Ratliff Todd M, Burnside Jeffery L, Hodge Ashley B, Naguib Aymen N, Gomez Daniel
The Heart Center at Nationwide Children's Hospital, Columbus, Ohio; and.
Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio.
J Extra Corpor Technol. 2018 Jun;50(2):113-116.
Many blood conservation techniques and strategies have been implemented to aid in decreasing the use of allogenic blood utilization during pediatric cardiothoracic surgery. Use of techniques, such as acute normovolemic hemodilution, retrograde autologous prime, venous autologous prime, and autotransfuion, may lead to a decrease in the need for allogenic blood products. Autotransfusion has become a standard of care for all cardiothoracic surgical procedures requiring cardiopulmonary bypass (CPB). Although widely used, there is still debate over which wash solution will produce the most physiologically normal autotransfusion product. Pediatric patients can be at a higher risk for electrolyte imbalance intraoperatively and postoperatively. In an attempt to minimize this, we sought out to evaluate three different wash solutions and how they would affect the final autotransfusion product. This comparison consisted of three wash solutions; .9% sodium chloride, Normosol-R, and Plasma-Lyte A. Based on the evaluation of all wash solutions, Plasma-Lyte A produced the most physiological normal final autotransfusion product in regards to electrolytes.
许多血液保护技术和策略已被应用于减少小儿心胸外科手术中异体血的使用。采用急性等容血液稀释、逆行自体预充、静脉自体预充和自体输血等技术,可能会减少对异体血制品的需求。自体输血已成为所有需要体外循环(CPB)的心胸外科手术的标准治疗方法。尽管自体输血被广泛应用,但对于哪种冲洗液能产生最接近生理状态的自体输血产物仍存在争议。小儿患者在术中和术后发生电解质失衡的风险可能更高。为了尽量减少这种情况,我们试图评估三种不同的冲洗液以及它们对最终自体输血产物的影响。这种比较包括三种冲洗液:0.9%氯化钠、Normosol-R和Plasma-Lyte A。基于对所有冲洗液的评估,就电解质而言,Plasma-Lyte A产生的最终自体输血产物最接近生理状态。