Document Detail


Perfusion technique for nonhaemic cardiopulmonary bypass prime in neonates and infants under 6 kg body weight.
MedLine Citation:
PMID:  15376767     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiopulmonary bypass (CPB) in neonates and infants is associated with significant haemodilution when priming of the CPB circuit is accomplished without transfusion of homologous blood components. The degree of haemodilution and, thus, the requirements for blood transfusion may be reduced when the CPB circuit is miniaturized without compromising patient safety. METHOD: Between January 2002 and October 2003, selected neonates and small infants were operated on using a nonhaemic prime extracorporeal circuit. CPB priming volume could be reduced from 300 mL to 190 mL by using a dedicated neonatal CPB console with mast-mounted roller pump heads. Reduction of priming volume resulted from shortening of all CPB lines to the minimum, downsizing of all CPB lines, exclusion of unused CPB components, use of vacuum-assisted venous drainage and from close co-operation between the perfusionist, cardiac surgeon and anaesthesiologist. The reduction in priming volume was achieved without eliminating the arterial line filter as safety device. RESULTS: A total of nine patients weighing between 3.2 and 5.9 kg (mean 4.7 kg) and with a body surface area of 0.22-0.35 m2 (mean 0.29 m2) were operated on with the use of the modified neonatal CPB circuit and a nonhaemic prime. Bypass time varied from 38 to 167 min (mean 96 min). The mean haematocrit on CPB was 22.5% with a range of 17-29%. The postoperative course of all patients was uneventful. CONCLUSION: A significant reduction in CPB priming volume makes nonhaemic prime CPB in neonates and small infants undergoing complex repair of congenital heart defects possible.
Authors:
Frank Merkle; Wolfgang Boettcher; Fritz Schulz; Andreas Koster; Michael Huebler; Roland Hetzer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Perfusion     Volume:  19     ISSN:  0267-6591     ISO Abbreviation:  Perfusion     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-09-20     Completed Date:  2005-02-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8700166     Medline TA:  Perfusion     Country:  England    
Other Details:
Languages:  eng     Pagination:  229-37     Citation Subset:  IM    
Affiliation:
Academy for Perfusion, Deutsches Herzzentrum Berlin, Berlin, Germany. merkle@dhzb.de
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MeSH Terms
Descriptor/Qualifier:
Blood Transfusion, Autologous
Blood Volume
Body Weight*
Cardiopulmonary Bypass*
Extracorporeal Membrane Oxygenation / instrumentation
Female
Heart Defects, Congenital / surgery*
Hemodilution
Humans
Infant
Infant, Newborn
Male
Reperfusion / methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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