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Short-Term Effects and Safety Analysis of Retrograde Autologous Blood Priming for Cardiopulmonary Bypass in Patients with Cardiac Valve Replacement Surgery

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Abstract

This randomized, double-blind study evaluated the short-term effects and safety of perioperative retrograde autologous priming (RAP) for cardiopulmonary bypass (CPB) in patients with cardiac replacement surgery to determine if this approach is a better substitute for crystal liquids priming in patients with valvular heart disease. We observed that RAP significantly decreased the actual priming volume, preserved the hematocrit and hemoglobin level during CPB to a certain degree, and decreased lactate accumulation in CPB period. Moreover, RAP lowered the volume of transfusion and dosage blood products. Thus, our results showed that RAP approach effectively improved tissue perfusion and lowered intraoperative Lac levels, by reducing the hemodilution, which safely and reliably improve the microcirculation perfusion.

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References

  1. Zaid, R. R., et al. (2013). Pre- and post-operative diastolic dysfunction in patients with valvular heart disease: Diagnosis and therapeutic implications. Journal of the American College of Cardiology, 62(21), 1922–1930.

    Article  PubMed  Google Scholar 

  2. Khilji, S. A., & Khan, A. H. (2004). Acute renal failure after cardiopulmonary bypass surgery. Journal of Ayub Medical College, Abbottabad, 16(3), 25–28.

    PubMed  Google Scholar 

  3. Ekert, H., et al. (2006). Elective administration in infants of low-dose recombinant activated factor VII (rFVIIa) in cardiopulmonary bypass surgery for congenital heart disease does not shorten time to chest closure or reduce blood loss and need for transfusions: A randomized, double-blind, parallel group, placebo-controlled study of rFVIIa and standard haemostatic replacement therapy versus standard haemostatic replacement therapy. Blood Coagulation and Fibrinolysis, 17(5), 389–395.

    Article  CAS  PubMed  Google Scholar 

  4. Song, L., et al. (2011). Effects of peri-operative glucose levels on adverse outcomes in infants receiving open-heart surgery for congenital heart disease with cardiopulmonary bypass. Perfusion, 26(2), 133–139.

    Article  Google Scholar 

  5. Ranieri, V. M., et al. (1999). Time-course of impairment of respiratory mechanics after cardiac surgery and cardiopulmonary bypass. Critical Care Medicine, 27(8), 1454–1460.

    Article  CAS  PubMed  Google Scholar 

  6. Kapoor, P., et al. (2011). Changes in myocardial lactate, pyruvate and lactate–pyruvate ratio during cardiopulmonary bypass for elective adult cardiac surgery: Early indicator of morbidity. Journal of Anaesthesiology Clinical Pharmacology, 27(2), 225–232.

    Article  CAS  Google Scholar 

  7. Murai, N., et al. (2005). Venous drainage method for cardiopulmonary bypass in single-access minimally invasive cardiac surgery: Siphon and vacuum-assisted drainage. Journal of Artificial Organs, 8(2), 91–94.

    Article  PubMed  Google Scholar 

  8. Dogan, R., et al. (2003). Three unusual cases where cardiopulmonary bypass was used in thoracic surgery. Respiration, 70(5), 537–540.

    Article  PubMed  Google Scholar 

  9. Gruenwald, C. E., et al. (2010). Management and monitoring of anticoagulation for children undergoing cardiopulmonary bypass in cardiac surgery. The Journal of Extra-Corporeal Technology, 42(1), 9–19.

    PubMed  PubMed Central  Google Scholar 

  10. Salis, S., et al. (2008). Cardiopulmonary bypass duration is an independent predictor of morbidity and mortality after cardiac surgery. Journal of Cardiothoracic and Vascular Anesthesia, 22(6), 814–822.

    Article  PubMed  Google Scholar 

  11. Kearsey, C., et al. (2013). Assessing the effectiveness of retrograde autologous priming of the cardiopulmonary bypass machine in isolated coronary artery bypass grafts. Annals of The Royal College of Surgeons of England, 95(3), 207–210.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Rosengart, T. K., et al. (1998). Retrograde autologous priming for cardiopulmonary bypass: A safe and effective means of decreasing hemodilution and transfusion requirements. Journal of Thoracic and Cardiovascular Surgery, 115(2), 426–438. (discussion pp. 438–439).

    Article  CAS  PubMed  Google Scholar 

  13. Murphy, G. S., et al. (2004). The failure of retrograde autologous priming of the cardiopulmonary bypass circuit to reduce blood use after cardiac surgical procedures. Anesthesia & Analgesia, 98(5), 1201–1207.

    Article  Google Scholar 

  14. Bliacheriene, F., et al. (2012). Anesthesia for cardiac surgery under cardiopulmonary bypass in pregnant patients: Experience with nine cases. International Journal of Obstetric Anesthesia, 21(4), 388–389.

    Article  CAS  PubMed  Google Scholar 

  15. Colangelo, N., et al. (2006). Vacuum-assisted venous drainage in extrathoracic cardiopulmonary bypass management during minimally invasive cardiac surgery. Perfusion, 21(6), 361–365.

    Article  PubMed  Google Scholar 

  16. Hou, X., et al. (2009). Retrograde autologous priming of the cardiopulmonary bypass circuit reduces blood transfusion in small adults: A prospective, randomized trial. European Journal of Anaesthesiology, 26(12), 1061–1066.

