WVith the technical assistance of C. Polk Smith, B.S. W ITHIN LESS THAN a decade, clinical experience with techniques of extracorporeal eirculation has made possible the successful surgical correction of numerous congenital and acquired lesions of the hleart. In the majority of inistaniees, a pool of freslh, heparinized blood has beeni required to prime the various types of pump oxygenators. The need for such a pool of homologous blood has presented considerable difficulty in regard to blood

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... curement inl many ceenters, antd recentlv a number of adverse physiological changes associated with cardiopulmonary bvpass have been attributed to reactions from the use of large amounts of homologous blood.' Approximately 18 months ago, our experience with emergency pulmonary embolectomy emphasized to us the need for blood substitutes.2 At that time, animal investigations demonstrated the feasibility of using 5 per cent dextrose in distilled water to prime the pumip oxygenator, and we recommended this technique for emergency situations.3 Both Panieo4 and Long5 lhave reported the use of blood substitutes for extracorporeal eirculationl. Greer, Carey. anid Zuhdi6 demonstrated that 5 per cent dextrose in distilled water could be used clinically to primne the pumlp oxygenator, combining this approach with hypothermia; more recently, DeWall7 elaborated upon a similar technique. On the basis of these reports and confirmation of the results of Gadboys and associates1 in our own laboratory, we developed a technique of open-heart surgery using disposable From the Cora anid Webb Mading Service (HE-03137 and HTS-5387) and the Houston Heart Association. oxygenators priuned with 3 per cent dextrose in distilled water under norinothermic condi-tionS.8 Clinical experience witlh muore thani 100 consecutive cases in which this techniique was employed denmonistrated that this method prov,ides niot onily coniveniiencee, but also superior results in almost every respect." To determinie the renal heimiodynamic effects of such a teelniique of extracorporeal eirculation, the followving investigationi was performed. Materials and Methods Sixteen mongrel dogs, varying in weight from 15 to 30 Kg., were anesthetized with pentobarbital sodium. Respiration was controlled by intermittent positive pressure through an endotracheal tube. An indwelling urinary bladder catheter was inserted, and control renal function studies were performiled. The chest was opened through the right fifth intercostal space, and the azygos vein was ligated. The pericardiunm was opened longitudinallv anterior to the right phrenic nerve, and umbilical tapes were placed around the superior and inferior veenae cavae and passed through catheters for subsequent use as tourniquets. Following heparinizationl, catheters were iniserted inlto the superior and iniferior veiiae eavae through the righlt atriuiti, and the left femoral artery was (anI1ulated. The animilals wer e alternately divided illto two gril'oups. In onie goroup, fr-esh hepariiiized blood, drawn under local anesthesia, was used to primiie the pumllp oxygeniator. In the other group, 5 per cent dextrose in distilled water was used as the primiing agent. The priminig volumue was calculated onthe basis of 30 ml. per Kg. of the animal's body weight. Total cardiopulinoniary bypass fromii the venae eavae to the femoral artery was instituted, tightening the vena eaval tourniquets. Roller pumps were used, and oxygenation was obtained by emnploying the bubble diffusion prinleiple and disposable plastic oxygenators.' Flow rate was maintained at 80 nil. per minute per Kg. body weight. Replacemlent of blood loss with stored, acid-citratedextrose blood approximiiated 400 ml. in both