Contemporary Australian priming constituents for adult perfusion centres: a survey

Abstract

Aim: Evidence for the ideal/best practice priming solution remains meagre and largely historical. The aim of this survey was to determine the constituents of contemporary priming solutions in adult open-heart centres across Australia. This would provide insight on the level of variation within current Australian priming practices and inform perfusionists of how their current priming methods compare to the spectrum of Australian practice. Method: A total of 15 survey questions covering various aspects of priming constituents were sent via email to perfusionists in all 63 adult open-heart centres across Australia. Results: This prime survey received a 100% response rate across Australia. All units prime with a balanced physiological solution, 73% of units prime with Plasma-Lyte 148 and 19% with Hartmann’s solution. No synthetic colloids are used for priming in Australia. Up to 6,520 (30%) cases per annum receive heparin as the only additive to their prime base solution. All other cases had various combinations of sodium bicarbonate, mannitol and albumin added for a variety of recorded reasons. Conclusion: Contemporary Australian priming practices show a marked level of conformity between units. Variation exists in the rationale for adding sodium bicarbonate, mannitol and albumin. Further investigations into the clinical effects of these additives are required to determine if the rationale for their addition is historical or judicious in this contemporary era of low prime volumes, physiological base solutions and coated bypass circuits.