State Key Laboratory of Cardiovascular Disease, Department of Cardiopulmonary Bypass, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Artif Organs. 2020 Jan;44(1):58-66. doi: 10.1111/aor.13561. Epub 2019 Oct 7.
Our aim was to explore the effect of two different priming strategies (artificial colloid only vs. artificial colloid combined with human serum albumin) on the prognosis of children weighing less than 5 kg undergoing on-pump congenital heart disease (CHD) surgery. A total of 65 children weighing less than 5 kg who underwent on-pump CHD surgery in our hospital from September 2016 to December 2017 were enrolled in this study. The children were randomly divided into two groups: artificial colloid priming group (AC group, n = 33) and artificial colloid combined albumin priming group (ACA group, n = 32). The primary clinical endpoint was the peri-CPB colloid osmotic pressure (COP). Secondary clinical endpoints included perioperative blood product and hemostatic drug consumption, postoperative renal function, coagulation function, postoperative renal function, and postoperative recovery parameters. COP values were not significant in the priming system as well as peri-CPB time points between the two groups (P > .05). Platelet consumption in the AC group was significantly lower than that in the ACA group (P < .05). There were no significant differences in the use of other blood products and hemostatic drugs as well as perioperative coagulation parameters between the two groups (P > .05). Postoperative length of stay in the AC group was significantly lower than that in the ACA group (P < .05). There were no significant differences in mortality, postoperative mechanical ventilation time, ICU time, and perioperative adverse events (including postoperative AKI) occurrences between the two groups (P > .05). In the on-pump cardiac surgeries of patients weighing less than 5 kg, total colloidal priming would not affect peri-CPB COP values, postoperative coagulation function, and blood products consumption. Total artificial colloidal priming strategy is feasible in low-weight patients.
我们的目的是探讨两种不同的预充策略（仅使用人工胶体与人工胶体联合人血白蛋白）对体重小于 5kg 的体外循环先天性心脏病（CHD）手术患儿预后的影响。本研究共纳入 2016 年 9 月至 2017 年 12 月在我院接受体外循环 CHD 手术的 65 例体重小于 5kg 的患儿。将患儿随机分为两组：人工胶体预充组（AC 组，n=33）和人工胶体联合白蛋白预充组（ACA 组，n=32）。主要临床终点为体外循环期间胶体渗透压（COP）。次要临床终点包括围术期血液制品和止血药物的消耗、术后肾功能、凝血功能、术后恢复参数。两组预充系统及体外循环期间 COP 值均无显著差异（P＞.05）。AC 组血小板消耗明显低于 ACA 组（P＜.05）。两组围术期其他血液制品和止血药物的使用以及凝血参数无显著差异（P＞.05）。AC 组术后住院时间明显短于 ACA 组（P＜.05）。两组死亡率、术后机械通气时间、ICU 时间和围术期不良事件（包括术后 AKI）发生率均无显著差异（P＞.05）。在体重小于 5kg 的体外循环心脏手术中，总胶体预充不会影响体外循环期间 COP 值、术后凝血功能和血液制品消耗。总人工胶体预充策略在低体重患者中是可行的。
