A new PRECiSe (priming reduced extracorporeal circulation setup) minimizes the need for blood transfusions: first clinical results in coronary artery bypass grafting.
Hemodilution by the crystalloid priming volume of standard heart-lung machines in cardiac surgery is associated with impaired organ function and increased blood transfusion requirements. The aim of this study was to evaluate the effect of the use of the newly developed priming reduced extracorporeal circulation setup (PRECiSe) on perioperative hemodilution and transfusion requirements. In a matched prospective study, 40 patients who underwent operations with the PRECiSe in elective primary coronary artery bypass surgery were compared with 40 patients who underwent operations with the standard heart-lung machine. A significant reduction in final priming volume resulted in a significantly reduced degree of hemodilution and transfusion requirements during and after extracorporeal circulation. In the PRECiSe group, only 10% of the patients needed transfusions during their hospital stay, whereas 35% of the patients in the control group required any transfusion (P < .05). The average transfusion per patient was 0.16 units in the PRECiSe group and 1.25 units in the control group (P < .05). The PRECiSe was demonstrated to be safe and effective in coronary artery bypass surgery with respect to transfusion requirements and hemodilution, as well as with regard to patient safety, as represented by perioperative myocardial performance.
Beholz
Sven
S
Department of Cardiovascular Surgery, Charité, University Berlin, Germany. sven.beholz@charite.de
Zheng
Liling
L
Kessler
Michael
M
Rusche
Martin
M
Konertz
Wolfgang
W
D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D001803:Blood Transfusion / Q000706:statistics & numerical data; D001026:Coronary Artery Bypass; D000077324:Crystalloid Solutions; D005112:Extracorporeal Circulation / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006355:Heart-Lung Machine; D006438:Hemodilution; D006801:Humans; D007552:Isotonic Solutions; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
D000077324:Crystalloid Solutions; D007552:Isotonic Solutions