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Clinical Trial
Effects of priming volume reduction on allogeneic red blood cell transfusions and renal outcome after heart surgery.
- M Ranucci, V Pistuddi, G Carboni, M Cotza, A Ditta, A Boncilli, S Brozzi, G Pelissero, and Surgical and Clinical Outcome Research (SCORE) Group.
- Departments of Cardiothoracic - Vascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy cardioanestesia@virgilio.it.
- Perfusion. 2015 Mar 1; 30 (2): 120-6.
IntroductionExcessive hemodilution during cardiopulmonary bypass (CPB) is associated with an increased rate of red blood cell (RBC) transfusion and acute kidney injury (AKI). Minimization of the oxygenator priming volume is a measure to contain hemodilution. In this study, we evaluated the new oxygenator, Sorin Inspire 6™, with respect to its ability to limit hemodilution, RBC transfusion rate and postoperative AKI rate.MethodsA retrospective study on a consecutive series of 1,724 adult patients receiving heart surgery with CPB. Patients treated with the Inspire 6™ were assigned to the low priming volume oxygenator (LPVO) group (N=383) and patients treated with conventional oxygenators to the conventional group (N=1,341). Dynamic priming volume, time course of the hematocrit, RBC transfusions and AKI rate were compared between the groups.ResultsPriming volume was significantly (p=0.001) lower in the LPVO group (624±113 mL) vs. the conventional group (775±150 mL), with higher values of hematocrit during and after CPB. After correction for other confounders, patients in the LPVO group had a significantly lower RBC transfusion rate (odds ratio 0.68, 95% confidence interval 0.52-0.90, p=0.006) and AKI rate (odds ratio 0.55, 95% confidence interval 0.32-0.93, p=0.032).ConclusionThe Inspire 6™ oxygenator allows a significant containment of hemodilution during CPB, reducing the risk of RBC transfusions and postoperative AKI.© The Author(s) 2014.
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