Retrograde Autologous Priming For Cardiopulmonary Bypass: A Safe And Effective Means Of Decreasing Hemodilution And Transfusion Requirements

Rosengart, Todd K.; DeBois, William; O’Hara, Maureen; Helm, Robert E.; Gómez, Maritza Díaz; Lang, Samuel J.; Altorki, Nasser K.; Ko, Wilson; Hartman, Gregg S.; Isom, O. Wayne; Krieger, Karl H.

doi:10.1016/s0022-5223(98)70287-9

Cited by 114 publications

(104 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The original RAP method, described by Rosengart et al [7], modified by Eising et al [10], as follows, was adopted in this investigation (Figure 1 mmHg, using small doses of intravenously administered phenylephrine. A recirculation bag was connected to the venous line.…”

Section: Methods Of the Retrograde Autologous Priming (Rap)mentioning

confidence: 99%

“…Retrograde autologous priming (RAP) is a method of CPB, at low cost, which has been described [1,7] as modification of the method proposed, in 1959, by Panico and Neptune [8]. Previous studies have shown that this method reduces hemodilution during CPB, the reduction of blood transfusions by increasing the hematocrit intraoperatively, especially in patients who have risk factors as anemia, small body surface area, and refuses to receive blood products [1].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Perfusato autólogo retrógrado no circuito de circulação extracorpórea em pacientes adultos

Reges¹,

Vicente²,

Rodrigues³

et al. 2011

Rev Bras Cir Cardiovasc

View full text Add to dashboard Cite

Introduction: Retrograde autologous priming (RAP) is a cardiopulmonary bypass (CPB) method, at low cost. Previous studies have shown that this method reduces hemodilution and blood transfusions needs through increased intraoperative hematocrit.Objective: To evaluate RAP method, in relation to standard CPB (crystalloid priming), in adult patients.Methods: Sixty-two patients were randomly allocated to two groups: 1) Group RAP (n = 27) of patients operated using the RAP and; 2) Control group of patients operated using CPB standard crystalloid method (n = 35). The RAP was performed by draining crystalloid prime from the arterial and venous lines, before CPB, into a collect recycling bag. The main parameters analyzed were: 1) CPB hemodynamic data; 2) Hematocrit and hemoglobin values; 3) The need for blood transfusions.Results: It was observed statistically significant fewer transfusions during surgery and reduced CPB hemodilution using RAP. The CPB hemodynamic values were similar, observing a tendency to use lower CPB flows in the RAP group patients.Conclusion: This investigation was designed to be a small-scale pilot study to evaluate the effects of RAP, which were demonstrated concerning the CPB hemodilution and blood transfusions.

show abstract

Section: Methods Of the Retrograde Autologous Priming (Rap)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perfusato autólogo retrógrado no circuito de circulação extracorpórea em pacientes adultos

Reges¹,

Vicente²,

Rodrigues³

et al. 2011

Rev Bras Cir Cardiovasc

View full text Add to dashboard Cite

show abstract

“…Starting preoperatively by raising the level of hemoglobin by use of EPO and iron therapy, eliminating any hemodilution, to proper operative field drainage to reduce the incidence of hematomas related to various invasive maneuvers over the course of hospitalization, keeping the hemoglobin value under 15.5 to avoid associated complications with high hematocrit value [16]. The most recent example of this comprehensive multimodality approach is the mini-cardiopulmonary bypass system that we have been using for the last three years, combined with retro-priming and a cell saver [16][17][18][19][20][21] which maintains a constant hemoglobin level, often low in cardiac patients. Volume expansion in these patients is associated with a real risk of hemodilution and active participation of the anesthetist is essential to avoid additional iatrogenic vasoplegia, which is greatly facilitated by concentration-aimed ultra-fasttrack anesthesia protocols [22].…”

Section: ) Transfusion Pro and Conmentioning

confidence: 99%

Blood Conservation Strategy during Cardiac Valve Surgery in Jehovah's Witnesses: a Comparative Study with Non-Jehovah's Witnesses

Kim

Lee

2016

Korean J Crit Care Med

View full text Add to dashboard Cite

Background: Refusal of heterogenic blood products can be for religious reasons as in Jehovah's Witnesses or otherwise or as requested by an increasing number of patients. Furthermore blood reserves are under continuous demand with increasing costs. Therefore, transfusion avoidance strategies are desirable. We describe a historic comparison and current results of blood saving protocols in Jehovah's Witnesses patients.

show abstract

“…During this drainage, the bloodless prime is redirected to a separate reservoir. This is a well established way to decrease autologous blood transfusion in adult cardiac surgery [67,68] . This strategy is very uncommon in pediatric cardiac surgery, but it could be part of a bloodless surgical program [69] .…”

Section: Maneuver Of Retrograde Autologous Primingmentioning

confidence: 99%

Perfusionist strategies for blood conservation in pediatric cardiac surgery

Durandy¹

2010

WJC

View full text Add to dashboard Cite

There is increasing concern about the safety of homologous blood transfusion during cardiac surgery, and a restrictive transfusion practice is associated with improved outcome. Transfusion-free pediatric cardiac surgery is unrealistic for the vast majority of procedures in neonates or small infants; however, considerable progress has been made by using techniques that decrease the need for homologous blood products or even allow bloodless surgery in older infants and children. These techniques involve a decrease in prime volume by downsizing the bypass circuit with the help of vacuumassisted venous drainage, microplegia, autologous blood predonation with or without infusion of recombinant (erythropoietin), cell salvaging, ultrafiltration and retrograde autologous priming. The three major techniques which are simple, safe, efficient, and cost-effective are: a prime volume as small as possible, cardioplegia with negligible hydric balance and circuit residual blood salvaged without any alteration. Furthermore, these three techniques can be used for all the patients, including emergencies and small babies. In every pediatric surgical unit, a strategy to decrease or avoid blood bank transfusion must be implemented. A strategy to minimize transfusion requirement requires a combined effort involving the entire surgical team with pre-, peri-, and postoperative planning and management.

show abstract

Retrograde Autologous Priming For Cardiopulmonary Bypass: A Safe And Effective Means Of Decreasing Hemodilution And Transfusion Requirements

Abstract: These data suggest that retrograde autologous priming is a safe and effective means of significantly decreasing hemodilution and the number of patients requiring red cell transfusion during cardiac operations.

Cited by 114 publications

References 24 publications

Perfusato autólogo retrógrado no circuito de circulação extracorpórea em pacientes adultos

Perfusato autólogo retrógrado no circuito de circulação extracorpórea em pacientes adultos

Blood Conservation Strategy during Cardiac Valve Surgery in Jehovah's Witnesses: a Comparative Study with Non-Jehovah's Witnesses

Perfusionist strategies for blood conservation in pediatric cardiac surgery

Contact Info

Product

Resources

About