Original Article

Comparison of Two Colloid Constituents in Prime Solutions and the Effect on Blood Loss Following Cardiopulmonary Bypass

Cooper Hospital/University Medical Center, School of Cardiovascular Perfusion, Camden, NJ

^* Address correspondence to: Anthony J. DelRossi, M.D., Department of Surgery, Division of Cardiothoracic Surgery, Three Cooper Plaza, Suite 411, Camden, NJ 08103

Abstract

A retrospective study was conducted on a population of 24 patients who had undergone coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB). This population is divisible into two groups that differ in prime constituents. Group A used 500cc of 6% Hydroxyethyl starch (Hespan) as the colloid, and Group B used 150cc of 25% albumin. No statistically significant differences were found in the preoperative demographics. All of these cases were done using the same perfusion technique and equipment. Intraoperative values displayed levels of significant difference (p <.05) between the two groups with respect to 1) bypass platelet count; and 2) greater usage of protamine in Group A.

Group A Hespan = Platelet count x 1000/ml was 99.90+/-32.4, Blood loss (cc's) was 1033.3+/-305.5, Protamine:Heparin ratio was 1.41:1.0 +/- .37

Group B Albumin = Platelet count x 1000/ml was 153.84 +/- 34.17; Blood loss was 929.6+/- 105.4; Protamine:Heparin ratio was 1.01:1.0 +/- .43

In the postoperative phase which ended when the chest tube was removed, levels of significant difference were as follows:

Group A Hespan = Platelet Ct.#2 x 1000/ml was 124.87 +/- 30.62, Blood loss (cc's) was 1390.25 +/- 405.78, PPF Admin. ratio was 1417 +/- 506.32.

Group B Albumin= Platelet count x 1000 ml was 159.71 +/- 41.22; Blood loss= 1087.0 +/- 385.72, PPF Admin. ratio was 875 +/- 291.94.

From this study it seems as though there are two factors contributing to the increased blood loss seen in Group A that may result from Hespan usage - the intraoperative and postoperative decreased platelet count and the increased amount of protamine used. Furthermore, Group A patients required substantially more PPF postoperatively.