The application of micro pump crystal solution perfusion device in infants' con-genital heart diseases with cardiopulmonary bypass

Chen Xiang-zhou; Liu Mei; Xiao Ying-bin; Wang Xue-feng; Wang Yong

doi:10.13498/j.cnki.chin.j.ecc.2014.03.06

Abstract：Objective To observe the clinical effect of myocardial protection using micro pump crystal solution perfusion de-vice in infants'congenital heart diseases with cardiopulmonary bypass ( CPB) . Methods Form Jun. 2010 to Oct. 2012, 100 infants ( body weight <10 kg) with ventricular septal defect ( VSD) scheduled for cardiac surgery with CPB were enrolled and randomized into experimental ( E) group and control ( C) group, 50 cases each. After aortic cross clamping, the way of antegrade cardioplegia perfusion with hyperpotassemia ( potassium 20 mmol/L) was chosen as myocardial protection method for all infants. Micro pump crystal solution perfusion device was used in E group and traditional blood reservoir perfusion device was used in C group. The concentrations of potas-sium, hematocrit ( Hct) , lactate ( Lac) from the arterial blood gas were compared between two groups at following time points:preop-eration (T1), 20 min after CPB (T2), aortic declamping (T3), leaving operating room (T4). The time of CPB and aortic cross clamping, cardiac resuscitation rate, filter fluid during CPB, total volume of CPB priming and banked red blood cell ( BRBC) transfu-sion perioperative, left ventricle ejection fraction (EF) and blood concentration of creatine kinase (CK), creatine kinase MB (CK-MB) before and after operation of two groups were collected. Results 1.There were no significant differences in preoperative and post-operative EF, time of CPB and aortic cross clamping, cardiac resuscitation rate between two groups ( P>0.05) . 2. There were no sig-nificant differences in the concentrations of potassium, hematocrit ( Hct) , lactate ( Lac) from the arterial blood gas between two groups in T1, T2, T3, T4 ( P>0.05) . 3. The concentration of CK and CKMB on the preoperative day, 1 day and 3 day postoperatively be-tween two groups had no significant differences ( P>0.05) , which was increased significantly on the 1 day postoperatively ( P<0.01) and recovered on 3 day postoperatively. 4. There were significant differences in the total volume of CPB priming and perioperative BRBC transfusion between two groups ( P<0.05). Conclusion The micro pump crystal solution perfusion device can provide comparative myocardial protective effect as traditional blood reservoir perfusion device, but the former can reduce the volume of CPB priming and perioperative BRBC transfusion in infants'congenital heart diseases with CPB.