Hematic Antegrade Repriming: A Reproducible Method to Decrease the Cardiopulmonary Bypass Insult.

The current practice of cardiopulmonary bypass (CPB) requires a preoperative priming of the circuit that is frequently performed with crystalloid solutions. Crystalloid priming avoids massive embolism but is unable to eliminate all microbubbles contained in the circuit. In addition, it causes a sudden hemodilution which is correlated with transfusion requirements and an increased risk of cognitive impairment. Several repriming techniques using autologous blood, collectively termed retrograde autologous priming (RAP), have been demonstrated to reduce the hemodilutional impact of CPB. However, the current heterogeneity in the practice of RAP limits its evidence and benefits. Here, we describe hematic antegrade repriming as an easy and reliable method that could be applied with any circuit in the market to decrease transfusion requirements, emboli, and inflammatory responses, reducing costs and the impact of CPB on postoperative recovery.

[1]  P. Farina,et al.  Description of the Minimized Extracorporeal Circuit to perform Haematic Antegrade Repriming in Cardiopulmonary Bypass , 2020 .

[2]  P. Farina,et al.  Haematic Antegrade Repriming procedure to initiate a safer cardiopulmonary bypass. , 2020 .

[3]  N. Barker,et al.  Vasoplegic syndrome following cardiothoracic surgery—review of pathophysiology and update of treatment options , 2020, Critical Care.

[4]  P. Weerwind,et al.  Retrograde autologous priming to reduce allogeneic blood transfusion requirements: a systematic review , 2020, Perfusion.

[5]  B. Ji,et al.  Vacuum-assisted venous drainage in adult cardiac surgery: a propensity-matched study. , 2019, Interactive cardiovascular and thoracic surgery.

[6]  D. Fitzgerald,et al.  2019 EACTS/EACTA/EBCP guidelines on cardiopulmonary bypass in adult cardiac surgery. , 2019, European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery.

[7]  Wei Gao,et al.  Correlation between acute degradation of the endothelial glycocalyx and microcirculation dysfunction during cardiopulmonary bypass in cardiac surgery. , 2019, Microvascular research.

[8]  K. Glogowski,et al.  Retrograde Autologous Priming Technique to Reduce Hemodilution during Cardiopulmonary Bypass in the Pediatric Cardiac Patient. , 2019, The journal of extra-corporeal technology.

[9]  M. Ranucci,et al.  Inflammation and coagulation following minimally invasive extracorporeal circulation technologies. , 2019, Journal of thoracic disease.

[10]  M. Horsfield,et al.  Perioperative Cerebral Microbleeds After Adult Cardiac Surgery , 2018, Stroke.

[11]  G. Myers,et al.  Endothelial Glycocalyx and Cardiopulmonary Bypass. , 2017, The journal of extra-corporeal technology.

[12]  E. Chung,et al.  Intraoperative Embolization and Cognitive Decline After Cardiac Surgery , 2016, Seminars in cardiothoracic and vascular anesthesia.

[13]  J. Vender,et al.  The Failure of Retrograde Autologous Priming of the Cardiopulmonary Bypass Circuit to Reduce Blood Use After Cardiac Surgical Procedures , 2004, Anesthesia and analgesia.

[14]  S. Karthikeyan,et al.  Retrograde autologous priming of the cardiopulmonary bypass circuit reduces blood transfusion after coronary artery surgery. , 2002, The Annals of thoracic surgery.

[15]  G. Hartman,et al.  Retrograde autologous priming for cardiopulmonary bypass: a safe and effective means of decreasing hemodilution and transfusion requirements. , 1998, The Journal of thoracic and cardiovascular surgery.

[16]  D. Dacar.  Continuous Blood Density Measurements and Volume Changes during Extracorporeal Circulation in Patients Undergoing Cardiac Surgery , 1995, The Thoracic and cardiovascular surgeon.

[17]  D. S. Martínez,et al.  Embolia: el enemigo silente. Estudio multicéntrico anónimo para la descripción de eventos embólicos evitables en circulación extracorpórea , 2018 .

[18]  A. Fiane,et al.  Measurement of gaseous microemboli in the prime before the initiation of cardiopulmonary bypass , 2018, Perfusion.

[19]  J. Pérez,et al.  To HAR or not to HAR. Identificación de predictores transfusionales en Circulación Exctracorpórea , 2016 .

[20]  A. Hoeft,et al.  [Cardiopulmonary bypass in cardiac surgery]. , 2012, Der Anaesthesist.

[21]  W. Neptune,et al.  A mechanism to eliminate the donor blood prime from the pump-oxygenator. , 1960, Surgical forum.