Retrogrades autologes priming (RAP)

Aim of our study was to examine, whether less excessive hemodilution, with the onset of extracorporeal circulation, shows effects on the extent of postoperative interstitial edema. For this purpose 20 patients, undergoing elective CABG operations, were randomized to a standard priming group (n = 10) or the retrograde autologous priming group (RAP). RAP was performed by draining the crystalloid priming volume off the heart-lung machine and replace it with the patient's own blood. Cardiac, as well as pulmonary parameters, extravascular lung water (EVLW), plasma colloid osmotic pressure, crystalloid fluid balance and body weight were evaluated. RAP decreased the pronounced hemodilution and the fall of colloid osmotic pressure. The extent of postoperative interstitial edema could be reduced. It prevented EVLW accumulation and weight gain. RAP resulted in a 2 days decreased length of hospital stay.