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Intentional Hemodilution: 500 Consecutive Cases of Open-Heart Procedures

Intentional Hemodilution: 500 Consecutive Cases of Open-Heart Procedures Abstract BLOOD procurement for extracorporeal circuit priming has posed significant problems to workers in open-heart surgery. From the inception of this new surgical modality, attempts have been made to reduce or completely do away with the priming requirements of various pump oxygenators. In 1959, Panico7 developed a bubble oxygenator in which blood was not used as the priming material; instead physiologic saline was used. From his results and observations, there evolved the concept of hemodilution. Zuhdi,11 Roe,9 Cooley,2 DeWall,3 and Long5 used this technique with various perfusates as prime for the basic bubble oxygenators. Being initially a low-prime system, it was found readily adaptable to their purpose. Despite the large volume of perfusate necessary to prime a rotating disc oxygenator, it has been shown by Raison,8 Ablaza et al,1 Hellstrom,4 and recently Neville6 that hemodilution is also feasible with this type References 1. Manufactured by Pharmachem Inc., Bethlehem, Pa. 2. Abbott Laboratories, Chicago, Illinois. 3. Ablaza, S.G.G., et al: Intentional Hemodilution: Use of a Rotating Disc Oxygenator Primed With Acid Citrate Dextrose Blood and Low Molecular Weight Dextran: A Preliminary Report , Arch Surg 87:548, 1963.Crossref 4. Cooley, D.A.; Beall, A.C., Jr.; and Grondin, P.: Open-Heart Operations With Disposable Oxygenators, 5% Dextrose Prime and Normothermia , Surgery 12:713, 1962. 5. DeWall, R.A.; Lillehei, R.C.; and Sellors, R.D.: Hemodilution Perfusion for Open-Heart Surgery , New Eng J Med 266:1078, 1962.Crossref 6. Hellstrom, G., and Bjork, V.O.: Hemodilution With Rheomacrodex During Total Body Perfusion , J Thorac Cardiov Surg 45:39, 1963. 7. Long, D.M., Jr., et al: The Use of Low Molecular Weight Dextran and Serum Albumin as Plasma Expanders in Extracorporeal Circulation , Surgery 50:12, 1961. 8. Neville, W.E., et al: Clinical Experience With Buffered Ringer's Lactate Solution for Total Prime of the Disc Oxygenator During Cardiopulmonary Bypass , J Thorac Cardiov Surg 43:101, 1964. 9. Panico, F.G., and Neptune, W.B.: A Mechanism to Eliminate Donor Blood Prime From the Pump-Oxygenator , Surg Forum 10:605, 1960. 10. Raison, J.C.A.: A Clinical Report of the Use of Low Molecular Weight Dextran and Rotating Oxygenator , Thorax 17:338, 1962.Crossref 11. Roe, B.B.; Hepps, S.A.; and Swenson, E.E.: Hemodilution With and Without Low-Mole Dextran: Laboratory Studies and Clinical Experience , Circulation 28:792, 1963. 12. Wells, R.E., Jr.: Rheology of Blood in the Microvasculature , New Eng J Med 270:889, 1964.Crossref 13. Zuhdi, N., et al: Double Helical Reservoir Heart-Lung Machine : Arch Surg 82:320, 1961.Crossref 14. Zuhdi, N., et al: Comparative Merits and Results of Primes of Blood and Five Per Cent Dextrose in Water for Heart-Lung Machines: Analysis of 250 Patients , J Thorac Cardiov Surg 47:66, 1964. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Intentional Hemodilution: 500 Consecutive Cases of Open-Heart Procedures

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References (14)

Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1965.01320180027007
Publisher site
See Article on Publisher Site

Abstract

Abstract BLOOD procurement for extracorporeal circuit priming has posed significant problems to workers in open-heart surgery. From the inception of this new surgical modality, attempts have been made to reduce or completely do away with the priming requirements of various pump oxygenators. In 1959, Panico7 developed a bubble oxygenator in which blood was not used as the priming material; instead physiologic saline was used. From his results and observations, there evolved the concept of hemodilution. Zuhdi,11 Roe,9 Cooley,2 DeWall,3 and Long5 used this technique with various perfusates as prime for the basic bubble oxygenators. Being initially a low-prime system, it was found readily adaptable to their purpose. Despite the large volume of perfusate necessary to prime a rotating disc oxygenator, it has been shown by Raison,8 Ablaza et al,1 Hellstrom,4 and recently Neville6 that hemodilution is also feasible with this type References 1. Manufactured by Pharmachem Inc., Bethlehem, Pa. 2. Abbott Laboratories, Chicago, Illinois. 3. Ablaza, S.G.G., et al: Intentional Hemodilution: Use of a Rotating Disc Oxygenator Primed With Acid Citrate Dextrose Blood and Low Molecular Weight Dextran: A Preliminary Report , Arch Surg 87:548, 1963.Crossref 4. Cooley, D.A.; Beall, A.C., Jr.; and Grondin, P.: Open-Heart Operations With Disposable Oxygenators, 5% Dextrose Prime and Normothermia , Surgery 12:713, 1962. 5. DeWall, R.A.; Lillehei, R.C.; and Sellors, R.D.: Hemodilution Perfusion for Open-Heart Surgery , New Eng J Med 266:1078, 1962.Crossref 6. Hellstrom, G., and Bjork, V.O.: Hemodilution With Rheomacrodex During Total Body Perfusion , J Thorac Cardiov Surg 45:39, 1963. 7. Long, D.M., Jr., et al: The Use of Low Molecular Weight Dextran and Serum Albumin as Plasma Expanders in Extracorporeal Circulation , Surgery 50:12, 1961. 8. Neville, W.E., et al: Clinical Experience With Buffered Ringer's Lactate Solution for Total Prime of the Disc Oxygenator During Cardiopulmonary Bypass , J Thorac Cardiov Surg 43:101, 1964. 9. Panico, F.G., and Neptune, W.B.: A Mechanism to Eliminate Donor Blood Prime From the Pump-Oxygenator , Surg Forum 10:605, 1960. 10. Raison, J.C.A.: A Clinical Report of the Use of Low Molecular Weight Dextran and Rotating Oxygenator , Thorax 17:338, 1962.Crossref 11. Roe, B.B.; Hepps, S.A.; and Swenson, E.E.: Hemodilution With and Without Low-Mole Dextran: Laboratory Studies and Clinical Experience , Circulation 28:792, 1963. 12. Wells, R.E., Jr.: Rheology of Blood in the Microvasculature , New Eng J Med 270:889, 1964.Crossref 13. Zuhdi, N., et al: Double Helical Reservoir Heart-Lung Machine : Arch Surg 82:320, 1961.Crossref 14. Zuhdi, N., et al: Comparative Merits and Results of Primes of Blood and Five Per Cent Dextrose in Water for Heart-Lung Machines: Analysis of 250 Patients , J Thorac Cardiov Surg 47:66, 1964.

Journal

Archives of Surgery – American Medical Association

Published: Dec 1, 1965

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