TITLE

Low-prime perfusion circuit and autologous priming in CABG surgery on a Jehova's Witness: a case report

AUTHOR(S)
van Kempen, RAB; Gasiorek, JM; Bloemendaal, K; Storm van Leeuwen, RPH; Bulder, ER
PUB. DATE
January 2002
SOURCE
Perfusion;Jan2002, Vol. 17 Issue 1, p69
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Cardiac surgery on Jehovah's Witnesses is a great challenge for the cardiothoracic surgery team and especially for the perfusionist. To reduce the risk of surgery in these patients, a very small extracorporeal circuit was designed to decrease the amount of priming volume and thereby the degree of hemodilution. A small bypass system was built, consisting of a 3/8-in. arterial line and a 3/8-in. venous line, a venous collapsible reservoir, a centrifugal pump, a hollow fiber oxygenator and a cell saver reservoir. The circuit priming volume was 650 ml. By using antegrade and retrograde autologous priming, the total amount of priming was reduced to ± 50 ml. Bypass time was 63 min with an average blood flow of 5300 ± 114 ml/min and postmembrane pressures of 180 ± 45 mmHg. Venous line pressure was monitored and kept between - 8 and - 20 mmHg with a mean arterial pressure (MAP) of 55 ± 12.3 mmHg. The hematocrit before extracorporeal circulation (ECC) was 36%, per-ECC 35% and post-ECC 35%. On the fifth postoperative day, the hematocrit was 40%. The patient was discharged 7 days after surgery. A low-prime circuit, in combination with autologous priming, seems to be safe and effective in avoiding the use of banked blood.
ACCESSION #
6567720

 

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