Key result
Prime removal from the cardiopulmonary bypass circuit significantly reduced intraoperative transfusions compared to standard bypass (4% vs 19%, P=0.003).
Why the study?
Does prime removal from the cardiopulmonary bypass circuit maintain higher hematocrit and reduce intraoperative transfusions in patients undergoing coronary revascularization?
Cohort
Does prime removal from the cardiopulmonary bypass circuit maintain higher hematocrit and reduce intraoperative transfusions in patients undergoing coronary revascularization?
Absolute Event Rate: 4% vs 19%
p-value: p=0.003
Prime removal during cardiopulmonary bypass is a simple technique that effectively maintains higher intraoperative hematocrit and reduces the need for blood transfusions during coronary revascularization.
Purpose: Hemodilution during cardiopulmonary bypass may lead to anemia requiring intraoperative transfusions. Prime removal from the cardiopulmonary bypass circuit was used to limit dilution and intraoperative transfusions. Methods: The technique of prime removal consists of arterial and then venous side evacuation of crystalloid prior to cardiopulmonary bypass. The effectiveness of this technique, to maintain a higher hematocrit and reduce intraoperative transfusions, was studied prospectively in two consecutive groups of patients undergoing coronary revascularization (controls versus primeless). Results: Intraoperative hematocrits were significantly higher ( P < 0.0001) and transfusions lower (4%) in the primeless versus the control group (19%) ( P = 0.003). Prime removal is of particular benefit in anemic (hematocrit ≤ 35%) and/or small patients (body surface area ≤ 2 m2). Conclusion: The technique of prime removal is simple, safe and cost-effective, reducing intraoperative transfusions, especially in small and/or anemic patients. It could be part of blood conservation strategies in most adult cardiac operations.
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Rousou et al. (1999) conducted a cohort in Coronary revascularization. Prime removal from the cardiopulmonary bypass circuit vs. Control group (standard cardiopulmonary bypass) was evaluated on Intraoperative transfusions (p=0.003). Prime removal from the cardiopulmonary bypass circuit significantly reduced intraoperative transfusions compared to standard bypass (4% vs 19%, P=0.003).
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