Reduction of priming volumes of the cardiopulmonary bypass (CPB) circuit in
neonatal cardiac surgery to decrease haemodilution and blood transfusion r
equirements can be achieved with the use of neonatal low prime oxygenators
and smaller diameter tubing. We have further reduced our prime volume with
the use of a custom-designed arm allowing for remote positioning of a doubl
e-headed roller pump. This arm enables the double pump to be placed alongsi
de the main heart-lung machine close to the operating table, and to positio
n the pump inlet and outlet tubing immediately at the reservoir outlet and
oxygenator inlet, respectively, therefore reducing tubing lengths. Priming
volumes of four cases using this configuration were compared to four cases
using our standard neonatal bypass setup. Results showed a 29% decrease in
priming volume and a 58% reduction in blood utilization during CPB. This re
duction in priming volume is clinically significant as it lowers the ratio
of priming volume to patient brood volume and reduces homologous blood requ
irements.