We used to add Voluven to priming solution of cardiopulmonary bypass in adult cardiac coronary patients since five years ago. Now we want to omit Voluven to have a complete crystalloid prime with lactated ringer. What is your experience in daily practice. It seems that literature is not conclusive about Voluven.
Dear Ervin Severdija
Many thanks for your response. Your approach for retrograde autologous priming is very interesting. we have used it in our anemic patients with favorable results. it prevented us from giving many packed cell units if any to these patients.
However, I wonder if we can use lactated ringer as it reduces the need for NaHCO3 in priming solution. Besides, what's the rationale for using Albumine in priming solution as it is an expensive human product and studies have shown no harm with omitting it:
http://ats.ctsnetjournals.org/cgi/content/full/72/3/850
I found another systematic review about the effect of hydroxyethyl starch (HES) 130/0.4 on hemostasis which shows that it's not superior to crystaloids and other colloids:
http://link.springer.com/content/pdf/10.1007%2Fs00134-011-2385-z
Of course, there is no evidence supporting priority of newer HES (Voluven) over other colloids used in priming solution regarding bleeding tendency:
http://www.ncbi.nlm.nih.gov/pubmed/20056447
با سلام استفاده از کلوییدها در پرایم طبق اطلاعیه سازوان اف - دی - ای امریکا باعث افزایش مورتالیته خواهد شد. وممنوع شده است. این مطلب در سایت آن سازمان در بخش داروها وجود دارد. اما در اطفال هنوزمنع نشده است. حسن رحیمی [email protected].
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