Impact of miniaturization of cardiopulmonary bypass circuit on blood transfusion requirement in neonatal open-heart surgery.
This study was undertaken to determine the impact of miniaturization of a cardiopulmonary bypass (CPB) circuit on blood transfusion and hemodynamics in neonatal open-heart surgery. Neonates (n = 102) undergoing open-heart surgery between 2002 and 2006 were included and divided into three groups: group 1 (n = 28), Dideco 902 oxygenator + 5/16" line; group 2 (n = 29), Dideco 901 oxygenator + 1/4" line; group3 (n = 45), Dideco 901 oxygenator + 3/16" arterial + 1/4" venous line. Amount of priming volume, blood and bicarbonate sodium use during CPB, and hemodynamics were compared. Priming volume in the groups 2 and 3 was significantly less compared with the group 1 (group 1, 575 +/- 37 ml; group 2, 328 +/- 12 ml, group 3, 326 +/- 5 ml, p < 0.05). Blood transfusion and bicarbonate sodium use during CPB in groups 2 and 3 were significantly less compared with group 1. Hemodynamics during CPB was comparable. There were no differences between groups 2 and 3 in any parameter. Miniaturization of the CPB circuit resulted in decrease in priming volume and subsequent reduction in blood and bicarbonate sodium use. Downsizing the lines had minimal impact on any of the parameters studied, and further efforts should be made to achieve neonatal open-heart surgery without blood transfusion.
Department of Cardiovascular Surgery, Okayama University Graduate School of Medicine and Dentistry, Okayama City, Japan.
Yasuhiro
Y
Kotani
Osami
O
Honjo
Mahito
M
Nakakura
Shinya
S
Ugaki
Takuya
T
Kawabata
Yosuke
Y
Kuroko
Satoru
S
Osaki
Ko
K
Yoshizumi
Shingo
S
Kasahara
Kozo
K
Ishino
Shunji
S
Sano
D001794:Blood Pressure; D001803:Blood Transfusion / Q000706:statistics & numerical data; D006348:Cardiac Surgical Procedures / Q000379:methods / Q000706:statistics & numerical data; D002315:Cardiopulmonary Bypass / Q000379:methods* / Q000706:statistics & numerical data; D015331:Cohort Studies; D004867:Equipment Design; D005112:Extracorporeal Circulation / Q000295:instrumentation* / Q000706:statistics & numerical data; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation; D006400:Hematocrit; D006439:Hemodynamics; D006801:Humans; D007231:Infant, Newborn; D008904:Miniaturization; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome