Efektivitas Retrograde Autologous Priming dalam Menurunkan Volume Kebutuhan Transfusi Sel Darah Merah Selama Operasi pada Bedah Jantung Koroner dengan Mesin Pintas Jantung Paru: A Randomized Controlled Trial

Cindy Elfira Boom, Dian Kesumarini, Riza Cintyandy, Lisa Sanjaya, Krisna Andria, Hilda Zareva, Cahya Rudiana, I Made Adi Parmana

Abstract


Pemakaian mesin pintas jantung paru (PJP) dalam operasi coronary artery bypass graft (CABG) dapat meningkatkan kebutuhan transfusi darah. Tujuan penelitian ini untuk mengetahui efektivitas retrograde autologous priming (RAP) dalam menurunkan volume transfusi sel darah merah/packed red cell (PRC) pada pasien bedah jantung koroner dengan mesin PJP. Penelitian ini melibatkan 52 pasien yang dijadwalkan menjalani operasi coronary artery bypass graft (CABG). RAP dimulai selama bypass dalam satu kelompok dengan mengalirkan larutan kristaloid dari jalur arteri dan vena ke dalam kantong penampung dengan volume penarikan RAP yang dimaksudkan dan disesuaikan untuk setiap pasien. Non-RAP menggunakan teknik konvensional PJP. 52 pasien (RAP = 26; kontrol = 26) dilibatkan dalam analisis. Pasien dalam kelompok RAP menerima volume transfusi PRC intraoperatif yang jauh lebih rendah dibanding dengan pasien pada kelompok non-RAP (median, 0 mL vs 205 mL, p=0,014). Analisis regresi linier berganda menunjukkan bahwa prosedur RAP mempengaruhi secara signifikan (p<0,05) volume PRC yang dibutuhkan dalam transfusi intraoperatif. RAP selama operasi bedah jantung koroner dengan mesin PJP adalah prosedur yang aman dan efektif yang secara signifikan mengurangi kebutuhan transfusi volume PRC.

 

Keywords


Bedah jantung koroner; pintas jantung paru; retrograde autologous priming; transfusi sel darah merah

