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Priming with blood

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ann-katrin.krokstrom View Drop Down
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Joined: Sep 12 2007
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  Quote ann-katrin.krokstrom Quote  Post ReplyReply bullet Topic: Priming with blood
    Posted: Jan 18 2009 at 6:26am
For pediatric cases, when you add blood to the prime, do you find it necessary to first prime the circuit with crystalloid solution(se perfusion guideline)? Why? If yoy use a coated oxygenator, does it better protect the red blood cells if the oxygenator is  initially primed with crystalloid solution?/Ann-katrin
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Prasannasimha View Drop Down
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  Quote Prasannasimha Quote  Post ReplyReply bullet Posted: Jun 21 2009 at 5:20am
It is better to first prime with crystalloid and run it especially if you use a prebypass filter. After this you can just drop the amount of blood that is required.
I try to practice near zero transfusion protocol for all my surgeries (at lesast above 10 kgs and we try hard between 5-10 Kgs. This requires decreasing  the size of the CPB circuit, vacuum assist  retorgrade priming and meticulous hemostasis and return of the whole blood amount post CPB back to the patient. If blood is to be added we try to add only that much which is required and try to limit transfusion exposure to minimum units preferably onlythe unit that was used on CPB which continues to beused if required post CPB and in the ICU and till discharge.
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dragosmodiga View Drop Down
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  Quote dragosmodiga Quote  Post ReplyReply bullet Posted: Sep 18 2009 at 4:21pm
 In order to better impregnate(soak if you like the term) the membrane and the filters,due to the different density and viscosity between cristalloid and different types of hematic primings, you should prefer to run the ECC first with cristalloid
                                                                                                      Dragos
 
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dragosmodiga View Drop Down
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  Quote dragosmodiga Quote  Post ReplyReply bullet Posted: Sep 18 2009 at 4:26pm
 This way " precondition" the membrane fibers and the filter to a higher permeability
                                                                                                                  Dragos
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