A comparison of Balsol versus Ringers Lactate as cell saver washing solutions for packed red blood cells as part of priming solution in paediatric elective Cardiac Surgery with Cardio Pulmonary Bypass

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Date
2018-08
Authors
Swanepoel, M.
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Publisher
University of the Free State
Abstract
Introduction: The need to add Packed Red blood cells (PRBC) to the Cardio Pulmonary Bypass (CPB) circuit prime cause unphysiological acid-base, electrolyte and metabolite values. The main reason why filtering techniques are used prior to paediatric cardiac bypass are to prepare a nearly physiological priming solution. It has become standard practice to wash PRBC before adding it to neonate CPB. Aim: The aim was to measure and compare pH, electrolytes, metabolites, Haematocrit and Haemoglobin of packed RBC, washed with either Balsol or Ringers Lactate. Methodology: A series of 20 units of packed RBC’s was used and randomised to a Balsol group (control group) and a Ringers lactate group (interventional group) according to a randomisation list. A blood sample was obtained pre and post wash and analysed. Results: In both groups there was a significant decrease in Potassium (K+), Sodium (Na+), Glucose, Haematocrit and Haemoglobin. In the Ringers Lactate group there was a significant increase in Partial pressure of Oxygen (pO2) and Calcium (Ca2+). In the Balsol group there was a significant increase in pH. There was a statistically significant difference in the percentage change between the two groups for pH, Partial pressure of Carbon dioxide (pCO2), pO2, Ca2+ and Lactate. Conclusion: The pCO2, pO2, Ca2+, Lactate and Bicarbonate (HCO3-) is closer to physiological values in the Ringers Lactate group and the pH, K+ and Cl- is closer to physiological values in the Balsol group. Glucose, Na+, Hct and Hb changed to the same extend in both groups.
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Keywords
Dissertation (M.Med. (Anaesthesiology))--Univesity of the Free State, 2018, Paediatric cardiac bypass, Filtering techniques
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