Modifying cardiopulmonary bypass (CPB) circuit’s priming technique before the onset of CPB in cardiac patients known with sickle-cell disease or sickle cell trait has been observed to be of substantial significance in dealing with such challenges without having any life-threatening consequences. We modified our routine heparinized crystalloid priming of the CPB circuit with partial exchange transfusion by adding donor blood (packed red blood cells), fresh frozen plasma (FFP), and bicarbonate. This has helped us bring down the overall sickle cell hemoglobin in the blood thereby reducing its risk of sickling.
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References
1.
GaryOwensGM. New horizons in the management of sickle cell disease (SCD): What managed care needs to know about novel therapies in an evolving treatment paradigm. In: Sickle Cell Disease Monograph; 2019, www.namcp.org. Jeremy Williams, Virginia, United Status.
ShahPKhaleelMThuptimdangW, et al. Mental stress causes vasoconstriction in subjects with sickle cell disease and in normal controls. Haematologica2020; 105(1): 83–90.
FarrellKDentLNguyenM L, et al. The relationship of oxygen transport and cardiac index for the prevention of sickle cell crises. J Natl Med Assoc2010; 102(11): 1000–1008.
6.
StanleyACChristianJM. Sickle cell disease and perioperative considerations: review and retrospective report. J Oral Maxillofacial Surg2013; 71(6): 1027–1033.
Chacon-PortilloMAMossadEBZea-VeraR, et al. Sickle cell-related complications in patients undergoing cardiopulmonary bypass. World J Pediatr Congenit Heart Surg2020; 11(5): 565–571.
9.
AliJMBesserMGoddardM, et al. Catastrophic sickling crisis in patient undergoing cardiac transplantation with sickle cell trait. Am J Transplant2019; 19(8): 2378–2382.
10.
ThogmartinJRWilsonCIPalmaNA, et al. Sickle cell trait-associated deaths: a case series with a review of the literature. J Forensic Sci2011; 56(5): 1352–1360.
11.
MennesIVan de VeldeMMissantC. Sickle cell anaemia and the consequences on the anaesthetic management of cardiac surgery. Acta Anaesthesiologica Belgica2012; 63(2): 81–89.
12.
BalasundaramSKassayMDuranC. A safe technique for cardiopulmonary bypass in sickle cell disease. Perfusion1990; 5(4): 291–295.
13.
EgrieGWoodsonKAlphonsoN, et al. A child with sickle cell disease and anomalous right coronary artery. Ann Thorac Surg2007; 84(6): 2114–2116.
14.
MathurGTen EyckPKnudsonC M. Predicting changes in hemoglobin S after simple transfusion using complete blood counts. Transfusion2018; 58(1): 138–144.
15.
CrawfordTCCarterMVPatelRK, et al. Management of sickle cell disease in patients undergoing cardiac surgery. J Card Surg2017; 32(2): 80–84.
16.
CalafioreAMTeodoriGMezzettiA, et al. Intermittent antegrade warm blood cardioplegia. Ann Thorac Surg1995; 59(2): 398–402.
17.
SachithanandanANanjaiahPWrightCJ, et al. Mitral and tricuspid valve surgery in homozygous sickle cell disease: perioperative considerations for a successful outcome. J Card Surg2008; 23(2): 167–168.
18.
SandersDSmithBSowellS, et al. Sickle cell disease and complex congenital cardiac surgery: a case report and review of the pathophysiology and perioperative management. Perfusion2014; 29(2): 153–158.