Evidence map›Paper›PMID 41873655›Full record

ArticlePaediatric anaesthesia2026

Impact of Priming Volume Reduction on Hematocrit Retention in Pediatric Cardiopulmonary Bypass: A Retrospective Analysis.

Tokimitsu Hibino, Yusuke Okui, Yoshie Toba, Satoko Kondo, Hiromi Ikegami, Kiyoshi Suzuki, Fumiko Ogura, Hiroshi Masui, Norihisa Kitamoto, Masaaki Koide and 1 more

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Article in Paediatric anaesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

11 authors.

Tokimitsu HibinoDepartment of Social Medical Sciences, Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan.ORCID 0009-0009-9861-6092
Yusuke OkuiDepartment of Anesthesiology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.ORCID 0009-0003-4275-2921
Yoshie TobaDepartment of Anesthesiology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
Satoko KondoDepartment of Anesthesiology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
Hiromi IkegamiDepartment of Anesthesiology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.ORCID 0000-0002-6301-4763
Kiyoshi SuzukiDepartment of Anesthesiology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.
Fumiko OguraDepartment of Anesthesiology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.ORCID 0009-0008-0019-1149
Hiroshi MasuiDepartment of Clinical Engineering, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.ORCID 0009-0004-6091-5728
Norihisa KitamotoDepartment of Clinical Medical Engineering, Faculty of Medical Sciences, Fujita Health University, Toyoake, Japan.ORCID 0009-0006-8216-3699
Masaaki KoideDepartment of Cardiovascular Surgery, Seirei Hamamatsu General Hospital, Hamamatsu, Japan.ORCID 0009-0007-0740-6301
Tsutomu YamazakiDepartment of Social Medical Sciences, Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan.ORCID 0000-0001-6510-9865

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRetrograde autologous priming and venous antegrade priming replace the cardiopulmonary bypass circuit crystalloid with patient blood to mitigate hemodilution. However, their effectiveness in pediatric patients, particularly when analyzed as continuous variables, remains unclear.

aimsWe aimed to evaluate the effects of autologous priming techniques on blood conservation and patient safety during pediatric cardiac surgery.

methodsThis retrospective cohort study included 191 patients (age 0-14 years; weight > 6 kg) who underwent repair of ventricular and/or atrial septal defects. The primary endpoint was the correlation between the priming volume reduction rate (proportion of priming solution replaced) and the hematocrit retention ratio (hematocrit immediately after cardiopulmonary bypass initiation divided by pre-bypass hematocrit). Secondary outcomes, including transfusion rates, regional cerebral oxygen saturation, and lactate levels, were compared between a retrograde autologous priming group (n = 144) and a control group (n = 47). All patients underwent venous antegrade priming.

resultsThe priming volume reduction rate correlated positively with the hematocrit retention ratio (Spearman's ρ = 0.545, p < 0.001). Multiple regression confirmed this independent association: a 0.1 increase in the priming volume reduction rate corresponded to a 0.5% absolute increase in hematocrit at bypass initiation. The retrograde autologous priming group had a significantly higher transfusion-free surgery rate (93.1% vs. 76.6%; relative risk ratio 1.22; p = 0.005). Regarding safety and the postoperative course, no significant intergroup differences were found in trends in regional cerebral oxygen saturation (Time × retrograde autologous priming interaction) or in lactate levels. Similarly, intensive care unit and hospital lengths of stay did not differ significantly between groups. Safety analyses suggested no evidence of cerebral perfusion suppression during retrograde autologous priming.

conclusionThese findings suggest that even partial retrograde autologous priming is effective to mitigate hemodilution and is independently associated with improved hematocrit retention and a significant reduction in transfusion risk after initiation of cardiopulmonary bypass in pediatric patients.

trial registrationThis study was registered with the UMIN Clinical Trials Registry, Japan, prior to commencement (Trial ID: R000067879).

Indexed as

Cardiopulmonary BypassHemodilutionAdolescentBlood TransfusionBlood Transfusion, AutologousCardiac Surgical ProceduresChildChild, PreschoolCohort StudiesFemaleHematocritHumansInfantInfant, NewbornMaleRetrospective Studiesblood transfusioncardiopulmonary bypasshematocritpediatric cardiac surgeryretrograde autologous primingvenous antegrade priming

Identifiers

PMID41873655
PMCPMC13161507

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.