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Abstract

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.

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

Abstract

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