Thesis (Ph.D.) - Cairo University - Faculty of Science - Department of Biophysics

Objectives: Different types of colloidal priming for cardiopulmonary bypass (CPB) have been used to reduce fluid load and to avoid the fall of plasma colloid osmotic pressure (COP) that leads to edema formation and consequently can cause organ dysfunction. The discussion about the optimal priming composition, however, is still controversial. The present study investigated the effect of a hyperoncotic CPB-prime with hydroxyethyl starch (HES) 6% (200;0.5), 20% albumin in comparison to crystalloid (7.2% hypertonic saline (HS) and ringer) on pulmonary functions at post CPB is investigated. Methods: Participated in these study 125 patients randomly distributed in five groups according to CPB perfusate solution: Perfusate solution as follows: Ringer, HES, more concentrated HES, albumin and hypersaline prime were used for group1 to group5 sequentially. Hb conc., WBC count, albumin, serum creatinine, serum osmolarity, oxygen arterial tension and inspired fraction ratio (PaO2/FiO2), oxygen alveolar-arterial gradient (GA-aO2) and pulmonary shunt were evaluated after anesthetic induction, at surgery completion and in the first and second postoperative day and were compared for all groups by analysis of Variance for repeated measurements (p<0.05). Results: Data showed that Hb conc. (11±0.5), serum osmolarity (270±6), CAO2 (16.6±1.7), DaVO2 (4.8±1.8) decreased significantly in ICU for all groups expect for GP5. Serum creatinine for GP5 (0.85±0.1) is less than other groups

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