Joe Basha’s PerfWeb #92 — RAPP (Retrograde Autologous Pump Prime) — Perfusion

Emily Foreman, CCP reviews her peer-reviewed publication on RAPP as a transfusion management procedure. In this YouTube video, Emily Foreman, CCP presents the findings of a paper published towards the end of 2021. The paper is titled "To Wrap or Not to Wrap." The purpose of the study was a quality improvement project to determine if wrapping during cardiac surgeries was beneficial for their patients. The speaker explains that their institution has a low prime bypass circuit and a strict anesthesia preoperative protocol. They analyzed about 40 different data points on each patient and examined reported benefits and possible negative consequences of wrapping during cardiac surgeries. They conducted a retrospective study by comparing two groups of patients: those who were wrapped during surgery and those who were not. They looked at various factors, including red blood cell transfusion index, oxygen delivery, postoperative acute kidney injury, albumin administration, ventilator times, ICU length of stay, and 30-day mortality. The speaker presents their original theories, such as the belief that wrapping may negatively impact acute kidney injury incidence and reduce oxygen delivery. However, their analysis revealed that wrapping did not have a statistically significant impact on most of the studied parameters. The only notable finding was a higher post-operative albumin administration in the wrapped group. The conclusion drawn from the study was that wrapping during cardiac surgeries was not beneficial in their patient population, considering their specific preoperative fluid administration protocols and prime circuit. They also mention the need for further research, particularly in cases involving condensed circuits. Overall, the study did not support the idea that wrapping was advantageous for their patients, and the speaker highlights the limitations and challenges they faced during the analysis.