Severdija E E, Heijmans J H, Theunissen M, Maessen J G, Roekaerts P H, Weerwind P W
Department of Cardiothoracic surgery, Maastricht University Medical Centre and CARIM Cardiovascular Research Institute Maastricht, P. Debyelaan 25, Maastricht, the Netherlands.
Perfusion. 2011 Jul;26(4):315-21. doi: 10.1177/0267659111408379. Epub 2011 May 18.
The hypothesis was tested whether retrograde autologous priming (RAP) of the cardiopulmonary bypass system, compared to a standard primed system (NON-RAP group), results in less haemodilution and less transfusion of packed red blood cells. Retrospectively, data was collected from the medical charts of one hundred patients undergoing elective coronary artery bypass grafting using cardiopulmonary bypass. Fifty patients where RAP was used have been compared to fifty patients using NON-RAP. The prime volume in the NON-RAP group was 1,627±108 mL versus 782±96 mL in the RAP group (p<0.001). The lowest haematocrit during perfusion was 22% in the NON-RAP group versus 26% when the RAP technique was used (p<0.001). In the NON-RAP group, 26% of the patients received packed red cells in contrast to 6% in the RAP group (p<0.012). A positive association was found between RAP and less transfusion of packed red blood cells (p<0.012). In conclusion, retrograde autologous priming, reducing the prime volume of the cardiopulmonary bypass system, causes less haemodilution and reduces intraoperative transfusion of packed red blood cells.
与标准预充系统（非逆行自体预充组）相比，体外循环系统的逆行自体预充（RAP）是否能减少血液稀释及浓缩红细胞的输注。回顾性地从100例行择期冠状动脉搭桥术并使用体外循环的患者病历中收集数据。将50例使用RAP的患者与50例使用非RAP的患者进行比较。非RAP组的预充量为1,627±108 mL，而RAP组为782±96 mL（p<0.001）。灌注期间的最低血细胞比容在非RAP组为22%，而使用RAP技术时为26%（p<0.001）。在非RAP组中，26%的患者接受了浓缩红细胞输注，而RAP组为6%（p<0.012）。发现RAP与较少的浓缩红细胞输注之间存在正相关（p<0.012）。总之，逆行自体预充减少了体外循环系统的预充量，导致较少的血液稀释并减少了术中浓缩红细胞的输注。
