Minimized extracorporeal circuit during the haematic antegrade repriming aplication: a detailed description.

Abstract

Introduction: Cardiac surgery is continuously evolving towards a lower insult. Minimum invasive procedures and different perfusion techniques are also being studied to enhance the results. The aim of this study is to propose a standardized minimized extracorporeal circuit design to guarantee a predetermined low contact surface and haemodilution when the haematic antegrade repriming is being applied.
Materials & Method: After a review of the current evidence a minimized circuit of 3/8 inch diameter was proposed and approved by our cardiac surgery team
Results: The initial dynamic priming of the circuit is lower than 1000 ml. After haematic antegrade repriming manoeuvres, the haemodilution is reduced to 300 ml of crystalloid priming.
Discussion: The standardization of the circuit reduces errors, offers continuity between centres and savings. The bases of haematic antegrade repriming the detailed and reproducible measures that could exceed the benefits of the isolated effect of reducing the tubing, applying vacuum to increase the drainage or repriming the circuit with autologous blood. As a differencing factor, the standardization and detailing of the procedure offers reproducible results that should be assessed
Conclusions: Detailing the minimized extracorporeal circuit used during haematic antegrade repriming increases the replicability of the procedure, diminishes the technical differences in practice between centers and the incidence of errors. As well, it offers a significant potential in reducing the overall impact of the cardiopulmonary bypass.