Issue |
J Extra Corpor Technol
Volume 17, Number 3, September 1985
|
|
---|---|---|
Page(s) | 96 - 102 | |
DOI | https://doi.org/10.1051/ject/1985173096 | |
Published online | 13 September 2023 |
Original Article
Evaluation of Blood Cardioplegia Administration Systems
1
Division of Cardiovascular Surgery, Department of Surgery, North Shore University Hospital, Manhasset, NY
2
Department of Surgery, Cornell University Medical College, NY
* Direct communications to: Yehuda Tamari, M.S., Division of Cardiovascular Surgery, North Shore University Hospital, Manhasset, NY 11030
Four different blood cardioplegia administration systems (CAS) were evaluated for ease of use, cooling capacity, uniformity of mixing and blood flow capability. The CAS were one single pass (SP) and three recirculating CAS (RC). Each of the RC had a different reservoir; the first a cardiotomy reservoir (CARD), the second a transfer bag, and the third the GISH system.
Each CAS was primed and debubbled with crystalloid. For RC, blood was collected, potassium added, and the solution cooled to 10°C. With SP, the infusate temperature at the field was measured at different flows and oxygenator temperatures. Hematocrit and potassium were measured at the start and end of cardioplegia administration.
Single pass had the least tubing, lowest priming volume and the simplest design. For RC, l0°C infusate temperature was obtained fastest with the heat exchanger at the pump outlet and slowest at the reservoir inlet. For SP, the temperature at the field increased as either the oxygenator temperature and/or the cardioplegia flow rate increased. Only RC with CARD produced nonuniform mixing (initial potassium and hematocrit compared to the end of infusion were 16 percent lower and 36 percent higher respectively). At 10°C infusate temperature, RC allowed higher flow rates than SP. The GISH administration tubing had high resistance (800 mmHg at 500 mllmin).
GISH is flow-limited by resistance and SP by cooling capacity. Clinically, if oxygenator temperature and infusion flows are such that SP can be used it is preferred. Otherwise, RC with low resistance tubing and heat exchanger within the reservoir is optimal.
© 1985 AMSECT
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