The effect of bloodless pump prime on cerebral oxygenation in paediatric patients

Abstract

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.

Early or late fresh frozen plasma administration in newborns and small infants undergoing cardiac surgery: the APPEAR randomized trial

“…In newborns and small infants undergoing cardiac surgery, red blood cells (RBCs) are usually added to the CPB priming volume to prevent excessive haemodilution. [4][5][6] At the same time, maintenance of a physiologic colloid oncotic pressure during CPB must be preserved to prevent interstitial fluid accumulation; 7 8 this is achieved by adding either 5% albumin, fresh frozen plasma (FFP), or colloids to the priming. At present, few studies have investigated the superiority of FFP or albuminbased priming solutions in newborns and small infants, and the results are conflicting.…”

Multifactorial Comparison of Modified and Conventional Perfusion Strategies in A Porcine Model of Cardiopulmonary Bypass

“…Oxygen carrying capacity is achieved by maintaining an optimum hematocrit level in circulating blood. Hemodilutional anemia from priming and maintaining the CPB during cardiac surgery is known to increase the risk of inadequate cerebral oxygen delivery and is of major concern in both pediatric [32] and adult [33] population. The hematocrit of 25% to 30% during bypass used in this study is recommended as the hematocrit level that would provide the best cerebral oxygen saturation [33].…”

Bilateral monitoring of cerebral oxygen saturation results in recognition of aortic cannula malposition during pediatric congenital heart surgery

“…Possible etiologies of a decreased rSO 2 i during CPB include inadequate bypass flow, hypocarbia with resulting cerebral hypoperfusion, hypoxemia, inadequate MAP, and inadequate hematocrit (9). An initial decrease in rSO 2 i secondary to hemodilution is often seen with an asanguinous pump prime; however, a blood prime was used in this patient because of his size.…”