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paediatric priming

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jaganmohan View Drop Down
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Joined: May 04 2007
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  Quote jaganmohan Quote  Post ReplyReply bullet Topic: paediatric priming
    Posted: May 04 2007 at 2:28am
hi,iam jaganmohan.i am going to finish postgraduate diploma in perfusiontechnology in apollo hospital,chennai,india.i want with explanation about priming,priming fluids and muf&cuf? plz give details.  
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asmar View Drop Down
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  Quote asmar Quote  Post ReplyReply bullet Posted: May 08 2007 at 8:24am

500ml of plasmalyte,50cc of 25%human albuman, unit of blood,soluemedrol,cefazolin

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ZAMZAMI View Drop Down
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  Quote ZAMZAMI Quote  Post ReplyReply bullet Posted: May 09 2007 at 8:11am
prime : 1st 500cc of lactated ringer (L/R) or plasmalyte is used to prime your circuit then drain the reservoir till minimum level, 2nd add 100cc of 20% human albumin to coat the circuit, 3rd 2000 iu of Heparin in prime along with 3cc/kg of 20% mannitol , 20cc of NaHCO3, 50CC/KG CEFAZOLIN
then when all that is circulated you add blood accordingly to your hematocrit calculation .thats about the prime now we go to the modified ultrafiltration.
it's a teqnique used after comming of bypass in peds to bring the Hgb up ad to get ride of extrafluid and hyperkalemia if using a blood cardioplegia.
CUF: which is a conventional ultrafiltration where you can use to filtrate extrafluid during adult and ped cardiac surgeries.
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Kuzima View Drop Down
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  Quote Kuzima Quote  Post ReplyReply bullet Posted: Oct 10 2007 at 3:44am
Hi!
I think the important is that prime depends of the weight and age of the child.
Usually (approx)- albumin 10% 10 cc/kg, mannit 10 cc/kg, Na-hidrocarbonate 5-10 cc/kg, RBC - depends of preoperative hematocrit - to make the intraoperative Ht 25-29, aprotinin - depends of the institution protols.
   Your comments, pls.
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RANA M WASEEM View Drop Down
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  Quote RANA M WASEEM Quote  Post ReplyReply bullet Posted: Nov 02 2007 at 2:05am
cuf is convential ultrafiltration that is done during surgery to remove extra water  inflammatory mediators etc  collect blood from arterial outlet pass it from the pump to the haemoconcentrator
that haemoconcentrate the blood n pass it  back in venous reserviour
similarey muf modified ultrafiltration done after bypass collect blood from arterial liine n pass it  into patient through venous cannulaEmbarrassed
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noridzalis View Drop Down
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  Quote noridzalis Quote  Post ReplyReply bullet Posted: Nov 23 2007 at 12:48am
using Medtronic Minimax plus oxygenator, 1/4 x 1/4 tubing:
1. 400 plasmalyte
2. 50cc 20% albumin (x2 if no blood is added)
3. 10% mannitol (based on bw)
4. 300cc packed cell (<10kg, MUST use leukocyte filter)
5. 30cc NaHCO3 (10cc for every 100cc blood)
 
this priming solution will fill up the whole tubing including bld cardioplegia circuit (in condition that the tubing is already shortened). heparin is added 3000IU. however, when using 3/8 x 1/4 tubing, need to add around 100cc plasmalyte.
 
usually the level of this priming solution is slightly above my safety level (80cc) which is my purpose to do so to prevent hemodilution that will affect the BP during initiation of CPB. however, must remember to ALERT the level sensor to prevent air embolism.
 
When using terumo baby RX, the total of priming volume is around 400cc (include everything mentioned above)
 


Edited by noridzalis - Nov 23 2007 at 12:53am
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