Comparison of the Effect of Blood Prime with Target Hematocrit 23% versus 28% on Transfusion and Blood Biochemical Characteristics in Pediatric Cardiac Surgery

Abstract Introduction: Blood prime has been widely used with various target hemoglobin levels during Cardiopulmonary bypass (CPB) with induced heart arrest. The appropriate target hematocrit in prime blood is very important with the aim of proper perfusion and reducing the need for inotrope and blood transfusion. In this study, two target hematocrits in prime blood were compared on cardiopulmonary bypass. Methods: One hundred patients were recruited and randomly allocated into two groups with a target hematocrit after blood prime of 23% (HCT23) (Group 1) and 28% (HCT28) (Group 2) using block randomization. Then they were monitored for blood gas analysis, lactate, electrolytes, and hemostasis parameters. Results: Patients in the Group 1 experienced lower hemoglobin and higher lactate values during CPB and after that and received more inotropes and more blood transfusions. Conclusions: Setting target hemoglobin at 23% for priming, despite decreasing the blood administration at the beginning, is associated with significant increase in the transfusion of blood components during and after the operation and is associated with worse outcomes in the terms of the inotrope consumption. Moreover, it is associated with further increase of the lactate and depicts weaker perfusioning of the organs. Therefore, we suggest that setting prime hemoglobin target at 28% is preferred over the priming with 23% target hemoglobin.