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Pump Prime (pump + prime)
Selected AbstractsEffects of Minimal Dose Aprotinin on Blood Loss and Fibrinolytic System-Complement Activation in Coronary Artery Bypass Grafting SurgeryJOURNAL OF CARDIAC SURGERY, Issue 4 2006Ferit Cicekcioglu M.D. Methods: Forty-four patients scheduled for primary CABG were randomly assigned to the aprotinin (n = 24) or control group (n = 20). In aprotinin group, aprotinin was administered in two equal doses (before skin incision and added to the pump prime). Ventilation time, intensive care unit stay, mediastinal tube drainage, hospitalization, transfusion requirements, and postoperative morbidities and mortality were noted. Hematologic markers of fibrinolytic activity and complement activation were also measured pre- and postoperatively. Results: Although less mediastinal drainage occurred in aprotinin group, the difference was not statistically significant. Other postoperative variables like transfusion requirements, morbidities, and mortality were also found to be similar between groups. Among hematologic parameters, only postoperative levels of ,2-antiplasmin and plasminogen activator inhibitor-1 were significantly higher in aprotinin group. Conclusions: Although plasmin inhibitors begin to rise at this very low aprotinin dosage, it is not advisable to use this aprotinin regimen in CABG patients. [source] The effect of bloodless pump prime on cerebral oxygenation in paediatric patientsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2004S. H. Han Background:, In paediatric patients, crystalloid prime for cardiopulmonary bypass (CPB) causes further haemodilution in comparison with blood-containing prime. Thus it may affect the cerebral oxygen supply/demand balance. The purpose of the study was to compare the effect of bloodless pump prime with that of blood-containing prime on cerebral oxygenation in children. Methods:, Thirty-six paediatric patients scheduled for elective repair of atrial or ventricular septal defect were enrolled. In Group C (n = 18), the CPB circuit was primed only with crystalloid. In Group B (n = 18), red blood cells were added to achieve a haematocrit (Hct) of 20% during CPB. The regional cerebral oxygen saturation (rSO2) value measured by near-infrared spectroscopy was compared between the two groups. Results:, In both groups, rSO2 decreased below baseline at the start of CPB and during rewarming (P < 0.001, for both groups during each period). At the start of CPB, haemodilution was greater in Group C than in Group B (Hct 16.1 ± 0.7% vs. 20.7 ± 0.5%; P < 0.01), and there was a greater reduction in rSO2 in Group C (49.0 ± 5.4% vs. 59.2 ± 7.0%; P < 0.01). During rewarming, rSO2 was significantly lower in Group C than in Group B (57.8 ± 5.3% vs. 62.8 ± 6.2%; P < 0.01). Conclusions:, In paediatric patients, the haemodilution associated with crystalloid priming causes a greater reduction in rSO2 than with blood-containing prime at the starting period of CPB and the rewarming period. [source] Which may be effective to reduce blood loss after cardiac operations in cyanotic children: tranexamic acid, aprotinin or a combination?PEDIATRIC ANESTHESIA, Issue 1 2005FÜSUN S. BULUTCU MD Summary Background:, Children with cyanotic heart disease undergoing cardiac surgery in which cardiopulmonary bypass is used are at increased risk of postoperative bleeding. In this study, the authors investigated the possibility of reducing postoperative blood loss by using aprotinin and tranexamic acid alone or a combination of these two agents. Methods:, In a prospective, randomized, blind study, 100 children undergoing cardiac surgery were investigated. In group 1 (n = 25) patients acted as the control and did not receive either study drugs. In group 2 (n = 25) patients received aprotinin (30.000 KIU·kg,1 after induction of anesthesia, 30.000 KIU·kg,1 in the pump prime and 30.000 KIU·kg,1 after weaning from bypass). In group 3 (n = 25) patients received tranexamic acid (100 mg·kg,1 after induction of anesthesia, 100 mg·kg,1 in the pump prime and 100 mg·kg,1 after weaning from bypass). In group 4 (n = 25) patients received a combination of the two agents in the same manner. Total blood loss and transfusion requirements during the period from protamine administration until 24 h after admission to the intensive care unit were recorded. In addition, hemoglobin, platelet counts and coagulation studies were recorded. Results:, Postoperative blood loss was significantly higher in the control group (group 1) compared with children in other groups who were treated with aprotinin, tranexamic acid or a combination of the two agents (groups 2, 3 and 4) during the first 24 h after admission to cardiac intensive care unit (40 ± 18 ml·kg,1·24 h,1, aprotinin; 35 ± 16 ml·kg,1·24 h,1, tranexamic acid; 34 ± 19 ml·kg,1·24 h,1, combination; 35 ± 15 ml·kg,1·24 h,1). The total transfusion requirements were also significantly less in the all treatment groups. Time taken for sternal closure was longer in the control group (68 ± 11 min) compared with treatment groups 2, 3 and 4, respectively (40 ± 18, 42 ± 11, 42 ± 13 min, P < 0.05). The coagulation parameters were not found to be significantly different between the three groups. Conclusions:, Our results suggested that both agents were effective to reduce postoperative blood loss and transfusion requirements in patients with cyanotic congenital heart disease. However, the combination of aprotinin and tranexamic acid did not seem more effective than either of the two drugs alone. [source] | ||||||||||