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Related Experiment Videos

Hemolysis during cardiopulmonary bypass.

R Martin1, S McKenty, Y Thisdale

  • 1Department of Anaesthesia, University of Sherbrooke, Canada.

Journal of Cardiothoracic Anesthesia
|December 1, 1989
PubMed
Summary

Priming solutions with glucose and rapid pump acceleration significantly increase red blood cell hemolysis during cardiopulmonary bypass. Using lactated Ringer's alone or with slower acceleration reduces red blood cell trauma.

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Area of Science:

  • Cardiovascular Surgery
  • Biomedical Engineering
  • Hematology

Background:

  • Red blood cell hemolysis is a significant complication during cardiopulmonary bypass (CPB).
  • The composition of the priming solution and pump flow dynamics can influence red blood cell trauma.

Purpose of the Study:

  • To investigate the impact of priming solution composition and initial CPB acceleration on red blood cell hemolysis.
  • To identify factors contributing to red blood cell trauma during CPB.

Main Methods:

  • Eighty adult patients undergoing coronary artery grafting with CPB were randomized into four groups.
  • Groups differed based on priming solution (lactated Ringer's with 5% dextrose vs. lactated Ringer's alone) and initial pump flow acceleration (1 minute vs. 2 minutes).
  • Plasma hemoglobin levels were measured to assess hemolysis.

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Main Results:

  • Plasma hemoglobin levels were four times higher in the group using lactated Ringer's with 5% dextrose and a 1-minute acceleration compared to other groups (P < 0.001).
  • A significant degree of hemolysis was observed with the combination of lactated Ringer's with 5% dextrose prime and rapid pump flow initiation.

Conclusions:

  • There is a significant interaction between glucose in the priming solution and the initial acceleration of CPB pump flow.
  • Combining lactated Ringer's with 5% dextrose priming solution and a short time interval to full pump flow exacerbates red blood cell hemolysis.