Retrograde Autologous Priming and Mannitol for Reducing Hemodilution in Cardiac Surgery (RAPPER-MAN)
Hemodilution, Coronary Artery Disease, Fluid Overload
About this trial
This is an interventional treatment trial for Hemodilution focused on measuring retrograde autologous priming, mannitol, cardiopulmonary bypass, cardiac surgery, hemodilution
Eligibility Criteria
Inclusion Criteria:
- ≥18 years of age.
- Undergoing a first-time cardiac surgical procedure (i.e. isolated CABG, isolated single cardiac valve surgery or a combination of both or isolated ascending aorta replacement) with the use of cardiopulmonary bypass (CPB) and median sternotomy.
Exclusion Criteria:
- Left ventricle ejection fraction <25%
- Emergency surgery
- History of bleeding disorder
- Inherited thromboembolic or infective endocarditis (active)
- Previous cardiac surgery
- Severe renal impairment (serum creatinine >250 μmol/L)
- Hemoglobin <80 g/L
- Thrombocytopenia (<50,000 platelets per μL)
- Expected circulatory arrest
- Body weight ≤50 kg
- Allergy to mannitol
- Pregnancy or breast feeding
Sites / Locations
- Hamilton General Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Active Comparator
Retrograde autologous priming + mannitol
Retrograde autologous priming alone
Conventional priming + mannitol
Conventional priming alone
Priming solution (≥600 mL) will be removed from the extracorporeal circuit within 10 minutes before the initiation of cardiopulmonary bypass. Priming solution may be removed from 3 locations within the extracorporeal circuit (i.e. arterial, venous and cardioplegia lines) as determined by the perfusionist team. In addition, mannitol will be added as a bolus (0.3 g/kg) to the venous reservoir of the cardiopulmonary bypass machine within 5 min before the start of cardiopulmonary bypass.
Priming solution (≥600 mL) will be removed from the extracorporeal circuit within 10 minutes before the initiation of cardiopulmonary bypass. Priming solution may be removed from 3 locations within the extracorporeal circuit (i.e. arterial, venous and cardioplegia lines) as determined by the perfusionist team.
Participants will receive conventional priming. In addition, mannitol will be added as a bolus (0.3 g/kg) to the venous reservoir of the cardiopulmonary bypass machine within 5 min before the start of cardiopulmonary bypass.
Participants will receive conventional priming alone.