*Clinical Perfusionist, Department of Cardio-Thoracic and Vascular Surgery, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi
**Senior Perfusionist, Department of Cardio-Thoracic and Vascular Surgery, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi
***Additional Professor, Cardiac Anesthesia, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi
****Additional Professor, Cardio-Thoracic and Vascular surgery, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi
*****Professor, Cardiac Anesthesia, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi
******Professor and Head, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi
Online published on 1 December, 2014.
The issue of optimal priming solution for cardiopulmonary bypass is unclear. Colloids have the advantages of maintaining the colloid oncotic pressure and reducing tissue edema. However the use of colloids during coronary bypass surgery has been limited due to associated increase incidence of anaphylactoid reactions and clinical coagulopathy.
In this study we compared the effects of using 20% Albumin versus 6% Hydroxyethyl starch (HES) in the ratio of 1:5 and 1:2 respectively for the priming of CPB circuit in adult patients undergoing coronary artery bypass grafting (CABG).
Sixty patients of either sex in the range of 40–70 years of age undergoing CABG with the use of CPB were studied. The patients were randomly divided in following two groups (A & B). In group A (n=30), 20% Albumin solution with lactated Ringer's solution and in group B (n=30), 6% HES solution with lactated Ringer's solution was used for priming the CPB circuit.
All the surgeries were conducted by using same surgical, anesthetic and perfusion techniques. Various parameters compared between the two groups were Hb/HCT, PaO2, PaCO2, SO2 (%), urine output, serum Creatinine, blood urea, blood sugar, requirement of blood/blood products and requirement of any other additions like hemostatic agents.
Hospital mortality rate was zero in both the groups. However it was found that 6% hydroxyethyl starch can be used as an alternative along with Ringer's lactate in the ratio of 1:2 for priming the CPB circuit without any adverse effect or any contradiction. 6% HES is a safe alternative colloid for priming the cardiopulmonary bypass circuit and volume replacement in patients undergoing coronary artery bypass surgery as compared to 20% Albumin.
Cardiopulmonary Bypass, Priming solution, crystalloids and colloids, Albumin, Hydroxyethyl starch, inflammatory responses
