The effect of different priming solutions on the erythrocyte deformability and aggregation among cases undergoing elective coronary artery bypass surgery

SUMMARYThe effect of different priming solutions on the erythrocyte deformability andaggregation among cases undergoing elective coronary artery bypass surgeryDr. Ismail Yurekli, Dokuz Eylul University, Faculty of Medicine, Department ofCardiovascular Surgery, Izmir(ismail.yurekli@deu.edu.tr)The cardiopulmonary bypass (CPB) procedure employed to replace the function ofnative heart and lung during cardiac surgery is known to influence the normal homeostaticcircumstances of blood, including both the blood elements and plasma proteins. Thesechanges in blood are largely due to the adverse effects of the heart-lung machine involving thenon-physiological contact of blood with the artificial surfaces, the mechanical shear stress onblood cells, the non-pulsatile perfusion flow and concomitant procedure of hemodilution.Admired by this knowledge, we aimed to investigate the effects of different extracorporealpriming solutions (Ringer, HES 6% 130/0,4) on the aggregation and deformability oferythrocytes among selected cases undergoing elective coronary artery bypass surgery. Forthis reason, blood samples were taken at four different time intervals: before CPB, in 5thminute after CPB was initiated, in 15th minute after CPB ended and 24 hours after the onsetof CPB. Erythrocyte deformability measurements were carried out by an ektacytometer(LORCA [Laser-assisted Optical Rotational Cell Analyzer], RR Mechatronics, Hoorn, TheNetherlands) at different shear stress levels via laser diffraction analysis. Elongation index(EI) values were measured at nine different shear stress levels between 0,30-30 Pa.Erythrocyte aggregation measurements were also carried out by LORCA instrument andsaved as syllectogram. Aggregation index (AI) was calculated by an existing software. Thereweren?t any significant differences between two different priming solutions regarding theelongation indices at different shear rates and aggregation indices.Key words: Cardiopulmonary bypass, LORCA, hemorheology, HES 130/0.4, Ringer