Prospective study on cardiopulmonary bypass prime reduction and its effect on intraoperative blood product and hemoconcentrator use.

Purpose: Evaluate the feasibility and clinical significance of crystalloid prime reduction during the initiation of cardiopulmonary bypass (CPB) using a modified bridge on the cardioplegia delivery system.Methods: Prospective trial of crystalloid prime reduction using a standard Duraflow®-coated CPB circuit and Vanguard® 2:1 cardio plegia delivery system. Standard prime volume was 1500 cc of Plasmalyte. Prime was reduced via the bridge in the cardioplegia system during initiation of CPB. Packed red blood cells (PRBC) were transfused for hematocrit (Hct) less than 24% while rewarming. A hemoconcentrator was used if the patient’s circulating blood volume exceeded 150% of calculated. All data were prospectively collected.Results: Two hundred and twenty-two consecutive patients undergoing cardiac surgery utilizing CPB were evaluated. There were 107 patients with normal prime volume (NPV) and 115 patients with reduced prime volume (RPV). There was no significant difference in sex, mean age, weight, body surfac...