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References


  1. Engelman DT, Ali WB, Williams JB, Perrault LP, Reddy VS, Arora RC, dkk. Guidelines for perioperative care in cardiac surgery: enhanced recovery after surgery society recommendations. JAMA Surg. 2019;154(8):755–66.
  2. Applegate RL, Ziemann-Gimmel P, Kuo A, Shiloh AL, Maloney K, Buckman M, dkk. Evaluation of pulse cooximetry in patients undergoing abdominal or pelvic surgery. Anesthesiology. 2012;116(1):65–72.
  3. Yoshida T, Prudent M, D’Alessandro A. Red blood cell storage lesion: causes and potential clinical consequences. Blood Transfus. 2019;17(1):27.
  4. Kiser K, Sandhu H, Miller CC, Holt D. Implementation of a prescriptive extracorporeal circuit and its effect on hemodilution and blood product usage during cardiac surgery. J Extra Corpor Technol. 2020;52(4):295–302.
  5. Thapmongkol S, Masaratana P, Subtaweesin T, Sayasathid J, Thatsakorn K, Namchaisiri J. The effects of modified ultrafiltration on clinical outcomes of adult and pediatric cardiac surgery. Asian Biomedicine. 2017;9(5):591–9.
  6. Trapp C, Schiller W, Mellert F, Halbe M, Lorenzen H, Welz A, dkk. Retrograde autologous priming as a safe and easy method to reduce hemodilution and transfusion requirements during cardiac surgery. Thorac Cardiovasc Surg. 2015;63(07):628–34.
  7. Vandewiele K, Bové T, De Somer FMJJ, Dujardin D, Vanackere M, De Smet D, dkk. The effect of retrograde autologous priming volume on haemodilution and transfusion requirements during cardiac surgery. Interact Cardiovasc Thorac Surg. 2013;16(6):778–83.
  8. Sun P, Ji B, Zhu X, Liu J, Long C, Zheng Z. Effects of retrograde autologous priming on blood transfusion and clinical outcomes in adults: a meta-analysis. Perfusion. 2013;28(3):238–43.
  9. Beukers AM, de Ruijter JAC, Loer SA, Vonk A, Bulte CSE. Effects of crystalloid and colloid priming strategies for cardiopulmonary bypass on colloid oncotic pressure and haemostasis: a meta-analysis. Interact Cardiovasc Thorac Surg. 2022;35(3):ivac127.
  10. Sheshagiri N, Cheruvathur AV. Factors determining blood transfusion in patients undergoing off pump coronary artery bypass graft (OPCABG) surgery: a prospective cross-sectional study. Indian J Clin Anaesth. 2021;8(3):452–9.
  11. Ševerdija E, Heijmans J, Theunissen M, Maessen J, Roekaerts P, Weerwind P. Retrograde autologous priming reduces transfusion requirements in coronary artery bypass surgery. Perfusion. 2011;26(4):315–21.
  12. Lim E, Miyamura J, Chen JJ. Racial/Ethnic-Specific Reference Intervals for Common Laboratory Tests: A comparison among asians, blacks, hispanics, and white. Hawaii J Med Public Health. 2015;74(9):302–10.
  13. Gupta S, McEwen C, Basha A, Panchal P, Eqbal A, Wu N, dkk. Retrograde autologous priming in cardiac surgery: a systematic review and meta-analysis. Eur J Cardiothorac Surg. 2021;60(6):1245–56.
  14. Hou X, Yang F, Liu R, Yang J, Zhao Y, Wan C, dkk.Retrograde autologous priming of the cardiopulmonary bypass circuit reduces blood transfusion in small adults: a prospective, randomized trial: Eur J Anaesthesiol. 2009;26(12):1061–6.
  15. Vranken NP, Babar ZU, Montoya JA, Weerwind PW. Retrograde autologous priming to reduce allogeneic blood transfusion requirements: a systematic review. Perfusion. 2020;35(7):574–86.
  16. Balachandran S, Cross MH, Karthikeyan S, Mulpur A, Hansbro SD, Hobson P. Retrograde autologous priming of the cardiopulmonary bypass circuit reduces blood transfusion after coronary artery surgery. Ann Thorac Surg. 2002;73(6):1912–8.
  17. Koçoğlu Y, Memmedov S, Kayan E, Arkan B, Bozkaya TA, Akçevin A. Retrograde autologous priming for opposing the adverse effects of extracorporeal circulation during open heart surgery. Clin Surg. 2018;3(1):1–5.
  18. Zelinka ES, Ryan P, McDonald J, Larson J. Retrograde autologous prime with shortened bypass circuits decreases blood transfusion in high-risk coronary artery surgery patients. J Extra Corpor Technol. 2004;36(4):343–7.
  19. Hofmann B, Kaufmann C, Stiller M, Neitzel T, Wienke A, Silber RE, Treede H. Positive impact of retrograde autologous priming in adult patients undergoing cardiac surgery: a randomized clinical trial. J Cardiothorac Surg. 2018;13:1–8.
  20. Koçoğlu Y, Memmedov S, Kayan E, Arkan B, Bozkaya TA, Özyüksel A, dkk. Retrograde Autologous Priming for Opposing the Adverse Effects of Extracorporeal Circulation during Open Heart Surgery. Clin Surg. 2018; 3: 2004.
  21. Hofmann B, Kaufmann C, Stiller M, Neitzel T, Wienke A, Silber RE, Treede H. Positive impact of retrograde autologous priming in adult patients undergoing cardiac surgery: a randomized clinical trial. J Cardiothorac Surg. 2018;13(1):50.




DOI: https://doi.org/10.15851/jap.v12n2.3934

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