[Effect of priming solution and ultrafiltration on post-operative bleeding and blood transfusion in cardiac surgery. Randomized controlled trial].

نویسندگان

  • M Olmos Rodríguez
  • J A Ballester Hernández
  • M T Arteta Bárcenas
  • A Rodríguez Cerezo
  • M A Vidarte Ortiz de Artiñano
  • C Veiga Alameda
چکیده

OBJECTIVE Assess the effectiveness of priming the extracorporeal circulation system with albumin-mannitol combined with ultrafiltration during extracorporeal circulation to reduce post-operative bleeding and transfusion requirements in heart surgery, as well as its impact on the fluid balance, coagulation and hematocrit parameters, re-operation for bleeding, ICU, and hospital length of stay. MATERIAL AND METHODS A total of 134 patients scheduled for heart surgery were randomized to receive Ringer's lactate 1,500mL in the priming reservoir (group C), or mannitol 20% 250mL, albumin 20% 150mL and Ringer's lactate 1,100mL combined with ultrafiltration (group T). Bleeding volume, transfusions, fluid balance, coagulation, and hematology parameters were determined until 48h in the post-operative period. RESULTS There was a reduction of postoperative bleeding in group T, 1,165±789mL vs 992±662mL (P=.17), and red blood cell concentrate transfusions, 694±843mL vs 413±605mL (P=.03). Intra-operative and post-operative fluid balance was significantly less positive in group T, with an overall balance of 2,292±2,152mL vs 5,388±2,834mL (P<.001). There were higher values of hemoglobin and hematocrit, intraoperative (P<.001), on admission to ICU (P=.001), and at 6h (P=.05) in group T, and lower INR at 6h (P=.01) and 24h (P=.02). Re-operation rate and length of stay in ICU were higher in group C, but not statiscally significant. CONCLUSIONS The priming of extracorporeal reservoir with mannitol, albumin, and Ringer's lactate, combined with ultrafiltration, significantly improves intra- and post-operative fluid balance, resulting in a reduction in blood transfusions, with no significant decrease in post-operative bleeding, re-operation bleeding rate, and length of stay in the ICU.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Effect of priming solution and ultrafiltration on post-operative bleeding and blood transfusion in cardiac surgery. Randomized controlled trial

متن کامل

The Effect of Zero Balance Ultrafiltration of Priming Blood on Clinical Outcomes of Infants Undergo Cardiopulmonary Bypass

Introduction: Pediatric Cardiopulmonary Bypass (CPB) circuit invariably requires priming with Packed Red Blood Cells (PRBCs). Metabolic composition of stored PRBCs is unphysiological. Commencement of PRBC primed CPB leads to rapid transfusion of massive metabolic load. This predisposes pediatric patients to the risk of complications such as electrolyte disturbances, citrate toxicity, acidosis a...

متن کامل

Exogenous Fibrinogen Pertains Beneficial Effects in Managing Post-Cardiac Surgery Bleeding: A Randomized Clinical Trial

Introduction: Post cardiac surgery hemorrhagic syndromes, potentialized by implementing cardiopulmonary bypass, leads to increased hazards of blood products transfusion and pertains serious impacts on immediate patients outcome. The objective of this clinical trial was to investigate the efficiency of exogenous fibrinogen to control hemorrhagic syndromes following cardiac surgery in the intensi...

متن کامل

Modified ultrafiltration: role in adult cardiac surgical haemostasis.

BACKGROUND During cardiac surgery, cardiopulmonary bypass (CPB) leads to haemodilutional anaemia and activation of inflammatory mediators, affecting haemostasis. Modified Ultrafiltration (MUF) is being increasingly favoured for haemoconcentration without blood transfusion and reducing post operative bleeding. METHODS Aim of this study was to record the impact of modified ultrafiltration on ha...

متن کامل

The Effect of ringer Lactate as the Priming Solution of the Cardiopulmonary by Pass Circuit on Plasma Potassium Levels after Open Heart Surgery in Children

Background: Conduct of cardiopulmonary bypass (CPB) due to the higher volume of priming solution in comparison to the total blood volume in children requires careful consideration. Recently attention has been focused on the potential risk of hyperkalemia in these patients. Given its significant effects on cardiac rhythm, hyperkalemia is considered a medical emergency. In this cross-sectional st...

متن کامل

ذخیره در منابع من

ذخیره در منابع من قبلا به منابع من ذحیره شده

{@ msg_add @}


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Revista espanola de anestesiologia y reanimacion

دوره 62 2  شماره 

صفحات  -

تاریخ انتشار 2015