    Article  PubMed  Google Scholar 

  17. Saxena, P., et al. (2003). Intraoperative autologous blood donation and retrograde autologous priming for cardiopulmonary bypass: A safe and effective technique for blood conservation. Annals of Cardiac Anaesthesia, 6(1), 47–51.

    PubMed  Google Scholar 

  18. Silver, H. (1975). Banked and fresh autologous blood in cardiopulmonary bypass surgery. Transfusion, 15(6), 600–603.

    Article  CAS  PubMed  Google Scholar 

  19. Balachandran, S., et al. (2002). Retrograde autologous priming of the cardiopulmonary bypass circuit reduces blood transfusion after coronary artery surgery. The Annals of Thoracic Surgery, 73(6), 1912–1918.

    Article  PubMed  Google Scholar 

  20. Welsby, I. J., et al. (2002). The association of complication type with mortality and prolonged stay after cardiac surgery with cardiopulmonary bypass. Anesthesia & Analgesia, 94(5), 1072–1078.

    Article  Google Scholar 

  21. Manrique, A., et al. (2009). The association of renal dysfunction and the use of aprotinin in patients undergoing congenital cardiac surgery requiring cardiopulmonary bypass. Anesthesia & Analgesia, 109(1), 45–52.

    Article  CAS  Google Scholar 

  22. Hwang, J., et al. (2011). The effect of retrograde autologous priming of the cardiopulmonary bypass circuit on cerebral oxygenation. Journal of Cardiothoracic and Vascular Anesthesia, 25(6), 995–999.

    Article  PubMed  Google Scholar 

  23. Huebler, M., et al. (2006). Cardiopulmonary bypass for complex cardiac surgery using bivalirudin anticoagulation in a patient with heparin antibodies. Journal of Cardiac Surgery, 21(3), 286–288.

    Article  PubMed  Google Scholar 

  24. Murphy, G. S., et al. (2006). Retrograde autologous priming of the cardiopulmonary bypass circuit: Safety and impact on postoperative outcomes. Journal of Cardiothoracic and Vascular Anesthesia, 20(2), 156–161.

    Article  PubMed  Google Scholar 

  25. Ortega, G. M., et al. (2003). Alteration of vancomycin pharmacokinetics during cardiopulmonary bypass in patients undergoing cardiac surgery. American Journal of Health-System Pharmacy, 60(3), 260–265.

    PubMed  Google Scholar 

  26. Ling, I. S., et al. (1992). Changes of blood viscosity in patients undergoing cardiac surgery during cardiopulmonary bypass. Ma Zui Xue Za Zhi = Anaesthesiologica Sinica, 30(3), 153–157.

    CAS  PubMed  Google Scholar 

  27. Ranucci, M., et al. (2006). Lowest hematocrit on cardiopulmonary bypass impairs the outcome in coronary surgery: An Italian multicenter study from the National Cardioanesthesia Database. Texas Heart Institute Journal, 33(3), 300–305.

    PubMed  PubMed Central  Google Scholar 

  28. Sanchez, A. S. Salinas, et al. (2000). Adrenal cortex carcinoma with right atrium involvement. Surgery with cardiopulmonary bypass. Actas Urologicas Espanolas, 24(7), 590–593.

    Article  Google Scholar 

  29. Grieco, G., et al. (1996). Evaluating neuroprotective agents for clinical anti-ischemic benefit using neurological and neuropsychological changes after cardiac surgery under cardiopulmonary bypass. Methodological strategies and results of a double-blind, placebo-controlled trial of GM1 ganglioside. Stroke, 27(5), 858–874.

    Article  CAS  PubMed  Google Scholar 

  30. Kato, Y., et al. (1996). Deep hypothermia cardiopulmonary bypass and direct surgery of two large aneurysms at the vertebro-basilar junction. Acta Neurochirurgica (Wien), 138(9), 1057–1066.

    Article  CAS  Google Scholar 

  31. Gruenwald, C. E., et al. (2010). Randomized, controlled trial of individualized heparin and protamine management in infants undergoing cardiac surgery with cardiopulmonary bypass. Journal of the American College of Cardiology, 56(22), 1794–1802.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

This study was supported by the Technological Innovation Talent Special Foundation of Harbin, China (2009RFXXS018) and the Youth Science Foundation of Heilongjiang Province (QC2013C116).

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Authors and Affiliations

  1. Department of Cardiac Surgery, The Second Affiliated Hospital of Harbin Medical University, Nangang, Harbin, 150086, Heilongjiang, People’s Republic of China

    Ming Cheng, Jun-Quan Li, Tian-Chi Wu & Wei-Chen Tian

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  1. Ming Cheng
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  2. Jun-Quan Li
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  3. Tian-Chi Wu
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Correspondence to Ming Cheng or Jun-Quan Li.

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Cheng, M., Li, JQ., Wu, TC. et al. Short-Term Effects and Safety Analysis of Retrograde Autologous Blood Priming for Cardiopulmonary Bypass in Patients with Cardiac Valve Replacement Surgery. Cell Biochem Biophys 73, 441–446 (2015). https://doi.org/10.1007/s12013-015-0661-1

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