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cardiopulmonary bypass before anesthesia

Paul S Pagel, Brent T Boettcher, Derek J De Vry, Julie K Freed, Zafar Iqbal
OBJECTIVE: Transmitral blood flow produces a vortex ring (quantified using vortex formation time [VFT]) that enhances the efficiency of left ventricular (LV) filling. VFT is attenuated in LV hypertrophy resulting from aortic valve stenosis (AS) versus normal LV geometry. Many patients with AS also have aortic insufficiency (AI). The authors tested the hypothesis that moderate AI falsely elevates VFT by partially inhibiting mitral leaflet opening in patients with AS. DESIGN: Observational study...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
Philippe Klee, Delphine Arni, Sonja Saudan, Valérie M Schwitzgebel, Ruchika Sharma, Oliver Karam, Peter C Rimensberger
OBJECTIVES: Hyperglycemia after cardiac surgery and cardiopulmonary bypass in children has been associated with worse outcome; however, causality has never been proven. Furthermore, the benefit of tight glycemic control is inconsistent. The purpose of this study was to describe the metabolic constellation of children before, during, and after cardiopulmonary bypass, in order to identify a subset of patients that might benefit from insulin treatment. DESIGN: Prospective observational study, in which insulin treatment was initiated when postoperative blood glucose levels were more than 12 mmol/L (216 mg/dL)...
September 2016: Pediatric Critical Care Medicine
André Y Denault, Jean S Bussières, Ramiro Arellano, Barry Finegan, Paul Gavra, François Haddad, Anne Q N Nguyen, France Varin, Annik Fortier, Sylvie Levesque, Yanfen Shi, Mahsa Elmi-Sarabi, Jean-Claude Tardif, Louis P Perrault, Jean Lambert
PURPOSE: Inhaled milrinone (iMil) has been used for the treatment of pulmonary hypertension (PH) but its efficacy, safety, and prophylactic effects in facilitating separation from cardiopulmonary bypass (CPB) and preventing right ventricular (RV) dysfunction have not yet been evaluated in a clinical trial. The purpose of this study was to investigate if iMil administered before CPB would be superior to placebo in facilitating separation from CPB. METHODS: High-risk cardiac surgical patients with PH were randomized to receive iMil or placebo after the induction of anesthesia and before CPB...
October 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Mona Momeni, Alain Poncelet, Jean Rubay, Amine Matta, Laurent Veevaete, Thierry Detaille, Laurent Houtekie, Stéphan Clement de Clety, Emilien Derycke, Stéphane Moniotte, Thierry Sluysmans, Francis Veyckemans
OBJECTIVES: This study evaluated the prognostic value of postoperative cardiac troponin-I (cTnI) in predicting all-cause mortality up to 3 months after normothermic congenital cardiac surgery. DESIGN: Prospective observational study. SETTING: University hospital. PARTICIPANTS: All children ages 0 to 10 years. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: cTnI was measured after the induction of anesthesia but before the surgery, at the pediatric intensive care unit arrival, and at 4, 12, and 24 hours postoperatively...
February 23, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Juho Keski-Nisula, Eero Pesonen, Klaus T Olkkola, Terri Ahlroth, Juha Puntila, Sture Andersson, Pertti J Neuvonen, Pertti K Suominen
BACKGROUND: The optimal dose of methylprednisolone during pediatric open heart surgical procedures is unknown. This study compared the antiinflammatory and cardioprotective effects of high and lower doses of methylprednisolone in children undergoing cardiac operations. METHODS: Thirty children, between 1 and 18 months old and undergoing total correction of tetralogy of Fallot, were randomized in double-blind fashion to receive either 5 or 30 mg/kg of intravenous methylprednisolone after anesthesia induction...
September 2016: Annals of Thoracic Surgery
Liang Chen, Lin Lv, Cun Long, Song Lou
OBJECTIVE: To investigate whether human serum albumin coating before cardiopulmonary bypass (CPB) could improve platelet function and hemostasis and mitigate the inflammatory response among patients receiving aortic arch replacement with deep hypothermic circulatory arrest (DHCA). METHODS: Sixty patients were included and randomized into two groups: the Control Group (CG, receiving 40 g human albumin 5 minutes after the initiation of CPB) and the Study Group (SG, circulating the prime with 40 g albumin for 5 minutes before CPB)...
