Effects of cardiopulmonary bypass with low-priming volume on clinical outcomes in children undergoing congenital heart disease surgery
Abstract Background Cardiopulmonary bypass (CPB) with high-priming volume can significantly activate the inflammatory response and increse the usage of packed red blood cells (PRBCs). As risks and complications related to transfusions are increasing, many cardiac centers are focusing on reducing the...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13019-020-01151-w |
| _version_ | 1819043628621758464 |
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| author | Lei Wang Qiang Chen Yong Qiang Qiu Jian Xi Ye Jian Zhi Du Xiao Chai Lv Yan Ting Hou Liang Wan Chen |
| author_facet | Lei Wang Qiang Chen Yong Qiang Qiu Jian Xi Ye Jian Zhi Du Xiao Chai Lv Yan Ting Hou Liang Wan Chen |
| author_sort | Lei Wang |
| collection | DOAJ |
| description | Abstract Background Cardiopulmonary bypass (CPB) with high-priming volume can significantly activate the inflammatory response and increse the usage of packed red blood cells (PRBCs). As risks and complications related to transfusions are increasing, many cardiac centers are focusing on reducing the priming volume of CPB. In our center, efforts have also been made to reduce the priming volume, and the effects of CPB with low-priming volume on clinical outcomes in children undergoing congenital heart disease (CHD) surgery were investigated in this study to provide referential experiences for pediatric CPB. Methods The clinical case data of 158 children undergoing CHD surgery with CPB were collected. The children were divided into the low-priming-volume group (group A, n = 79) and the traditional group (group B, n = 79) according to the priming volume. The amount of PRBCs transfused, the postoperative hematological test results and the clinical outcomes of the two groups were compared by the independent sample t-test or the chi-square test. Results The amount of PRBCs transfused during CPB and during the whole operation were significantly lower in group A than in group B (p < 0.01), but the hemoglobin (Hb) concentration was higher in group A on the first day after surgery (p < 0.01) and before hospital discharge. However, the latter showed no statistical significant difference. The lowest postoperative platelet count was higher in group A than in group B (p < 0.05). There was no statistical difference in the postoperative inflammatory markers and the main clinical outcomes between the two groups. Conclusions The usage of PRBCs in CPB with low-priming volume decreased significantly, but the postoperative Hb concentration and platelet count could still be maintained at a high level, improving the use efficiency of PRBCs. CPB with low-priming volume did not affect the postoperative recovery of patients, so it is worthy of continuous promotion and optimization. |
| first_indexed | 2024-12-21T09:59:49Z |
| format | Article |
| id | doaj.art-590a88ee56bb45569c8eed6986159967 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-12-21T09:59:49Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-590a88ee56bb45569c8eed69861599672022-12-21T19:07:58ZengBMCJournal of Cardiothoracic Surgery1749-80902020-05-011511910.1186/s13019-020-01151-wEffects of cardiopulmonary bypass with low-priming volume on clinical outcomes in children undergoing congenital heart disease surgeryLei Wang0Qiang Chen1Yong Qiang Qiu2Jian Xi Ye3Jian Zhi Du4Xiao Chai Lv5Yan Ting Hou6Liang Wan Chen7Department of Cardiac Surgery, Union Hospital of Fujian Medical UniversityDepartment of Cardiac Surgery, Union Hospital of Fujian Medical UniversityDepartment of Cardiac Surgery, Union Hospital of Fujian Medical UniversityDepartment of Cardiac Surgery, Union Hospital of Fujian Medical UniversityDepartment of Cardiac Surgery, Union Hospital of Fujian Medical UniversityDepartment of Cardiac Surgery, Union Hospital of Fujian Medical UniversityDepartment of Cardiac Surgery, Union Hospital of Fujian Medical UniversityDepartment of Cardiac Surgery, Union Hospital of Fujian Medical UniversityAbstract Background Cardiopulmonary bypass (CPB) with high-priming volume can significantly activate the inflammatory response and increse the usage of packed red blood cells (PRBCs). As risks and complications related to transfusions are increasing, many cardiac centers are focusing on reducing the priming volume of CPB. In our center, efforts have also been made to reduce the priming volume, and the effects of CPB with low-priming volume on clinical outcomes in children undergoing congenital heart disease (CHD) surgery were investigated in this study to provide referential experiences for pediatric CPB. Methods The clinical case data of 158 children undergoing CHD surgery with CPB were collected. The children were divided into the low-priming-volume group (group A, n = 79) and the traditional group (group B, n = 79) according to the priming volume. The amount of PRBCs transfused, the postoperative hematological test results and the clinical outcomes of the two groups were compared by the independent sample t-test or the chi-square test. Results The amount of PRBCs transfused during CPB and during the whole operation were significantly lower in group A than in group B (p < 0.01), but the hemoglobin (Hb) concentration was higher in group A on the first day after surgery (p < 0.01) and before hospital discharge. However, the latter showed no statistical significant difference. The lowest postoperative platelet count was higher in group A than in group B (p < 0.05). There was no statistical difference in the postoperative inflammatory markers and the main clinical outcomes between the two groups. Conclusions The usage of PRBCs in CPB with low-priming volume decreased significantly, but the postoperative Hb concentration and platelet count could still be maintained at a high level, improving the use efficiency of PRBCs. CPB with low-priming volume did not affect the postoperative recovery of patients, so it is worthy of continuous promotion and optimization.http://link.springer.com/article/10.1186/s13019-020-01151-wCardiopulmonary bypassLow-priming volumeChildrenCongenital heart disease surgery |
| spellingShingle | Lei Wang Qiang Chen Yong Qiang Qiu Jian Xi Ye Jian Zhi Du Xiao Chai Lv Yan Ting Hou Liang Wan Chen Effects of cardiopulmonary bypass with low-priming volume on clinical outcomes in children undergoing congenital heart disease surgery Journal of Cardiothoracic Surgery Cardiopulmonary bypass Low-priming volume Children Congenital heart disease surgery |
| title | Effects of cardiopulmonary bypass with low-priming volume on clinical outcomes in children undergoing congenital heart disease surgery |
| title_full | Effects of cardiopulmonary bypass with low-priming volume on clinical outcomes in children undergoing congenital heart disease surgery |
| title_fullStr | Effects of cardiopulmonary bypass with low-priming volume on clinical outcomes in children undergoing congenital heart disease surgery |
| title_full_unstemmed | Effects of cardiopulmonary bypass with low-priming volume on clinical outcomes in children undergoing congenital heart disease surgery |
| title_short | Effects of cardiopulmonary bypass with low-priming volume on clinical outcomes in children undergoing congenital heart disease surgery |
| title_sort | effects of cardiopulmonary bypass with low priming volume on clinical outcomes in children undergoing congenital heart disease surgery |
| topic | Cardiopulmonary bypass Low-priming volume Children Congenital heart disease surgery |
| url | http://link.springer.com/article/10.1186/s13019-020-01151-w |
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