99%

“…The risk of bias was assessed using the modified Cochrane collaboration Risk of Bias Tool for the randomized studies, while the RTI tool was used for the observational studies. The randomized studies by Cheng et al 19 and Reges et al 25 were not entirely free of bias. Table 5 depicts a brief elucidation on the risk of bias for each predetermined type of bias in each study, whereas in Table 6 a overview of the risk of bias is presented.…”

Section: Risk Of Bias Within Studiesmentioning

confidence: 94%

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Retrograde autologous priming to reduce allogeneic blood transfusion requirements: a systematic review

et al. 2020

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Background: Efforts have been made to minimize transfusion of packed red blood cells in patients undergoing cardiac surgery with cardiopulmonary bypass. One method concerns retrograde autologous priming. Although the technique has been used for decades, results remain contradictory in terms of transfusion requirements. Objective: This systematic literature review aimed to summarize the evidence for the efficacy of retrograde autologous priming in terms of decreasing perioperative packed red blood cell requirements in adults. Methods: Two researchers independently searched PubMed for articles published in the past 10 years. The modified Cochrane collaboration Risk of Bias Tool and the Research Triangle Institute Item Bank were used to assess bias. Results: Eight studies were included, of which two randomized and six observational studies. Five studies, including one randomized study, report a significant decrease in packed red blood cell use in the retrograde autologous priming group compared to no retrograde autologous priming used. All studies are flawed by at least a high risk bias of bias score on one item of the bias assessment. Conclusion: Although most studies reported significantly fewer packed red blood cell transfusions in the retrograde autologous priming group, it is important to note that relatively few articles are available which are flawed by several types of bias. Prospective, randomized multi-center trials are warranted to conclude decisively on the benefits of retrograde autologous priming.

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“…A study in Sao Paulo, Brazil showed that RAP increases hematocrit during surgery, especially in people with anemia, followed by decreased hemolytic reactions due to decreased blood transfusion. However, some results reported the RAP as a useful method while some others not [10]. Kearsey et al study showed that there were no differences in blood transfusion, platelet, frozen plasma, 30-day mortality, reoperation, and the amount of hemoglobin between the RAP and the control group [11].…”

Section: Effect Of Retrograde Autologous Priming On Clinical Outcome Of Cardiopulmonary Bypassing On Patients Undergoing Coronary Artery mentioning

confidence: 99%

Effect of Retrograde Autologous Priming on Clinical Outcome of Cardiopulmonary Bypassing on Patients Undergoing Coronary Artery bypass Grafting

Rafiee

Toutounchi

Yazdani

et al. 2019

ijcp

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Introduction: Cardiopulmonary bypass is a standard and low mortality-associated method used across the world. This method allows cardiac surgery to be performed in a bloodless environment. The study aimed to compare Conventional priming and Retrograde autologous prime (RAP) on patients undergoing coronary artery bypass grafting (CABG). Methods: The study population was patients undergoing CABG using cardiopulmonary bypass in Rajaei Hospital, of whom 80 patients were selected by simple random sampling convenience sampling and then were randomly assigned to two groups: Conventional priming and RAP. Demographic information, blood components transfused in the operating room and the intensive care unit, ejection fraction (EF) of left ventricle and changes in blood gases were collect. Results: The mean requirement for red blood cell transfusion bags to the patient during surgery was lower in the RAP group than the conventional priming group (P = 0.002). But the difference after surgery in both groups was not significant statistically (P = 0.2). The difference amount of platelet transfusion during operation the difference was not statistically significant (P = 0.4). The difference postoperative platelet transfusion was not statistically significant (P = 0.7). The fresh frozen plasma transfusion during surgery in the RAP group lower than the usual prime group, but the difference was not statistically significant (P = 0.406). The Fresh frozen plasma (FFP) transfusion after surgery in the two groups was not statistically significant (P = 0.217). Conclusion: RAP is compared with conventional priming a safe and low-cost technique in reducing the priming volume of the CPB system, causes less hemodilution, and reduces the need for intra-and postoperative blood transfusion. Therefore, it is recommended to consider RAP as an effective and low-cost technique of priming Cardiopulmonary bypass circuits.

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Perfusato autólogo retrógrado no circuito de circulação extracorpórea em pacientes adultos

Cited by 15 publications

References 18 publications

Clinical applications of retrograde autologous priming in cardiopulmonary bypass in pediatric cardiac surgery

Clinical applications of retrograde autologous priming in cardiopulmonary bypass in pediatric cardiac surgery

Retrograde autologous priming to reduce allogeneic blood transfusion requirements: a systematic review

Effect of Retrograde Autologous Priming on Clinical Outcome of Cardiopulmonary Bypassing on Patients Undergoing Coronary Artery bypass Grafting

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