Related Experiment Videos
[Initial ultrafiltration to the priming solution with preserved blood for cardiopulmonary bypass in infants]
M Nagatsu1, Y Harada, T Takeuchi
1Department of Cardiovascular Surgery, Nagano Children's Hospital, Japan.
Insights
Ultrafiltration of initial priming solutions before cardiopulmonary bypass in infants significantly reduces harmful substances like potassium and lactic acid. This method helps preserve innate heart function during open heart surgery.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Biomedical Engineering
Context:
- Open heart surgery in infants often requires cardiopulmonary bypass (CPB).
- Initial priming solutions (IPS) for CPB typically contain significant amounts of preserved blood.
- Preserved blood can have detrimental effects on infant hearts and vessels.
Purpose:
- To evaluate the efficacy of ultrafiltration (UF) on initial priming solutions (IPS) before CPB.
- To reduce harmful substances in IPS and mitigate negative impacts of preserved blood.
- To assess the impact of UF on potassium concentrations and patient outcomes.
Summary:
- Ultrafiltration was performed on IPS in 42 pediatric cases before CPB.
- Concentrations of potassium, NH3, lactic acid, and pyruvic acid in IPS decreased significantly post-UF.
- Potassium levels in patient blood, IPS, and mixed blood were compared between infant and older pediatric groups.
Impact:
- UF significantly reduced harmful solutes in the IPS before CPB.
- Potassium concentrations showed significant differences between various blood samples, with minimal difference between post-UF IPS and mixed blood in infants.
- Nearly all patients (98%) maintained spontaneous heartbeats during the procedure, suggesting a positive impact on cardiac function.
Abstract:
In case of open heart surgery in infants, the initial priming solutions (IPS) of the cardiopulmonary bypasses (CPB) include considerable amount of preserved blood to assure us of the proper hematocrit during the CPB. Aiming at elimination of unfavorable effects of preserved blood on hearts and vessels, the ultrafiltrations (UF) to the IPS before the beginnings of CPB had been carried out in 42 pediatric cases. The IPS amounted to 915 +/- 25 (mean +/- SE) ml. in which 581 +/- 31 ml of preserved blood were included. The 1.5-fold amount infusions over the IPS, consisted of 5% glucose, normal saline and fresh frozen plasma, were added to the IPS, and just the same amount fluid were removed out by the UF. The concentrations of potassium, NH3, lactic acid and pyruvic acid in the IPS decreased significantly after UF (p = 0.001). The potassium concentrations were compared among the blood of patients (PB), the IPS before UF (IPS1), the IPS after UF (IPS2), and the mixed blood drawn 5-10 minutes after the beginnings of CPB (MB) in the cases under the age of 1 year (group-I, n = 26, 4.7 +/- 0.3 kg) and in the elders (group-E, n = 16, 15 +/- 2 kg). The results showed all significant differences but "IPS2 and MB" in group-I, and but "PB and MB" in group-E (ANOVA p = 0.001, p < 0.01 by Newman-Keuls). The 98% of cases kept their innate heart beatings until the aortic clamps at 22 +/- 1 degrees C (sending blood temp.).(ABSTRACT TRUNCATED AT 250 WORDS)