Influence of hematocrit and pump prime on cerebral oxygen saturation in on-pump coronary revascularization

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BackgroundThe couplings between cerebral oxygenation (rSO2), on-pump hematocrit and circuit prime are explored in this study.MethodsThirty-eight consecutive patients undergoing coronary revascularization with cardiopulmonary bypass (CPB) were matched on preoperative hematocrit <40% and >40% (n = 16). Similarly, six blood prime patients were matched with six crystalloid prime patients. Hematocrit and rSO2 levels were then compared on CPB.ResultsThe preoperative hematocrit >40% group retained higher levels on pump run (p <0.01) and significantly higher rSO2 prior to CPB (64.8 ± 9.6 versus 73.2 ± 7.3), and on and off CPB (61.1 ± 8.8 versus 67.4 ± 6.4). Blood priming increased absolute rSO2 (2.3 ± 6.3 versus −10.9 ± 5.9) and % rSO2 (4.7 ± 11.8 versus −14.2 ± 7.4%) in the low hematocrit group.ConclusionBlood primes are instrumental in high-risk and low preoperative hematocrit patients in preventing cerebral oxygen desaturation during initiation and maintenance of CPB.

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