Evaluation of Retrograde Autologous Priming (RAP) effect on Hemodilution and transfusion rate in operation room and ICU

To perform open heart surgery, the patient needs to be placed on the bypass system. This initial volume causes excessive dilution of the patient's blood and the use of blood products, which can alter the surgical procedure and recovery of the patient. The purpose of this study was to evaluate the usefulness of performing a retrograde autologous prime to reduce blood products consumption.

This is a prospective randomized clinical trial to evaluate whether RAP can reduce hemodilution in CPB and prevent allogeneic blood transfusion. In this study, 59 consecutive patients were randomly divided into two groups of RAP - with reverse autologous priming (n = 28) and control (Non RAP) - with normal priming (n = 31) being evaluated at Shahid Rajaee Cardiovascular Center between 1396-97.

Statistical evaluations were performed with Chi Square, T-Test, and Mann-Whitney U tests. It was identified by placing patients on bypass, hemoglobin and hematocrit in the first and second samples, end of bypass, and on ICU that was significantly higher in the experimental group. The number of patients receiving the product and the number of products consumed in the control group were significantly higher. The duration of mechanical ventilation was significantly lower but the ICU stay was not significantly different.

Conclusions :

From these results, it can be concluded that the implementation of RAP retrograde autologous priming can effectively preserve hemoglobin and hematocrit of patients in acceptable range and reduce the use of blood products in patients undergoing bypass.