Effect of artificial colloid priming during cardiopulmonary bypass on the coagulation function of pediatric patients weighting less than 5 kg with congenital heart disease_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

ZHOU Chun , FENG Zhengyi , ZHAO Ju , CUI Yongli , ZHAO Mingxia , HU Jinxiao , LIU Kai , TONG Yuanyuan ,  LIU Jinping

Department of Cardiopulmonary Bypass, Fuwai Hospital, National Center of Cardiovascular Disease, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100037, P.R.China;

Corresponding author：

LIU Jinping, Email: jinpingfw@hotmail.com

Keywords：

Cardiopulmonary bypass; children; artificial colloid; coagulation function

DOI：

10.7507/1007-4848.201811013

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Objective To investigate the effect of artificial colloid on coagulation function in pediatric patients weighing less than 5 kg with congenital heart disease during cardiopulmonary bypass in congenital heart disease surgery by using artificial colloid instead of human serum albumin.Methods A total of 65 pediatric patients with weight less than 5 kg who underwent congenital heart disease surgery in our hospital from September 2016 to December 2017 were included in the study. They were randomly divided into two groups: an artificial colloid group (the experimental group, n=33) and a human serum albumin combined artificial colloid group (the control group, n=32). Perioperative hemoglobin concentration (Hb), blood products and hemostatic drugs used, postoperative coagulation function index and pleural fluid volume 24 hours after surgery were monitored.Results There was no significant difference in perioperative Hb and chest tube drainage between the two groups. The platelet utilization rate in the experimental group was significantly lower than that in the control group (P<0.05). No significant difference was found in the dosage of other blood products and hemostatic drugs between the two groups during the perioperative period. There was no significant difference in coagulation parameters between the two groups before and after surgery (P>0.05).Conclusion The use of artificial colloid as colloid priming solution during cardiopulmonary bypass has no adverse effect on coagulation function in pediatric patients weighting less than 5 kg with congenital heart disease.

Citation： ZHOU Chun, FENG Zhengyi, ZHAO Ju, CUI Yongli, ZHAO Mingxia, HU Jinxiao, LIU Kai, TONG Yuanyuan, LIU Jinping. Effect of artificial colloid priming during cardiopulmonary bypass on the coagulation function of pediatric patients weighting less than 5 kg with congenital heart disease. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(8): 766-771. doi: 10.7507/1007-4848.201811013 Copy

1.	Russell JA, Navickis RJ, Wilkes MM. Albumin versus crystalloid for pump priming in cardiac surgery: meta analysis of controlled trials. Cardiothorac Vasc Anesth, 2004, 18(4): 429-437.
2.	Miao N, Yang J, Du ZT, et al. Comparison of low molecular weight hydroxyethyl starch and human albumin as priming solutions in children undergoing cardiac surgery. Perfusion, 2014, 29(5): 462-468.
3.	Innerhofer P, Fries D, Margreiter J, et al. The effects of perioperatively administered colloids and crystalloids on primary platelet-mediated hemostasis and clot formation. Anesth Analg, 2002, 95(4): 858-865.
4.	Miao X, Liu J, Zhao M, et al. The influence of cardiopulmonary bypass priming without FFP on postoperative coagulation and recovery in pediatric patients with cyanotic congenital heart disease. Eur J Pediatr, 2014, 173(11): 1437-1443.
5.	苗晓蕾, 刘晋萍, 崔勇丽, 等. 比较三种胶体液用于婴幼儿体外循环预充的临床效果. 中国体外循环杂志, 2014, 12(4): 201-205, 209.
6.	王甜, 刘晋萍, 邹丽华, 等. 体外循环实施无血浆预充策略对小儿心脏术后凝血及临床预后的影响. 中国体外循环杂志, 2016, 14(1): 3-8.
7.	Mulaj M, Faraoni D, Willems A, et al. Predictive factors for red blood cell transfusion in children undergoing noncomplex cardiac surgery. Ann Thorac Surg, 2014, 98(2): 662-667.
8.	Levi M, Jonge Ed. Clinical relevance of the effects of plasma expanders on coagulation. Semin Thromb Hemost, 2007, 33(8): 810-815.
9.	Haas T, Preinreich A, Oswald E, et al. Effects of albumin 5% and artificial colloids on clot formation in small infants. Anaesthesia, 2007, 62(10): 1000-1007.
10.	赵明霞, 冯正义, 赵举, 等. 婴幼儿体外循环中人工胶体液代替血浆的综合评价. 中国体外循环杂志, 2013, 11(2): 75-78.
11.	Miao X, Liu J, Zhao M, et al. Evidence-based use of FFP: the influence of a priming strategy without FFP during CPB on postoperative coagulation and recovery in pediatric patients. Perfusion, 2015, 30(2): 140-147.
12.	Van der Linden P, Dumoulin M, Van Lerberghe C. Efficacy and safety of 6% hydroxyethyl starch 130/0.4 (Voluven) for perioperative volume replacement in children undergoing cardiac surgery: a propensity-matched analysis. Crit Care, 2015, 19: 87.
13.	Wang T, Wang X, Liu J, et al. Substitution of artificial colloids for fresh frozen plasma in pediatric cardiopulmonary bypass surgery. Paediatr Anaesth, 2018, 28(10): 914-923.
14.	Kamra C, Beney A. Human albumin in extracorporeal prime: effect on platelet function and bleeding. Perfusion, 2013, 28(6): 536-540.
15.	Ratliff TM, Hodge AB, Preston TJ, et al. Bloodless pediatric cardiopulmonary bypass for a 3.2-kg patient whose parents are of Jehovah's Witness faith. J Extra Corpor Technol, 2014, 46(2): 173-176.
16.	Redlin M, Huebler M, Boettcher W, et al. Minimizing intraoperative hemodilution by use of a very low priming volume cardiopulmonary bypass in neonates with transposition of the great arteries. J Thorac Cardiovasc Surg, 2011, 142(4): 875-881.

