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

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.