Physiologic Studies during Cardiopulmonary Bypass Eliminating Heparinized Blood

¹ Cora and Webb Mading Department of Surgery, Baylor University College of Medicine, and the St. Luke's Episcopal, Texas Children's and Ben Taub General Hospitals

Many adverse physiologic changes following temporary cardiopulmonary bypass recently have been attributed to the use of large quantities of homologous blood to prime various types of pump oxygenators. We have adopted a technic of open heart surgery employing plastic disposable oxygenators, primed with 5 per cent dextrose in distilled water, under normothermic conditions. Results of this technic in 601 clinical cases have demonstrated its superiority to technics employing pooled homologous blood in almost every respect. In order to determine physiologic changes associated with this technic of open heart surgery, several investigations were performed and included determinations of changes in renal hemodynamics, changes in blood volume and formed elements of the blood, changes in body water and compartmentalization, changes in serum electrolytes, and changes in blood viscosity. The magnitude of hemolysis during and following this technic of cardiopulmonary bypass also was studied. Results of these studies would appear to offer additional evidence that this technic of open heart surgery is superior to those employing pooled homologous blood.