Horisberger J, Jegger D, Boone Y, Seigneul I, Pierrel N, Hurni M, Corno A F, von Segesser L K
Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Perfusion. 1999 Sep;14(5):351-6. doi: 10.1177/026765919901400506.
Reduction of priming volumes of the cardiopulmonary bypass (CPB) circuit in neonatal cardiac surgery to decrease haemodilution and blood transfusion requirements can be achieved with the use of neonatal low prime oxygenators and smaller diameter tubing. We have further reduced our prime volume with the use of a custom-designed arm allowing for remote positioning of a double-headed roller pump. This arm enables the double pump to be placed alongside the main heart-lung machine close to the operating table, and to position the pump inlet and outlet tubing immediately at the reservoir outlet and oxygenator inlet, respectively, therefore reducing tubing lengths. Priming volumes of four cases using this configuration were compared to four cases using our standard neonatal bypass setup. Results showed a 29% decrease in priming volume and a 58% reduction in blood utilization during CPB. This reduction in priming volume is clinically significant as it lowers the ratio of priming volume to patient blood volume and reduces homologous blood requirements.
在新生儿心脏手术中，使用新生儿低预充氧合器和更细直径的管道，可减少体外循环（CPB）回路的预充量，从而降低血液稀释程度和输血需求。我们通过使用定制设计的臂架进一步减少了预充量，该臂架可实现双头滚压泵的远程定位。此臂架能使双泵放置在靠近手术台的主心肺机旁，并将泵的进、出管道分别直接置于储液器出口和氧合器入口处，从而缩短了管道长度。将使用此配置的4例手术的预充量与使用我们标准新生儿体外循环设置的4例手术进行了比较。结果显示，体外循环期间预充量减少了29%，血液用量减少了58%。预充量的这种减少具有临床意义，因为它降低了预充量与患者血容量的比例，并减少了同源血的需求。
