1
|
Yang K, Huang H, Dai R, Zhang J, Wei X, Gao F, Wu X, Wu F, He S, Xin M. Modified cardiopulmonary bypass with low priming volume for blood conservation in cardiac valve replacement surgery. J Cardiothorac Surg 2023; 18:56. [PMID: 36732795 PMCID: PMC9896670 DOI: 10.1186/s13019-023-02175-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/28/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND The adverse effects of cardiopulmonary bypass during open cardiac surgery, including hemodilution, seem to be inevitable, especially for patients who generally have a relatively lower BMI with relatively small blood volumes. This study reports the modification and use of a cardiopulmonary bypass (CPB) system to reduce priming volume and hemodilution. METHODS This is a retrospective study of 462 adult patients who underwent cardiac valve replacement surgery from January 2019 to September 2021 at the General Hospital of Western Theater Command. The modified group consisted of 212 patients undergoing modified CPB. The control group included 250 patients receiving conventional CPB. Evaluated indices included fluid intake and output volumes during CPB, intraoperative indices related to CPB operation, usage of blood products during the peri-CPB period, and postoperative outcomes. RESULTS The modified group displayed a significant reduction in the crystalloid (200 mL vs. 600 mL, P < 0.05) and colloid priming volumes (450 mL vs. 1100 mL, P < 0.05), and ultrafiltration solution volume (750 mL vs. 1200 mL, P < 0.05). Furthermore, the modified group had a significantly lower rate of defibrillation (30.2% vs. 41.2%, P < 0.05). The intraoperative urine volume (650 mL vs. 500 mL, P < 0.05) and intraoperative hematocrit (Hct) (26% vs. 24%, P < 0.05) of the modified CPB group were also higher than in the control group. The modified group required a lower infusion volume of packed red blood cells (250 mL vs. 400 mL, P < 0.05) and lower infusion rates of packed red blood cells (17.9% vs. 25.2%, P < 0.05) and fresh frozen plasma (1.41% vs. 5.2%, P < 0.05). In addition, the modified group showed significantly improved indices related to postoperative recovery. CONCLUSIONS The modified CPB system effectively conserves blood and shows noteworthy potential for application in cardiac valve replacement surgery.
Collapse
Affiliation(s)
- Ke Yang
- grid.413855.e0000 0004 1764 5163Department of Cardiovascular Surgery, General Hospital of Western Theater Command (Chengdu Military General Hospital), No. 270, Rongdu Rd, Jinniu District, Chengdu, 610036 China ,grid.263901.f0000 0004 1791 7667Present Address: College of Medicine, Southwest Jiaotong University, Chengdu, 610036 China
| | - Honghao Huang
- grid.413855.e0000 0004 1764 5163Department of Cardiovascular Surgery, General Hospital of Western Theater Command (Chengdu Military General Hospital), No. 270, Rongdu Rd, Jinniu District, Chengdu, 610036 China ,grid.263901.f0000 0004 1791 7667Present Address: College of Medicine, Southwest Jiaotong University, Chengdu, 610036 China
| | - Ruiwu Dai
- grid.263901.f0000 0004 1791 7667Present Address: College of Medicine, Southwest Jiaotong University, Chengdu, 610036 China ,grid.413855.e0000 0004 1764 5163General Surgery Center, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, 610036 China
| | - Jinbao Zhang
- grid.413855.e0000 0004 1764 5163Department of Cardiovascular Surgery, General Hospital of Western Theater Command (Chengdu Military General Hospital), No. 270, Rongdu Rd, Jinniu District, Chengdu, 610036 China
| | - Xiaohong Wei
- grid.413855.e0000 0004 1764 5163Department of Cardiovascular Surgery, General Hospital of Western Theater Command (Chengdu Military General Hospital), No. 270, Rongdu Rd, Jinniu District, Chengdu, 610036 China
| | - Feng Gao
- grid.413855.e0000 0004 1764 5163Department of Cardiovascular Surgery, General Hospital of Western Theater Command (Chengdu Military General Hospital), No. 270, Rongdu Rd, Jinniu District, Chengdu, 610036 China
| | - Xiaochen Wu
- grid.413855.e0000 0004 1764 5163Department of Cardiovascular Surgery, General Hospital of Western Theater Command (Chengdu Military General Hospital), No. 270, Rongdu Rd, Jinniu District, Chengdu, 610036 China
| | - Fan Wu
- grid.413855.e0000 0004 1764 5163Department of Cardiovascular Surgery, General Hospital of Western Theater Command (Chengdu Military General Hospital), No. 270, Rongdu Rd, Jinniu District, Chengdu, 610036 China
| | - Siyi He
- grid.413855.e0000 0004 1764 5163Department of Cardiovascular Surgery, General Hospital of Western Theater Command (Chengdu Military General Hospital), No. 270, Rongdu Rd, Jinniu District, Chengdu, 610036 China
| | - Mei Xin
- grid.413855.e0000 0004 1764 5163Department of Cardiovascular Surgery, General Hospital of Western Theater Command (Chengdu Military General Hospital), No. 270, Rongdu Rd, Jinniu District, Chengdu, 610036 China
| |
Collapse
|