Influence of hematocrit and pump prime on cerebral oxygen saturation in on-pump coronary revascularization.
BACKGROUND
The couplings between cerebral oxygenation (rSO2), on-pump hematocrit and circuit prime are explored in this study.


METHODS
Thirty-eight consecutive patients undergoing coronary revascularization with cardiopulmonary bypass (CPB) were matched on preoperative hematocrit < 40% and > 40% (n = 16). Similarly, six blood prime patients were matched with six crystalloid prime patients. Hematocrit and rSO2 levels were then compared on CPB.


RESULTS
The preoperative hematocrit > 40% group retained higher levels on pump run (p < 0.01) and significantly higher rSO2 prior to CPB (64.8 +/- 9.6 versus 73.2 +/- 7.3), and on and off CPB (61.1 +/- 8.8 versus 67.4 +/- 6.4). Blood priming increased absolute rSO2 (2.3 +/- 6.3 versus -10.9 +/- 5.9) and % rSO2 (4.7 +/- 11.8 versus -14.2 +/- 7.4%) in the low hematocrit group.


CONCLUSIONS
Blood primes are instrumental in high-risk and low preoperative hematocrit patients in preventing cerebral oxygen desaturation during initiation and maintenance of CPB.
McCusker
Kevin
K
Portsmouth Regional Hospital, NH, USA.
Chalafant
Anthony
A
de Foe
Gordon
G
Gunaydin
Serdar
S
Vijay
Venkataramana
V
D000368:Aged; D001921:Brain / Q000378:metabolism; D002315:Cardiopulmonary Bypass; D002318:Cardiovascular Diseases / Q000097:blood / Q000601:surgery; D002560:Cerebrovascular Circulation; D005260:Female; D006400:Hematocrit; D006801:Humans; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010100:Oxygen / Q000378:metabolism; D010101:Oxygen Consumption; D012189:Retrospective Studies
D010100:Oxygen