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Summary

The cardiopulmonary bypass (CPB) circuit must be primed with a fluid solution. The volume of prime required is either based on a standard empirically derived volume greater than a minimum safe priming volume, or may be guided by the patient's weight or body surface area. The initial hematocrit (HCT) achieved after initiation of CPB is determined by the volume of the prime in relation to the patient's pre-CPB HCT. There are many different recipes for priming solutions using crystalloid, colloid or blood as primary constituents. Blood was used to prime the CPB circuit in an attempt to preserve a high hematocrit; early in the evolution of CPB this was thought to be an important determinant for successful outcome. The idea of using oxygen-carrying solutions as blood substitutes may be an attractive means of maintaining oxygen delivery. They would address the expense, limited supply and disease transmission associated with blood transfusion.

Cardiopulmonary bypass in neonates is markedly different from the procedure used in children above 10 kg and in adults. There are two major reasons for this—first, the mismatch between the volume of the heart-lung machine circuit and that of the blood in the patient and second, the immaturity of tissues in the first three months of life.

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Chapter 10 - Deep hypothermic circulatory arrest

Summary

Continuous perfusion without hemodilution in neonates—the experience at the Marie Lannelongue Hospital

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Chapter 10 - Deep hypothermic circulatory arrest

Summary

Continuous perfusion without hemodilution in neonates—the experience at the Marie Lannelongue Hospital