Comparative study to assess the effect of priming solutions (Plasmalyte-A and Ringer Lactate) on Acid–base balance during cardiopulmonary bypass for adult cardiac surgery

Abstract

Background: Priming solution used in cardiopulmonary bypass has different impact on body, primarily on the metabolic acidosis and electrolytes. This observational comparative study was done to find the metabolic effects of Ringer lactate and Plasmalyte-A as priming solutions for various metabolic parameters during adult cardiac surgery. Materials and Methods: In the present study, 52 subjects were included who received different priming solutions. Subjects were categorized into two groups. Group P received Plasmalyte-A as prime and Group R received Ringer lactate. From all these cases, samples were collected at predefined time durations, and results were compared between both groups. Observation and Results: A total of 52 patients were evaluated for the metabolic changes concerning different priming solutions. Group P included the subject who received Plasmalyte-A as pump prime (n = 26), and Ringer lactate was used as pump prime in Group R (n = 26). We compared various parameters such as pH: In Group R, a decrease in pH was statistically significant with P < 0.05 at 40 min of bypass (T40) and P < 0.05 at 6 h of postbypass (T6). Base Excess: The mean value in Group P was − 1.72 ± 2.18 and − 3.16 ± 2.48 and in Group R at 30 min of bypass (T30). A statistically significance was found between the two groups for this parameter (P < 0.05). Lactate and Strong Ions Difference: A statistically significant data were found between the two groups for this parameter throughout the bypass as well as postoperative hours with the P < 0.05. Conclusion: Plasmalyte-A is more favorable crystalloid solution as a pump prime fluid as it helped to maintain satisfactory metabolic parameters with less metabolic acidosis during adult cardiac surgeries.