The relationship between extracorporeal circuit prime, albumin, and postoperative weight gain in children

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Published on: September 20, 2019

J Aukerman1, T Voepel-Lewis, L Q Riegger

  • 1Department of Anesthesiology, University of Michigan Health Care Center, Ann Arbor 48109-0211, USA.

Journal of Cardiothoracic and Vascular Anesthesia
|August 26, 1998
PubMed

Insights

Adding albumin to the extracorporeal (EC) circuit prime and minimizing prime volume reduced postoperative weight gain in pediatric patients undergoing cardiopulmonary bypass (CPB). This finding suggests potential benefits for fluid management in pediatric cardiac surgery.

Area of Science:

  • Pediatric Cardiac Surgery
  • Fluid Management
  • Extracorporeal Circulation

Background:

  • Postoperative weight gain is a common concern in pediatric patients following cardiopulmonary bypass (CPB).
  • The composition of the extracorporeal (EC) circuit prime can influence fluid shifts and patient outcomes.

Purpose of the Study:

  • To evaluate the impact of albumin versus crystalloid prime on postoperative weight gain in children undergoing CPB.
  • To identify predictors of weight gain in this patient population.

Main Methods:

  • Retrospective case-controlled study of 76 children (newborn to 4 years) undergoing CPB for congenital heart anomaly correction.
  • Matched groups based on age, weight, and surgical repair: Group 1 (albumin prime) vs. Group 2 (crystalloid prime).

Main Results:

  • Children receiving albumin prime exhibited significantly less postoperative weight gain on postoperative days 1, 2, and 3 compared to those receiving crystalloid prime (p=0.04 on POD 1).
  • Albumin prime and prime volume (mL/kg) were significant predictors of weight gain (p < 0.004), with prime volume being more influential.
  • Lower body weight (<7.5 kg) was associated with greater prime volume and increased weight gain.

Conclusions:

  • Adding albumin to the EC circuit prime and minimizing prime volume may reduce postoperative weight gain in pediatric CPB patients.
  • Further prospective studies are needed to confirm these findings and explore other potential clinical benefits of albumin prime.
Abstract

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