Group comparison study of cocktail prime versus plasmalyte-A as a CPB prime-it's effect on patient outcome

Since the advent of cardiopulmonary bypass, many efforts have been made to avoid the complications related with CPB. Any component of the pump participates in occurrence of these adverse events, one of which is the type of prime solution. Cardiopulmonary bypass priming solution and volume are of special importance since it directly affects post op organ. Functions, extubation time, bleeding and blood product usage. In this study, I aimed to compare the effects of Plasmalyte-A with Cocktail prime (0.9%Normal Saline, Halfnor (0.45% Normal Saline) and 6% voluven, on post-op outcomes following CABG and Valve replacement.

100 patients undergoing elective CABG (On pump) and single valve replacement were prospectively studied. The patients were randomized in to two groups,

25 CABG & 25 Valve replacements were primed with Plasmalyte-A (group 1),

25 CABG & 25 Valve replacementswere primed with Cocktail prime (0.9%Normal Saline, Halfnor (0.45% Normal Saline) and 6% voluven. The postoperative outcomes of the patients werestudied.

With a mean patient age of 56.44±10.24 years for Plasmalyte-A (group 1), 60.96± 7.37 years for cocktail prime (group 2). The genders were 65 male/35 female patients. Both groups didn't have any detrimental effects on renal function.in group1, less postoperative blood loss, less amount of blood and fresh frozen plasma used but in group 2, there was a statistical significant bleeding at 4^th to 8^th hour post operatively (p value=0.04), There was a significant blood transfusion in group 2 than group 1 (p value = 0.02), There was no significant difference of extubation time in two groups.

As per my study conclusion there was not much significant when used Plasmalyte-A (group 1), Cocktail prime (group 2) as a CPB prime, but in CABG cases the bleeding was significantly high in Cocktail prime (group 2) compared to Plasmalyte-A (group 1). There was significant amount of blood and blood products (FFP & Platelets) were used in Cocktail prime (group2) compare to PLASMALYTE-A (group1). Based upon the statistical data and results we conclude that PLASMALYTE-A IS SUPERIOR TO COCKTAIL PRIME as a CPB prime solution.