Minimisation of priming volume and blood saving in paediatric cardiac surgery

Abstract

We started a programme of donor blood reduction for open heart surgeryin children in 1983. At first, only meticulous surgical and perfusiontechniques were used. Later, increased haemodilution was added.Miniaturisation of the perfusion circuit and introduction of blood takenprior from the patient further decreased donor blood requirements. In 1989,we used 0.89 l per patient compared to 3.2 l per patient in 1983.Miniaturisation of the circuit was tested in a pilot study on 30 childrenundergoing the Senning operation in 1988. Priming volume was reduced from661 +/- 72 ml to 421 +/- 62 ml. In 1989, 167 out of 194 children (86%)received a clear prime. Ninety-seven of 100 children whose weight was over15 kg received a clear prime: 55 did not require subsequent transfusion.Prime miniaturisation and autotransfusion can considerably reduce bloodrequirements for open heart surgery.