PROTECTION OF RED BLOOD CELLS DURING CARDIOPULMONARY BYPASS

Abstract

Aim. This study was aimed at developing biocompatibility of extracorporeal components due to the use of «adaptation composition» (AdC), reducing the negative impact of perfusion on the state of red blood cell due to the use of fructose-1,6-diphosphate (FDP) to decrease intraoperative hemolysis and tissue hypoxia. Material and methods. The study included 225 patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). The first group included patients who underwent surgery with the treatment of an extracorporeal circuit by AdC, the second group included patients who were administered the drug with the active substance FDP, the third group was the control group. The oxygenator was treated with AdC and PDF was administrated according to the protocol. Patient blood was sampling for complete blood cell count (CBC) and blood smears were at 4 stages of surgery: before CPB, at 10 min. CPB-time, at 60 min. CPB-time (rewarming stage) and after separation from CPB. Several parameters were studied: plasma free hemoglobin (plfHb), the erythrocytes osmotic, mechanical resistance of erythrocytes, erythrocyte membrane permeability (EMP), acid hemolysis, the blood smears were stained according to Pappenheim. Results. The best erythrocyte indices, hemolysis, osmotic, mechanical, acid, urea resistance of erythrocytes were observed in the groups where fructose-1,6-diphosphate and «adaptation composition» were used. At the preoperative stage, hypophosphatemia was detected in 16.8% out of 225 patients and 26.6% out of 225 patients have a clear tendency to ones. After CPB, there was no hypophosphatemia in the group where fructose-1,6-diphosphate was administered. The higher peripheralization of reticulocytes, echinocytes, and spherocytes was observed in the control group after perfusion. Conclusion. The use of AdC and FDP during CPB helps to reduce hemolysis and the better state of erythrocytes. Cardiopulmonary bypass (CPB) can negatively affect the state of red blood cell. The effect of fructose-1,6-diphosphate and «adaptation composition» on the state of erythrocytes during perfusion was studied.

Keywords

• cardiopulmonary bypass, fructose-1,6-diphosphate, adaptation composition, erythrocyte, hemolysis, mean cell volume, red cell width distribution, mean cell haemoglobin concentration, hypophosphatemia.