1. Russell JA, Navickis RJ, Wilkes MM. Albumin versus crystalloid for pump priming in cardiac surgery: meta analysis of controlled trials. Cardiothorac Vasc Anesth, 2004, 18(4): 429-437.
2. Miao N, Yang J, Du ZT, et al. Comparison of low molecular weight hydroxyethyl starch and human albumin as priming solutions in children undergoing cardiac surgery. Perfusion, 2014, 29(5): 462-468.
3. Innerhofer P, Fries D, Margreiter J, et al. The effects of perioperatively administered colloids and crystalloids on primary platelet-mediated hemostasis and clot formation. Anesth Analg, 2002, 95(4): 858-865.
4. Miao X, Liu J, Zhao M, et al. The influence of cardiopulmonary bypass priming without FFP on postoperative coagulation and recovery in pediatric patients with cyanotic congenital heart disease. Eur J Pediatr, 2014, 173(11): 1437-1443.
5. 苗晓蕾, 刘晋萍, 崔勇丽, 等. 比较三种胶体液用于婴幼儿体外循环预充的临床效果. 中国体外循环杂志, 2014, 12(4): 201-205, 209.
6. 王甜, 刘晋萍, 邹丽华, 等. 体外循环实施无血浆预充策略对小儿心脏术后凝血及临床预后的影响. 中国体外循环杂志, 2016, 14(1): 3-8.
7. Mulaj M, Faraoni D, Willems A, et al. Predictive factors for red blood cell transfusion in children undergoing noncomplex cardiac surgery. Ann Thorac Surg, 2014, 98(2): 662-667.
8. Levi M, Jonge Ed. Clinical relevance of the effects of plasma expanders on coagulation. Semin Thromb Hemost, 2007, 33(8): 810-815.
9. Haas T, Preinreich A, Oswald E, et al. Effects of albumin 5% and artificial colloids on clot formation in small infants. Anaesthesia, 2007, 62(10): 1000-1007.
10. 赵明霞, 冯正义, 赵举, 等. 婴幼儿体外循环中人工胶体液代替血浆的综合评价. 中国体外循环杂志, 2013, 11(2): 75-78.
11. Miao X, Liu J, Zhao M, et al. Evidence-based use of FFP: the influence of a priming strategy without FFP during CPB on postoperative coagulation and recovery in pediatric patients. Perfusion, 2015, 30(2): 140-147.
12. Van der Linden P, Dumoulin M, Van Lerberghe C. Efficacy and safety of 6% hydroxyethyl starch 130/0.4 (Voluven) for perioperative volume replacement in children undergoing cardiac surgery: a propensity-matched analysis. Crit Care, 2015, 19: 87.
13. Wang T, Wang X, Liu J, et al. Substitution of artificial colloids for fresh frozen plasma in pediatric cardiopulmonary bypass surgery. Paediatr Anaesth, 2018, 28(10): 914-923.
14. Kamra C, Beney A. Human albumin in extracorporeal prime: effect on platelet function and bleeding. Perfusion, 2013, 28(6): 536-540.
15. Ratliff TM, Hodge AB, Preston TJ, et al. Bloodless pediatric cardiopulmonary bypass for a 3.2-kg patient whose parents are of Jehovah's Witness faith. J Extra Corpor Technol, 2014, 46(2): 173-176.
16. Redlin M, Huebler M, Boettcher W, et al. Minimizing intraoperative hemodilution by use of a very low priming volume cardiopulmonary bypass in neonates with transposition of the great arteries. J Thorac Cardiovasc Surg, 2011, 142(4): 875-881.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Effect of artificial colloid priming during cardiopulmonary bypass on the coagulation function of pediatric patients weighting less than 5 kg with congenital heart disease

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