Effects of low priming volume during cardiopulmonary bypass on low-weight infants with congenital heart diseases: a prospective single center study

Wang Kui-liang; Cao Qian; Pan Si-lin; Xing Quan-sheng

doi:10.13498/j.cnki.chin.j.ecc.2017.04.01

Abstract：Objective To detect whether the low priming volume cardiopulmonary bypass(CPB) strategy could improve the postoperative outcome of low-weight infants with congenital heart diseases ( CHD) . Methods From January 2016 to December 2016, a total of 37 consecutive low-weight (≤5 kg) infants with simple CHDs in our center received CPB intracardiac surgical treatment. These patients were randomly divided into two groups:experimental group using the 3/16 inch micro circuit and membrane oxygenator with a built-in arterial filter ( n=20) while the control group using the 1/4 inch circuit and ordinary membrane oxygenator ( n=17) . The priming aim was to maitain the hematocrit ( Hct) around 25% during CPB . The data were collected as follow, patients characteris-tics before operations, total priming volume, static priming volume, red blood cell ( RBC) volume, perioperative blood lactate acid concentration and ICU duration. Results The static priming volume, RBC volume of control group were significantly less than those of experimental group (160.3±15.2 ml vs 272.9±13.1 ml, 111.2±12.9 ml vs 171.3±33.3 ml;P<0.05). The blood lactate acid concen-tration during CPB (<1.0 mmol/L vs 1.5±0.8 mmol/L;P<0.05), end of CPB(1.2±0.5 mmol/L vs 1.7±0.9 mmol/L;P<0.05) and 12h after CPB in experimental group (1.1±0.3 mmol/L vs 1.3±0.5 mmol/L;P<0.05) were significantly less than those in control group as well. The ICU duration of experimental group was shorter than that of control group (4.5±0.5 d vs 6.5±0.5 d;P<0.05). Conclusion New CPB strategy using the micro circuit and membrane oxygenator with a built-in arterial filter can reduce priming volume and blood volume effectively. The blood lactate acid concentration of CHD infants with low priming volume decreases and the outcomes are better.