Page 34 - ANZCP Gazette November 2021

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Perfusion 35(8)
Figure 2. Graph of prime base solution by number of units.
Tally of like responses
Respondents reasons for base solution selection
20
‘that’s what we’ve always used’
∗ 10 of which were of the 12 Hartmann’s units
∗ 2 were Ringers units
∗ 2 were ‘Both Hartmann’s & Plasma-Lyte’units
∗ 6 were Plasma-Lyte units
17
it’s more physiologically balanced/ isotonic (all Plasma-Lyte units)
9
there’s no lactate (in Plasma-Lyte)
5
provides metabolites (with Plasma-Lyte)
3
to avoid hyper Ca & hyper Cl- high strong ion difference (in Hartmann’s)
2
cite pH as a reason (no details given)
1
‘there’s no evidence for the extra cost for Plasma-Lyte’
1
improves renal outcomes (with Plasma-Lyte)
1
‘I don’t know why’
4
No response provided
Figure 3. Tally of responses to reasons for base solution selection.
patients per year) only add albumin ‘as required’ to their heparin and base solution. Thus, per annum up to 6,520 (30%) cases receive only heparin as an additive to their prime base solution. All other units had various combi- nations of sodium bicarbonate (NaHCO3), mannitol and albumin.
While all respondents provided the types of prime base solution and additives with doses, some respond- ents did not provide details on their reasons for doing so, whereas the other respondents provided more than one reason for their additives.
Albumin was a popular addition to Australian primes. 32 (50%) units add it routinely with another 11
units adding it ‘as required’ (Figure 5). Their indications for addition are listed in Figure 6.
When albumin was added to the prime, the dosages of albumin were variable (Figure 7). Figure 8 lists the vari- ety of reasons units added albumin to their primes.
Sodium bicarbonate was a prime additive in 28 cen- tres (44% of centres; 8,965 patients per year) while 35 Australian units (56% of units; 12,785 cases) do not rou- tinely add bicarbonate to their prime solution.
The variable dosing regimens reflect the type of base solution used (Figure 9).
Furthermore, the reason to add NaHCO3 to the prime depended on the base solution used. NaHCO3 was added
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