[Initial ultrafiltration to the priming solution with preserved blood for cardiopulmonary bypass in infants].
In case of open heart surgery in infants, the initial priming solutions (IPS) of the cardiopulmonary bypasses (CPB) include considerable amount of preserved blood to assure us of the proper hematocrit during the CPB. Aiming at elimination of unfavorable effects of preserved blood on hearts and vessels, the ultrafiltrations (UF) to the IPS before the beginnings of CPB had been carried out in 42 pediatric cases. The IPS amounted to 915 +/- 25 (mean +/- SE) ml. in which 581 +/- 31 ml of preserved blood were included. The 1.5-fold amount infusions over the IPS, consisted of 5% glucose, normal saline and fresh frozen plasma, were added to the IPS, and just the same amount fluid were removed out by the UF. The concentrations of potassium, NH3, lactic acid and pyruvic acid in the IPS decreased significantly after UF (p = 0.001). The potassium concentrations were compared among the blood of patients (PB), the IPS before UF (IPS1), the IPS after UF (IPS2), and the mixed blood drawn 5-10 minutes after the beginnings of CPB (MB) in the cases under the age of 1 year (group-I, n = 26, 4.7 +/- 0.3 kg) and in the elders (group-E, n = 16, 15 +/- 2 kg). The results showed all significant differences but "IPS2 and MB" in group-I, and but "PB and MB" in group-E (ANOVA p = 0.001, p < 0.01 by Newman-Keuls). The 98% of cases kept their innate heart beatings until the aortic clamps at 22 +/- 1 degrees C (sending blood temp.).(ABSTRACT TRUNCATED AT 250 WORDS)
Nagatsu
M
M
Department of Cardiovascular Surgery, Nagano Children's Hospital, Japan.
Harada
Y
Y
Takeuchi
T
T
Goto
H
H
Kaneko
T
T
Ota
Y
Y
D001804:Blood Transfusion, Autologous; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002648:Child; D002675:Child, Preschool; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D006440:Hemofiltration; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007552:Isotonic Solutions / Q000008:administration & dosage*; D008297:Male; D017680:Potassium Compounds / Q000008:administration & dosage; D014882:Water-Electrolyte Balance
D007552:Isotonic Solutions; D017680:Potassium Compounds; C018369:potassium cardioplegic solution; D005947:Glucose