TechniqueArticle

Neonatal Cardiopulmonary Bypass Circuit Blood Prime Quality Analysis

^* Department of Cardiovascular Perfusion, Cincinnati Children’s Hospital Medical Center, and ^‡ Division of Cardiothoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
^† Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio

Address correspondence to: Barbara B. Hendrix, CCP, The Heart Institute Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 2004 Cincinnati, OH 45229. E-mail: barbara.hendrix@cchmc.org

Received: 4 March 2021
Accepted: 4 May 2021

Abstract

Blood-primed cardiopulmonary bypass circuits are frequently necessary to achieve safe support during pediatric open-heart surgery. Literature is lacking regarding suitable prime constituents or methods for achieving a physiologically appropriate blood-primed circuit. We examined the chemistry and hematology of neonatal blood-primed circuits from the conclusion of the priming procedure until the initiation of bypass. Base deficit/excess, pH, pO₂, pCO₂, HCO₃, glucose, sodium, potassium, calcium, hematocrit, lactate, and osmolality were analyzed. Any deviation over time from the original prime value was compared for significance. Statistically significant changes were found between T0 and all time points for all parameters, except for pH and pO₂ out to 1 hour. Among all parameters, various rates of change were observed. Although most changes in the parameters were found to be statistically significant, those changes may not be clinically significant based on clinician interpretation. Attention to the prime quality beyond the immediate post-priming period may be beneficial. Should the time period between validation of the prime quality and initiation of bypass be extended, it may be advisable to reevaluate the prime quality.