A safe technique for cardiopulmonary bypass in sickle cell disease

Abstract

The use of exchange transfusion at the beginning of cardiopulmonary bypass (CPB) in five cases of sickle cell anaemia is described. The patient's circulating blood volume was drained into a bag through side tubing attached to the venous drainage line. Cardiopulmonary bypass was started with a prime consisting of donor packed cells, fresh frozen plasma, 25% albumin, lactated Ringer's solution, sodium bicarbonate and heparin. Moderate hypothermia, aortic crossclamping, topical hypothermia and cold crystalloid cardioplegia were used in all cases. The drained blood was spun down and the serum containing normal platelets and clotting factors was retransfused to the patient at the end of the operation. All five patients survived the procedure without complications and no homologous blood transfusion was required.

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References

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