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Chapter 5 - Priming Solutions for Cardiopulmonary Bypass Circuits

Published online by Cambridge University Press:  24 October 2022

By
Filip De Somer  and
Robert Young
Edited by
Florian Falter ,
Albert C. Perrino, Jr  and
Robert A. Baker
Florian Falter
Affiliation:
Royal Papworth Hospital, Cambridge
Albert C. Perrino, Jr
Affiliation:
Yale University Medical Center, Connecticut
Robert A. Baker
Affiliation:
Flinders Medical Centre, Adelaide
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Summary

The composition of the fluid used to prime cardiopulmonary bypass (CPB) circuits has been a source of great interest and debate ever since the inception of cardiopulmonary bypass in 1953. There has been significant progress in our understanding, but the ideal priming solution has still to be agreed upon and practice continues to vary widely between cardiac units. Circuits must be carefully de-aired with a compatible priming solution in order to prevent gas emboli from passing into the patient’s circulation at the commencement of CPB. Crystalloid and colloid priming solutions are now commonplace.

Keywords

HemodilutionCrystalloid solutionsColloid SolutioinsElectrolyte ManagementOsmolarityPriming Additives
Type
Chapter
Information
Cardiopulmonary Bypass , pp. 42 - 48
Publisher: Cambridge University Press
Print publication year: 2022

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References

Suggested Further Reading

Miles, L, Coulson, T, Galhardo, C et al. Pump priming practices and anticoagulation in cardiac surgery: Results from the Global Cardiopulmonary Bypass Survey. Anesth Analg 2017; 125(6): 1871–1877.CrossRefGoogle ScholarPubMed
Ranucci, M, Conti, D, Castelvecchio, S et al. Haematocrit on cardiopulmonary bypass and outcome after cardiopulmonary surgery in nontransfused patients. Ann Thorac Surg 2010; 89: 11–18.Google Scholar
Ranucci, M, Johnson, I, Willcox, T et al. Goal-directed perfusion to reduce acute kidney injury: A randomized trial. J Thorac Cardiovasc Surg; 2018: 156: 1918–1927.e2.CrossRefGoogle ScholarPubMed
Kunst, G, Milojevic, M, Boer, C et al. 2019 EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery. Br J Anaesth 2019; 123 (6): 713–757.CrossRefGoogle ScholarPubMed
Najmaii, S, Redford, D, Larson, D. Hyperglycemia as an effect of cardiopulmonary bypass: Intra-operative glucose management. J Extra Corpor Technol 2006: 38(2); 168–173.CrossRefGoogle ScholarPubMed
Munoz, E, Briggs, H, Tolpin, D et al. Low serum sodium during cardiopulmonary bypass predicts increased risk of postoperative stroke after coronary artery bypass graft surgery. J Thorac Cardiovasc Surg 2014; 147: 1351–1355.CrossRefGoogle ScholarPubMed
Polderman, K, Girbes, R. Severe electrolyte disorders following cardiac surgery: A prospective controlled observational study. Crit Care 2004; 8: 459–466.CrossRefGoogle ScholarPubMed
Waskowski, J, Pfortmueller, A, Erdoes, G et al. Mannitol for the prevention of peri-operative acute kidney injury: A systematic review. Eur J Vasc Endovasc Surg 2019; 58(1): 130–140.CrossRefGoogle ScholarPubMed
Whitlock, R, Devereaux, J, Teoh, K et al. Methylprednisolone in patients undergoing cardiopulmonary bypass (SIRS): A randomised, double-blind, placebo-controlled trial. Lancet 2015; 386: 1243–1253.Google Scholar
Canaday, S, Rompala, J, Rowles, J et al. Chronic severe hyponatremia and cardiopulmonary bypass: Avoiding osmotic demyelination syndrome. J Extra Corpor Technol. 2015;47(4): 228–230.Google Scholar

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