Page 36 - ANZCP Gazette November 2021

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Perfusion 35(8)
Figure 7. Dose of albumin in primes. Tally of like
10 9
4 4 2 2 2 2 1 1
reasoning
Respondents reasons for adding Albumin to coat the circuit
• 8 units of whichadd 100ml of 20% dose
to maintain oncotic pressure/ as a colloid
• 3 units add 100ml of 20%
• 5 units add 500ml of 4%
to reduce the inflammatory response
to reduce 3rd spacing/ reduce volume given to prevent high transmembrane pressure to prevent the loss of endogenous albumin to protect platelets
to give medications proteins to bind to
to minimise electrolyte impact
probably historical reasoning
Australian units use synthetic colloids or starches in their priming solutions. There was also conformity across Australia in the limited number of prime addi- tives and the finite range of dosing strategies. There was variation in the rationale for the addition of each con- stituent between units.
Plasma-Lyte and Hartmann’s solutions were used almost exclusively as base solutions for Australian adult perfusion primes. The only other variation was Ringer’s solution used by three units (5%). Plasma-Lyte was used by 46 units (73%), Hartmann’s by 12 units (19%) and both Hartmann’s and Plasma-Lyte by two units (3%). Three Hartmann’s units indicated their intention to move to a Plasma-Lyte-based prime.
Figure 8. Tally of reasons for using albumin.
Figure 9. Dose of 8.4% NaHCO3 across units.
33 NOVEMBER 2021 | www.anzcp.org