The Effect of ringer Lactate as the Priming Solution of the Cardiopulmonary by Pass Circuit on Plasma Potassium Levels after Open Heart Surgery in Children

Authors

1 Assistant Professor of Anesthesiology, Cardiac Anesthesia Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Associate Professor of Anesthesiology, Cardiac Anesthesia Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

3 Post Graduate Student, Assistant of Pediatrics, Medical School, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Background: Conduct of cardiopulmonary bypass (CPB) due to the higher volume of priming solution in comparison to the total blood volume in children requires careful consideration. Recently attention has been focused on the potential risk of hyperkalemia in these patients. Given its significant effects on cardiac rhythm, hyperkalemia is considered a medical emergency. In this cross-sectional study we aimed to determine the changes in K+ and other electrolytes following CPB in a pediatric cardiac surgery setting.
Method: Sixty children scheduled for pediatric cardiac surgery weighing more than 5 kilograms with Hct level above 30% were enrolled. The prime solution used was Ringer-lactate. Venous blood were collected at defined time points: before, during and after CPB and at discharge. A p-value of less than 0.05 was considered statistically significant.
Results: Mean age of the studied patients was 3.69±2.77 years. A rise in potassium levels during surgery was recorded. Also a significant difference in the potassium levels before surgery and at discharge were observed (p=0.007). A significant drop and a subsequent rise in the Hct level was seen overtime whereas a significant decrease in the PH and bicarbonate levels were detected. 31 experienced cardiac arrhythmia after undergoing CPB.
Conclusion: A K+-free crystalloid that will offset the K+ load of stored blood is highly anticipated in these patients

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