Hejjel, Laszlo and Szluka, Gabor and Goeboeloes, Laszlo and Szabados, Sandor and Varga, Tamas and Mayer, Klara and Devay, Attila and Foltan, Maik and Ugocsai, Peter and Philipp, Alois (2010) Pharmacotechnological pitfalls of priming - possible source of microembolization during open heart surgery. PERFUSION-UK, 25 (1). pp. 5-7. ISSN 0267-6591, 1477-111X
Full text not available from this repository. (Request a copy)Abstract
Objectives: Besides low mortality and morbidity rates in cardiac surgery, the associated cognitive dysfunction is the focus of interest. One possible reason is microembolisation. Methods and results: The authors analysed the crystallogenesis in the calcium-containing prime, inspired by their observation that the fluid sometimes becomes turbid during the priming process. Lactated Ringer-based prime solutions were tested, adding mannitol, NaHCO3, and heparin. The oxygenator was ventilated with compressed medical air. Samples were taken for dynamic light scattering particulate level analysis. The priming was furthermore modelled in the laboratory by mixing the components and then ventilating the mixture through with compressed air. Turbid solutions from the operating room contained 100-6500 nm crystals, while clear solutions contained 20-473 nm particles. In the model, continuous pH measurement showed pH 6.4-7.4 after blending the solutions, which then elevated the pH to 7.5-8.0 after ventilation with concomitant turbidity. The pH of the prime can be stabilized by the addition of ascorbic acid (1-2 mg/ml) and, also, the turbidity may be prevented. Conclusion: Ventilating the lactated Ringer-based calcium-containing primes after blending is not advisible because of alkalization and crystallogenesis. Ascorbic acid stabilizes the pH and prevents crystallogenesis in the prime. Pre-bypass filtration is recommended.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | INJURY; microembolization; prime; cardiac surgery; crystallogenesis; cognitive dysfunction |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Klinische Chemie und Laboratoriumsmedizin |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 24 Aug 2020 07:50 |
| Last Modified: | 24 Aug 2020 07:50 |
| URI: | https://pred.uni-regensburg.de/id/eprint/25586 |
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