Eda Balci1, Aslihan Aykut1, Asli Demir1, Kübra Vardar2, Gülsüm Karduz2, Uğur Aksu2
1 Anesthesiology and Reanimation Department, Ankara City Hospital, Ankara, Turkey
2 Department of Biology, Faculty of Science, The University of Istanbul, Istanbul, Turkey
Background: Although conventional cardiopulmonary bypass (cCPB) is still the most widely used method in open heart surgery, methods such as retrograde autologous priming (RAP) are increasingly popular in terms of limiting hemodilution. Our hypothesis is that the use of the RAP method in aortic surgery may result in a limitation of hemodilution and a decrease in fHb levels. For this purpose, plasma free hemoglobin (fHb) levels were investigated in adult open aortic arch repair with axillary artery cannulation patients using cCPB and rRAP methods.
Materials and Methods: In this study, a total of 36 patients undergoing aortic surgery using rRAP and standard cCPB were investigated. Measurements were performed at five time points: After induction of anesthesia, 5th minute of CPB, 10th minute of antegrade cerebral perfusion, 30th minute after declamping of aorta, and at sternum closure. Besides hemodynamic variables, arterial blood gas analysis and postoperative variables, patients were assessed for fHb levels.
Results: The rRAP group had a significantly lower increase in fHb levels in T3, T4, and T5 time points, when compared to the cCPB group (p = 0.002, 0.047, 0.009, respectively). There was no significant difference between the rRAP and cCPB groups in other intraoperative, and postoperative variables. Also, it was observed that rRAP did not make a difference in terms of blood and blood product transfusion.
Conclusion: In this study, in patients undergoing aortic surgery, a reduction in the increase of fHb was observed with the rRAP method which is a simple procedure that does not require high cost or advanced technology.
Ankara City Hospital, Anesthesiology and Reanimation Department, Universiteler District, Bilkent Street No: 1, Ankara
Source of Support: None, Conflict of Interest: None
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