[Home ] [Archive]   [ فارسی ]  
:: Main :: About us :: Current Issue :: Archive :: Search :: Submit :: Contact ::
:: Volume 17, Issue 1 (Spring 2020) ::
Sci J Iran Blood Transfus Organ 2020, 17(1): 27-35 Back to browse issues page
Evaluation of Retrograde Autologous Priming (RAP) effect on Hemodilution and transfusion rate in operation room and ICU
F. Kargar, B. Ghadrdoost, N. Aghdaii, A. Ghanbari
Keywords: Cardiac Surgery, Blood Transfusion, Hemodilution
Full-Text [PDF 408 kb]   (382 Downloads)     |   Abstract (HTML)  (2180 Views)
Type of Study: Research | Subject: Heart and Vessels Surgeon
Published: 2020/03/16
Full-Text:   (1062 Views)
  1. Sarkar M, Prabhu V. Basics of cardiopulmonary bypass. Indian J Anaesth 2017; 61(9): 760-7.
  2. Asopa S, Elahi M. Hemodilution during cardiopulmonary bypass: optimal hematocrit for safe outcome. Acute Card Care 2007; 9(1): 63-4.
  3. McQuilten ZK, Andrianopoulos N, Wood EM, Cole-Sinclair MF, McNeil JJ, Cameron PA, et al. Transfusion practice varies widely in cardiac surgery: Results from a national registry. J Thorac Cardiovasc Surg 2014; 147(5): 1684-90. e1.
  4. Alghamdi AA, Davis A, Brister S, Corey P, Logan A. Development and validation of Transfusion Risk Understanding Scoring Tool (TRUST) to stratify cardiac surgery patients according to their blood transfusion needs. Transfusion 2006; 46(7): 1120-9.
  5. Hou X, Yang F, Liu R, Yang J, Zhao Y, Wan C, et al. 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.
  6. Ferraris VA, Ferraris SP, Saha SP, Hessel II EA, Haan CK, Royston BD, et al. Perioperative blood transfusion and blood conservation in cardiac surgery: the Society of Thoracic Surgeons and The Society of Cardiovascular Anesthesiologists clinical practice guideline. Ann Thorac Surg 2007; 83(5): S27-86.
  7. Belway D, Rubens F, Wozny D, Henley B, Nathan H. Are we doing everything we can to conserve blood during bypass? A national survey. Perfusion 2005; 20(5): 237-41.
  8. Shann KG, Likosky DS, Murkin JM, Baker RA, Baribeau YR, DeFoe GR, et al. An evidence-based review of the practice of cardiopulmonary bypass in adults: a focus on neurologic injury, glycemic control, hemodilution, and the inflammatory response. J Thorac
    Cardiovasc Surg 2006; 132(2): 283-90.
  9. Hofmann B, Kaufmann C, Stiller M, Neitzel T, Wienke A, Silber RE, et al. Positive impact of retrograde autologous priming in adult patients undergoing cardiac surgery: a randomized clinical trial. J Cardiothorac Surg 2018; 13(1): 50.
  10. Shuhaiber JH. Randomized prospective trial for blood transfusion during adult cardiopulmonary bypass surgery. J Thorac Cardiovasc Surg 2005; 129(5): 1200-1.
  11. Karkouti K, Djaiani G, Borger MA,  Beattie WS, Fedorko L, Wijeysundera D, et al. Low hematocrit during cardiopulmonary bypass is associated with increased risk of perioperative stroke in cardiac surgery. Ann Thorac Surg 2005; 80(4): 1381-7.
  12. Karkouti K, Beattie W, Wijeysundera D, Rao V, Chan C, Dattilo K, et al. Hemodilution during cardiopulmonary bypass is an independent risk factor for acute renal failure in adult cardiac surgery. J Thorac Cardiovasc Surg 2005; 129(2): 391-400.
  13. Stafford-Smith M, Newman MF. What effects do hemodilution and blood transfusion during cardiopulmonary bypass have on renal outcomes? Nat Clin Pract Nephrol 2006; 2(4): 188-9.
  14. Boer C, Meesters MI, Milojevic M, Benedetto U, Bolliger D, von Heymann C, et al. 2017 EACTS/EACTA guidelines on patient blood management for adult cardiac surgery. J Cardiothorac Vasc Anesth 2018; 32(1): 88-120.
  15. Ferraris VA, Brown JR, Despotis GJ, Hammon JW, Reece TB, Saha SP, et al. 2011 update to the Society of Thoracic Surgeons and the Society of Cardiovascular Anesthesiologists blood conservation clinical practice guidelines. Ann Thorac Surg 2011; 91(3): 944-82.

Sci J Iran Blood Transfus Organ 2020;17(1): 27-35
Original Article


Evaluation of Retrograde Autologous Priming (RAP)
effect on Hemodilution and transfusion rate in operation
room and ICU
Kargar F.1, Ghadrdoost B.1, Aghdaii N.1, Ghanbari A.1
1Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
Background and Objectives
To perform open heart surgery, the patient needs to be placed on the bypass system. This initial volume causes excessive dilution of the patient's blood and the use of blood products, which can alter the surgical procedure and recovery of the patient. The purpose of this study was to evaluate the usefulness of performing a retrograde autologous prime to reduce blood products consumption.
Materials and Methods
This is a prospective randomized clinical trial to evaluate whether RAP can reduce hemodilution in CPB and prevent allogeneic blood transfusion. In this study, 59 consecutive patients were randomly divided into two groups of RAP - with reverse autologous priming (n = 28) and control (Non RAP) - with normal priming (n = 31) being evaluated at Shahid Rajaee Cardiovascular Center between 1396-97.
Statistical evaluations were performed with Chi Square, T-Test, and Mann-Whitney U tests. It was identified by placing patients on bypass, hemoglobin and hematocrit in the first and second samples, end of bypass, and on ICU that was significantly higher in the experimental group. The number of patients receiving the product and the number of products consumed in the control group were significantly higher. The duration of mechanical ventilation was significantly lower but the ICU stay was not significantly different.
From these results, it can be concluded that the implementation of RAP retrograde autologous priming can effectively preserve hemoglobin and hematocrit of patients in acceptable range and reduce the use of blood products in patients undergoing bypass.
Key words: Cardiac Surgery, Blood Transfusion, Hemodilution
Received:  28 Jul   2019
Accepted: 24 Dec 2019

Correspondence: Ghanbari A., MS in Perfusion Technician. Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences.
P.O.Box: 15745-1341, Tehran, Iran. Tel: (+9821) 22042026; Fax: (+9821) 22042026
E-mail: a.mghanbari@yahoo.com
Send email to the article author

Add your comments about this article
Your username or Email:


XML   Persian Abstract   Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Kargar F, Ghadrdoost B, Aghdaii N, Ghanbari A. Evaluation of Retrograde Autologous Priming (RAP) effect on Hemodilution and transfusion rate in operation room and ICU. Sci J Iran Blood Transfus Organ. 2020; 17 (1) :27-35
URL: http://bloodjournal.ir/article-1-1293-en.html

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Volume 17, Issue 1 (Spring 2020) Back to browse issues page
فصلنامه پژوهشی خون Scientific Journal of Iran Blood Transfus Organ
The Scientific Journal of Iranian Blood Transfusion Organization - Copyright 2006 by IBTO
Persian site map - English site map - Created in 0.04 seconds with 31 queries by YEKTAWEB 4463