Clinical Study On The Prognosis Of Pediatric With Congenital Heart Disease Less Than 5 Kg With Different Colloid Priming Strategies Of Cardiopulmonary Bypass

Objective To explore the effect of complete replacement of human serum albumin with artificial colloid as a priming solution on the prognosis of pediatric less than 5kg during cardiopulmonary bypass.Methods This is a prospective study,in a patient-and-assrssor-bilnded randomized trial,sixty-five pediatric less than 5 kg who underwent congenital heart surgery in our hospital from September 2016 to December 2017 were randomly divided into two groups:artificial colloids group(n = 33)and artificial colloids compound albumin group(n = 32).The primary clinical end point was the colloid osmotic pressure of the patient during cardiopulmonary bypass.Secondary clinical end points contains:CPB time,cross-clamping time,ultrafiltration volume,urine volume,hematocrit,and lactic during CPB in both groups.perioperative blood products and hemostatic drugs usage,postoperative coagulation function,postoperative liver and kidney biochemical indicators,urine volume and pleural fluid volume 24h after operation,postoperative mechanical ventilation time,postoperative ICU stay and hospitalization days,perioperative adverse event rate and mortality rate.Results There was no significant difference in priming colloid osmotic pressure between the two groups at various time points(P<0.05).There was no significant difference in CPB time,across-clamping time,ultrafiltration volume and urine volume,and perioperative HCT and lactic between the two groups(P>0.05).The rate of platelet usage in the control group during chest closing was higher than that in the experimental group(P<0.05).There was no significant difference in the amount of other blood products and coagulation index between the two groups during perioperative period(P>0.05).The levels of urea nitrogen and postoperative hospital stay in the control group were significantly higher than those in the experimental group(P<0.05).Urine volume of experimental group was lower than that of control group(P<0.05)24h after operation,but AKIN evaluation of acute renal function injury between the two groups shows no significant difference statistically(P>0.05).There was no significant difference between the two groups in the duration of mechanical ventilation and the incidence of perioperative adverse events and mortality rate(P>0.05).Conclusion The use of artificial colloids to completely replace human serum albumin as an extracorporeal circulation colloidal priming did not adversely affect the surgical outcomes of pediatric less than 5 kg with congenital heart defects.