Effect of pump prime on acidosis, strong-ion-difference and unmeasured ions during cardiopulmonary bypass

F Liskaser, David Story, M Hayhoe, Stephanie Poustie, Michael Bailey, Rinaldo Bellomo

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13 Citations (Scopus)

Abstract

We tested the hypothesis that a cardiopulmonary bypass prime with lactate would be associated with less acidosis than a prime with only chloride anions because of differences in the measured strong-ion-difference. We randomised 20 patients to a 1500 ml bypass prime with either a chloride-only solution (Ringera??s Injection; anions: chloride 152 mmol/l) or a lactated solution (Hartmanna??s solution; anions: chloride 109 mmol/l, lactate 29 mmol/l). Arterial blood was sampled before bypass and then two, five, 15 and 30 minutes after initiating bypass. We used repeated measures analysis of variance to compare groups. In both groups, the base-excess and measured strong-iondifference decreased markedly from baseline after two minutes of bypass. The chloride-only group had greater acidosis with lower base-excess and pH (P 0.05). There was, however, a difference in the net-unmeasured-ions (strong-ion-gap). We conclude that acid-base changes with cardiopulmonary bypass may differ with the prime but that the early differences between chloride-only and lactated primes appear not to be due to differences in the measured strong-ion-difference. We suggest future studies examine other possible mechanisms including unmeasured ions.
Original languageEnglish
Pages (from-to)767 - 772
Number of pages6
JournalAnaesthesia and intensive care
Volume37
Issue number5
Publication statusPublished - 2009

Cite this

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title = "Effect of pump prime on acidosis, strong-ion-difference and unmeasured ions during cardiopulmonary bypass",
abstract = "We tested the hypothesis that a cardiopulmonary bypass prime with lactate would be associated with less acidosis than a prime with only chloride anions because of differences in the measured strong-ion-difference. We randomised 20 patients to a 1500 ml bypass prime with either a chloride-only solution (Ringera??s Injection; anions: chloride 152 mmol/l) or a lactated solution (Hartmanna??s solution; anions: chloride 109 mmol/l, lactate 29 mmol/l). Arterial blood was sampled before bypass and then two, five, 15 and 30 minutes after initiating bypass. We used repeated measures analysis of variance to compare groups. In both groups, the base-excess and measured strong-iondifference decreased markedly from baseline after two minutes of bypass. The chloride-only group had greater acidosis with lower base-excess and pH (P 0.05). There was, however, a difference in the net-unmeasured-ions (strong-ion-gap). We conclude that acid-base changes with cardiopulmonary bypass may differ with the prime but that the early differences between chloride-only and lactated primes appear not to be due to differences in the measured strong-ion-difference. We suggest future studies examine other possible mechanisms including unmeasured ions.",
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Effect of pump prime on acidosis, strong-ion-difference and unmeasured ions during cardiopulmonary bypass. / Liskaser, F; Story, David; Hayhoe, M; Poustie, Stephanie; Bailey, Michael; Bellomo, Rinaldo.

In: Anaesthesia and intensive care, Vol. 37, No. 5, 2009, p. 767 - 772.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Effect of pump prime on acidosis, strong-ion-difference and unmeasured ions during cardiopulmonary bypass

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AU - Story, David

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AU - Bailey, Michael

AU - Bellomo, Rinaldo

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AB - We tested the hypothesis that a cardiopulmonary bypass prime with lactate would be associated with less acidosis than a prime with only chloride anions because of differences in the measured strong-ion-difference. We randomised 20 patients to a 1500 ml bypass prime with either a chloride-only solution (Ringera??s Injection; anions: chloride 152 mmol/l) or a lactated solution (Hartmanna??s solution; anions: chloride 109 mmol/l, lactate 29 mmol/l). Arterial blood was sampled before bypass and then two, five, 15 and 30 minutes after initiating bypass. We used repeated measures analysis of variance to compare groups. In both groups, the base-excess and measured strong-iondifference decreased markedly from baseline after two minutes of bypass. The chloride-only group had greater acidosis with lower base-excess and pH (P 0.05). There was, however, a difference in the net-unmeasured-ions (strong-ion-gap). We conclude that acid-base changes with cardiopulmonary bypass may differ with the prime but that the early differences between chloride-only and lactated primes appear not to be due to differences in the measured strong-ion-difference. We suggest future studies examine other possible mechanisms including unmeasured ions.

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