Cardiothoracic & vascular anesthesia
Impact of Priming Volume Reduction on Hematocrit Retention in Pediatric Cardiopulmonary Bypass: A Retrospective Analysis
Authors' conclusion
These findings suggest that even partial retrograde autologous priming is effective to mitigate hemodilution and is independently associated with improved hematocrit retention and a significant reduction in transfusion risk after initiation of cardiopulmonary bypass in pediatric patients.
Study context
- Population
- Patients aged 0–14 years, weight > 6 kg, undergoing repair of ventricular and/or atrial septal defects with CPB
- Participants
- 191 patients
- Exposure
- Retrograde autologous priming vs control
- Retrograde autologous primingn = 144
- Controln = 47reference
- Outcome
- Correlation between priming volume reduction rate (proportion of priming solution replaced) and hematocrit retention ratio (hematocrit immediately after CPB initiation / pre-bypass hematocrit)
Main finding
As reported in the abstract
Spearman's ρ (positive correlation), p < 0.001
0.545
Multiple regression: 0.1 increase in priming volume reduction rate → absolute increase in hematocrit at bypass initiation (independent association)
0.5%
Observational data: associations, not effects.
Secondary outcomes
Transfusion-free surgery
relative risk ratio 1.22 · P = 0.005
ICU and hospital LOS
- No significant difference between groups
Safety
Regional cerebral oxygen saturation trends and lactate levels
- No significant intergroup differences (Time × retrograde autologous priming interaction); no evidence of cerebral perfusion suppression
Original publication
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