Plasmalyte and Ringer Lactate as Priming Solutions in Pediatric Cardiopulmonary Bypass: A Comparative Study

Background: Pediatric heart surgery, particularly for cyanotic congenital heart conditions, commonly requires the utilization of cardiopulmonary bypass (CPB) to assist with surgical interventions. The choice of priming solution for the CPB circuit can influence postoperative outcomes. This study aimed to assess the impact of two different priming solutions, Plasmalyte and Ringer's Lactate, on postoperative outcomes, blood biochemistry, pulmonary and renal function, bleeding, and hemostasis in children undergoing open cardiac surgery with CPB. Methods: This randomized prospective study was conducted on 80 pediatric patients aged 1 to 10 years, undergoing elective cardiac surgery with CPB. Patients were randomly assigned to receive either Plasmalyte (Group A) or Ringer's Lactate (Group B) as their CPB circuit priming solution. Standardized protocols for anesthesia, CPB circuit components, and surgical techniques were maintained. Postoperative parameters including blood chemistry, perfusion indicators, and physiological measurements were recorded and analyzed. Results: After CPB initiation, lactate levels were significantly higher in Group B (Ringer's Lactate) compared to Group A (Plasmalyte) (P-value <0.001). Calcium levels also showed a significant difference between the two groups (P-value <0.001). Postoperative lactate levels remained higher in Group B (P-value <0.001), while bicarbonate, calcium, urine output, urea, and creatinine levels at 6th hour postoperatively were statistically significant (p<0.05). Conclusions: Priming the CPB circuit with Plasmalyte may be associated with favorable outcomes in terms of lactate and calcium levels compared to Ringer Lactate in pediatric patients undergoing cardiac surgery.