title: The effect of retrograde autologous priming of the cardiopulmonary bypass circuit on cerebral oxygenation.
abstract: OBJECTIVE
  The aim of this study was to investigate the effect of retrograde autologous priming (RAP) of the cardiopulmonary bypass (CPB) circuit on cerebral oxygenation.
  
  
  METHODS
  A retrospective cohort study.
  
  
  METHODS
  A university hospital.
  
  
  METHODS
  Ninety-four patients undergoing CPB.
  
  
  METHODS
  CPB was primed with a RAP technique in the RAP group (n = 46) or with a conventional technique in the control group (n = 48).
  
  
  RESULTS
  Cerebral oxygenation was monitored by measuring the regional cerebral oxygen saturation (rSO(2)). The rSO(2) and Hct values were compared between the groups during surgery. During the CPB period, the RAP group showed significantly higher values for rSO(2) (%) (immediately after the onset of CPB: 51.3 ± 8.4 and 56.3 ± 8.3; 30 minutes after the onset of CPB: 56.3 ± 5.1 and 59.7 ± 7.0; control group and RAP groups, respectively; p < 0.01 for each) and Hct (%) (immediately after the onset of CPB: 21.1 ± 3.7 and 23.1 ± 3.3; 30 minutes after the onset of CPB: 21.9 ± 3.7 and 23.3 ± 2.3; control group and RAP group, respectively; p < 0.02 for each). However, the 2 groups did not differ in rSO(2) (%) (67.2 ± 6.3 and 67.8 ± 6.4) or Hct (%) (27.8 ± 4.1 and 28.9 ± 3.6, control group and RAP group, respectively) at the end of the surgery.
  
  
  CONCLUSIONS
  The application of RAP to CPB limits the degree of hemodilution and improves cerebral oxygenation during CPB. The present findings suggest a potential benefit of RAP from a neurologic aspect.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Kyonggido, Korea.
authors.forename: Jinyoung
authors.initials: J
authors.lastname: Hwang
authors.forename: Jin
authors.initials: J
authors.lastname: Huh
authors.forename: Jinhee
authors.initials: J
authors.lastname: Kim
authors.forename: Sanghyon
authors.initials: S
authors.lastname: Park
authors.forename: Jeongwon
authors.initials: J
authors.lastname: Hwang
authors.forename: Francis Sahngun
authors.initials: FS
authors.lastname: Nahm
authors.forename: Sunghee
authors.initials: S
authors.lastname: Hahn
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D001794:Blood Pressure / Q000502:physiology; D001831:Body Temperature / Q000502:physiology; D001923:Brain Chemistry / Q000502:physiology*; D002315:Cardiopulmonary Bypass / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006400:Hematocrit; D006438:Hemodilution; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009422:Nervous System Diseases / Q000209:etiology; D010101:Oxygen Consumption / Q000502:physiology*; D010108:Oxyhemoglobins / Q000378:metabolism; D019265:Spectroscopy, Near-Infrared
chemical_list: D010108:Oxyhemoglobins