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Influence of hematocrit and pump prime on cerebral oxygen saturation in on-pump coronary revascularization

Kevin McCusker

Portsmouth Regional Hospital, NH, USA

Anthony Chalafant

Northeastern University, Boston, MA, USA

Gordon de Foe

Dartmouth Medical Center, Lebanon, NH, USA

Serdar Gunaydin

University of K. Kale, Turkey, sgunaydin{at}isnet.net.tr

Venkataramana Vijay

Tarrytown, New York, USA

Background: The couplings between cerebral oxygenation (rSO2), on-pump hematocrit and circuit prime are explored in this study.

Methods: Thirty-eight consecutive patients undergoing coronary revascularization with cardiopulmonary bypass (CPB) were matched on preoperative hematocrit < 40% and >40% (n=16). Similarly, six blood prime patients were matched with six crystalloid prime patients. Hematocrit and rSO2 levels were then compared on CPB.

Results: The pre-operative hematocrit >40% group retained higher levels on pump run (p < 0.01) and significantly higher rSO2 prior to CPB (64.8±9.6 versus 73.2±7.3), and on and off CPB (61.1±8.8 versus 67.4±6.4). Blood priming increased absolute rSO2 (2.3± 6.3 versus – 10.9±5.9) and% rSO2 (4.7±11.8 versus –14.2±7.4%) in the low hematocrit group.

Conclusion: Blood primes are instrumental in high-risk and low preoperative hematocrit patients in preventing cerebral oxygen desaturation during initiation and maintenance of CPB.

Perfusion, Vol. 21, No. 3, 149-155 (2006)
DOI: 10.1191/0267659106pf863oa
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S. Gunaydin, T. Sari, K. McCusker, U. Schonrock, and Y. Zorlutuna
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[Abstract] [PDF]