Files
Abstract
Albumin is a plasma protein that is present in the native circulation of all humans, and plays a critical role in maintaining blood pressure through the colloid osmotic pressure [COP] it exerts within blood vessels. During cardiothoracic surgery, it is common practice to add albumin to the cardiopulmonary bypass circuit prime in an attempt to reduce the drop in colloid osmotic pressure of the circulation. While this is inarguably important, a universal protocol for finding the appropriate amount of albumin to add does not exist. The purpose of this project was to develop a model for the addition of albumin in the cardiopulmonary bypass circuits of pediatric patients, based on theoretical calculations and current clinical evidence.
This project began with an investigation as to the relationship between outcomes and albumin concentration in a cardiopulmonary bypass prime solution. Literature was reviewed that was both current and relevant to pediatrics, cardiopulmonary bypass circuit priming, albumin, colloid osmotic pressure, and edema. After a thorough exploration of the literature and accompanying data, it was evident that the need for an appropriate albumin concentration was supported, and the development of such a protocol for it was pursued.
The end result of this project produced a set of equations, built into a spreadsheet-based calculator, that could be integrated into the practice of pediatric perfusion to determine the appropriate amount of albumin to be added into the cardiopulmonary bypass prime. The implementation of the equations and calculator is expected to result in better outcomes of the pediatric population after cardiothoracic surgery.