Assessment of Clinical and Laboratory Outcomes in Using of Albumin and Fresh Frozen Plasma as Cardiopulmonary Bypass Prime Solutions in Pediatric Arterial Switch Surgery

Abstract

Background: Cardiopulmonary bypass (CBP) prime solution in pediatric heart surgeries is critical to avoid adverse effects resulting from dilution of coagulation factors, red blood cells, and other plasma protein. This study aimed to evaluate clinical and laboratory outcomes of administration of albumin and fresh frozen plasma (FFP) in CPB prime solution in children candidates for arterial switch surgery.
 Methods: This cross-sectional study was performed on 30 transposition of the great arteries (TGA) patients, candidates for the arterial switch in Tehran Children's Medical Center, Iran. As CBP prime solution, 15 patients received albumin (1 gr/kg Albumin 20%) and 15 patients received FFP (15 cc/kg). also, clinical and laboratory parameters were measured in different intervals. The statistical analysis were performed by SPSS v.20.
 Results: The volume platelet infusion in the ICU was higher in FFP-received patients (40.00 ±20.70 ml) than albumin-received patients (26.67 ±25.82 ml; p-value =0.01). Upon entry into ICU, the mean of Hb and Hct in FFP-received patients (11.55 ±0.64 g/l and 34.44 ±2.44 %) was significantly higher than patients who received albumin (11.08 ±0.87 g/l and 31.44 ±3.97 %; p-value =0.04 for both). Upon entry into ICU and also 48 hours after admission into the ICU, the Cr level in the FFP-received group (median: 19 mg/dl) was significantly higher than the albumin-received group (median: 12 mg/dl; p-value =0.03).
 Conclusion: FFP in CPB prime solution reduces the hemostatic complications and infusion of blood products, as well as to stabilizes Hb and Htc. Therefore, FFP is more suitable as CPB prime solution.