A Comparative Review of Crystalloid, Albumin, Pentastarch and Hetastarch as Perfusates for Cardiopulmonary Bypass

A comparative review is made of the four most common asanguineous solutions used for the priming of cardiopulmonary bypass equipment. Increasing health care costs and concerns over the administration of blood derived products has cardiac programs examining their practice of using albumin as a routine part of the priming solution for bypass. Emphasis is being placed on the use of crystalloids with synthetic colloids, or crystalloids alone, as the priming agents for extracorporeal circulation. However new evidence has shown that the use of these solutions, without the addition of albumin, may be associated with the development of a cold induced agglutination. The data reviewed suggests that the ideal priming fluid may still not be available and recommendations are made.