Effects of priming volume reduction on allogeneic red blood cell transfusions and renal outcome after heart surgery

Marco Ranucci, V. Pistuddi, G. Carboni, M. Cotza, A. Ditta, A. Boncilli, S. Brozzi, G. Pelissero

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Excessive hemodilution during cardiopulmonary bypass (CPB) is associated with an increased rate of red blood cell (RBC) transfusion and acute kidney injury (AKI). Minimization of the oxygenator priming volume is a measure to contain hemodilution. In this study, we evaluated the new oxygenator, Sorin Inspire 6™, with respect to its ability to limit hemodilution, RBC transfusion rate and postoperative AKI rate. Methods; A retrospective study on a consecutive series of 1,724 adult patients receiving heart surgery with CPB. Patients treated with the Inspire 6™ were assigned to the low priming volume oxygenator (LPVO) group (N=383) and patients treated with conventional oxygenators to the conventional group (N=1,341). Dynamic priming volume, time course of the hematocrit, RBC transfusions and AKI rate were compared between the groups. Results; Priming volume was significantly (p=0.001) lower in the LPVO group (624±113 mL) vs. the conventional group (775±150 mL), with higher values of hematocrit during and after CPB. After correction for other confounders, patients in the LPVO group had a significantly lower RBC transfusion rate (odds ratio 0.68, 95% confidence interval 0.52-0.90, p=0.006) and AKI rate (odds ratio 0.55, 95% confidence interval 0.32-0.93, p=0.032). Conclusion: The Inspire 6™ oxygenator allows a significant containment of hemodilution during CPB, reducing the risk of RBC transfusions and postoperative AKI.

Original languageEnglish
Pages (from-to)120-126
Number of pages7
JournalPerfusion
Volume30
Issue number2
DOIs
Publication statusPublished - Mar 16 2015

Keywords

  • acute kidney injury
  • cardiopulmonary bypass
  • hemodilution
  • outcome
  • transfusions

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Advanced and Specialised Nursing
  • Safety Research
  • Medicine(all)

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