Assessment of Clinical and Laboratory Outcomes in Using of Albumin and Fresh Frozen Plasma as Cardiopulmonary Bypass Prime Solutions in Pediatric Arterial Switch Surgery

Mehdi Fathi; Mandana Hosseinzadeh; Mehraveh Sadeghi Ivraghi; Mahmood Hoseinzadeh Maleki; Lida Jarahi; Horieh Pakniat; Elnaz Bakhtiary; Zahra Ahmadi Hasanabad

doi:10.18502/aacc.v8i4.10178

Mehdi Fathi Department of Anesthesia, Faculty of Medical Sciences, Mashhad University of Medical Science, Mashhad, Iran.
Mandana Hosseinzadeh Mashih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mehraveh Sadeghi Ivraghi Department of Medicine, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran.
Mahmood Hoseinzadeh Maleki Department of Cardiac Surgery, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Lida Jarahi Department of Community Medicine and Public Health, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Horieh Pakniat Department of Perfusion Technology, Faculty of Medical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.
Elnaz Bakhtiary Department of Anesthesia, Faculty of Medical Sciences, Iran University of Medical Science, Tehran, Iran.
Zahra Ahmadi Hasanabad Department of Perfusion Technology, Faculty of Medical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran.

DOI: https://doi.org/10.18502/aacc.v8i4.10178

Keywords: Cardiopulmonary bypass; Transposition of great vessels; Albumins

Abstract

Background: Cardiopulmonary bypass (CBP) prime solution in pediatric heart surgeries is critical to avoid adverse effects resulting from dilution of coagulation factors, red blood cells, and other plasma protein. This study aimed to evaluate clinical and laboratory outcomes of administration of albumin and fresh frozen plasma (FFP) in CPB prime solution in children candidates for arterial switch surgery.

Methods: This cross-sectional study was performed on 30 transposition of the great arteries (TGA) patients, candidates for the arterial switch in Tehran Children's Medical Center, Iran. As CBP prime solution, 15 patients received albumin (1 gr/kg Albumin 20%) and 15 patients received FFP (15 cc/kg). also, clinical and laboratory parameters were measured in different intervals. The statistical analysis were performed by SPSS v.20.

Results: The volume platelet infusion in the ICU was higher in FFP-received patients (40.00 ±20.70 ml) than albumin-received patients (26.67 ±25.82 ml; p-value =0.01). Upon entry into ICU, the mean of Hb and Hct in FFP-received patients (11.55 ±0.64 g/l and 34.44 ±2.44 %) was significantly higher than patients who received albumin (11.08 ±0.87 g/l and 31.44 ±3.97 %; p-value =0.04 for both). Upon entry into ICU and also 48 hours after admission into the ICU, the Cr level in the FFP-received group (median: 19 mg/dl) was significantly higher than the albumin-received group (median: 12 mg/dl; p-value =0.03).

Conclusion: FFP in CPB prime solution reduces the hemostatic complications and infusion of blood products, as well as to stabilizes Hb and Htc. Therefore, FFP is more suitable as CPB prime solution.