The research on different processing techniques to priming in infants under cardiopulmonary bypass

Abstract

Objective To explore the effect of different processing techniques to priming and the prognosis in infants during cardiac surgery under cardiopulmonary bypass(CPB). Methods 90 cases of pediatric patients under 5kg undergoing CPB open heart surgery were randomly selected, in group A(n=30), stored blood was added to the reservoir after crystalloid priming, then zero balanced ultrafiltration(ZBUF) for the mixed priming solution; in group B(n=30), stored blood was cleaned by cell saver first, then added to the reservoir; in group C(n=30) , ZBUF technique was combined with cell saver for the priming. Modified ultrafiltration(MUF) was set up afer weaning bypass in all three groups, crystalloid solution was added to the reservoir to replace the residual blood to the patients. The general information, the quality and processing time of the mixed priming solution, the lactate level, free hemoglobin(f-Hb), inflammatory factor(IL-6/TNF-α) from T0 to T4, the positive inotropic drug lasting time, mechanical ventilation time and ICU time were all recorded. Results There were no statistical differences among 3 groups for general condition. The lactate, f-Hb, IL-6 and TNF-αlevel in B and C group from T1 to T4 was significantly lower than A group, but no statistical meaning between B and C group. B and C group can significantly reduced the positive inotropic drug lasting time, mechanical ventilation time and ICU time. Conclusion To infants, blood priming pretreated by cell saver can improve the quality of blood protection significantly than traditional ZBUF, also get labor saving and time saving effects, finally improve the prognosis. Key words: Cardiopulmonary bypass Infants Congenital heart disease