A new formula to calculate perfusion rate in advanced hemodilution and tepid cardiopulmonary bypass

BACKGROUND: During cardiopulmonary bypass, perfusion flow rate is generally calculated only with the patient body surface. Recently, far advanced hemodilution during cardiopulmonary bypass and tepid bypass circulation are common. PURPOSE: We have arrived at an appropriate flow rate formula, in which factors like temperature, hemoglobin concentration, the target mixed venous oxygen saturation (SvO2), and the amount of oxygen consumption are included. Our formula was compared with the conventional one. MATERIAL AND METHOD: Seventy-four points of cardiopulmonary bypass data under total cardiopulmonary bypass in 33 patients were studied. Our formula's validity was re-evaluated. Then, the SvO2 values were predicted by applying the flow rate value as per conventional calculation in to our formula. RESULTS: The flow rate of our formula and the actual flow rate are well correlated (r = 0.9212). In the prediction of the SvO2 by the conventional method, 36.5% were calculated to have a SvO2 of less than 60%. Furthermore, with a hemoglobin concentration of 7 g/dl, 73.3% were calculated to have a SvO2 of less than 60%. With a body temperature of 34 degrees centigrade, 53.8% were calculated to have a SvO2 of less than 60%. On the other hand, to maintain SvO2 level at 70% by the conventional method, if the patient hemoglobin concentration was 10 g/dl, temperature should be maintained at 36 degrees centigrade, and when hemoglobin concentration is 7 g/dl, the temperature should be maintained at 33 degrees centigrade. CONCLUSION: In advanced hemodilution or tepid cardiopulmonary bypass, use of appropriate flow rate formula is recommended, which takes into account the indispensable factors such as hemoglobin levels, temperature, and the target SvO2.