October 2016: Perfusion
A E Bautin, M M Galagudza, D M Tashkhanov, S V Datsenko, A O Marichev, A A Kostareva, E N Kravchuk, A Yu Bakanov, M L Gordeev
OBJECTIVE: To evaluate cardioprotective effects of remote ischemic preconditioning (RIPC) in cardiac surgery patients undergoing aortic valve replacement depending on the type of anesthesia and investigate the level of myocardial protein kinase C epsilon (PKC-ε) expression after RIPC. METHODS: In prospective randomized trial, forty eight patients aging from 50 to 75 years old (64 (56 ;69)) were included All patients were scheduled for aortic valve replacement using cardiopulmonary bypass (CPB)...
November 2015: Anesteziologiia i Reanimatologiia
N M H Bulow, E Colpo, R P Pereira, E F M Correa, E P Waczuk, M F Duarte, J B T Rocha
Cardiopulmonary bypass (CPB) with extracorporeal circulation produces changes in the immune system accompanied by an increase in proinflammatory cytokines and a decrease in anti-inflammatory cytokines. We hypothesize that dexmedetomidine (DEX) as an anesthetic adjuvant modulates the inflammatory response after coronary artery bypass graft surgery with mini-CPB. In a prospective, randomized, blind study, 12 patients (4 females and 8 males, age range 42-72) were assigned to DEX group and compared with a conventional total intravenous anesthesia (TIVA) group of 11 patients (4 females and 7 males)...
2016: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
Gaisheng Yang, Xiaodong Xue, Yanying Chen, Zhihong Song, Zhen Jiang, Kejian Hu
OBJECTIVES: To study the effect of cardiopulmonary bypass (CPB) on nuclear factor-kappa B (NF-κB) and cytokine expression and pulmonary function in dogs. MATERIALS AND METHODS: Twelve male mongrel dogs were divided into a methylprednisolone group (group M) and a control group (group C). All animals underwent aortic and right atrial catheterization under general anesthesia. Changes in pulmonary function and hemodynamics were monitored and the injured site was histologically evaluated...
December 2015: Iranian Journal of Basic Medical Sciences
B A Akselrod, D A Guskov, E R Charchyan, S V Fedulova, A S Oystrakh, A A Eremenko, L S Lokshin, Z R Khachatryan, L A Medvedeva, N A Trekova
UNLABELLED: Aortic arch reconstruction is one of the most difficult surgical procedures. Therefore the aims of our study were: to choose appropriate flow rate for antegrade cerebral perfusion and assess its adequacy in relation to cerebral metabolic demands; to evaluate safety of temperature settings during the surgery; to assess the effectiveness of chosen protocol for brain and visceral organ protection during aortic arch reconstruction surgery. Our study included 67 patients. Patients of the first group (n = 33) underwent aortic arch reconstruction with antegrade cerebral perfusion and hypothermic circulatory arrest (target core temperature 26 °C)...
September 2015: Anesteziologiia i Reanimatologiia
Zui Zou, Hong B Yuan, Bo Yang, Fengying Xu, Xiao Y Chen, Guan J Liu, Xue Y Shi
BACKGROUND: Perioperative hypertension requires careful management. Angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II type 1 receptor blockers (ARBs) have shown efficacy in treating hypertension associated with surgery. However, there is lack of consensus about whether they can prevent mortality and morbidity. OBJECTIVES: To systematically assess the benefits and harms of administration of ACEIs or ARBs perioperatively for the prevention of mortality and morbidity in adults (aged 18 years and above) undergoing any type of surgery under general anaesthesia...
2016: Cochrane Database of Systematic Reviews
Takuma Maeda, Koichi Toda, Masataka Kamei, Shigeki Miyata, Yoshihiko Ohnishi
The purpose of this study was to elucidate the difference in inotrope use between patients who underwent left ventricular assist device (LVAD) implantation with preoperative extracorporeal membrane oxygenation (ECMO) and those who underwent LVAD implantation without preoperative ECMO. One hundred and eight patients who underwent LVAD implantation were enrolled in this study. Prior to LVAD implantation, 27 patients received ECMO support (ECMO group) and the other 81 patients did not (non-ECMO group). Cardiac index (CI), mean arterial pressure (MAP), mixed venous oxygen saturation (SvO2), and the vasoactive inotropic score (VIS) were recorded at weaning from cardiopulmonary bypass (CPB), 30 min after weaning from CPB (min after CPB), 60 min after CPB, and at the end of surgery...
2015: SpringerPlus
Yong-Hee Park, In-Kyung Song, Ji-Hyun Lee, Hee-Soo Kim, Chong-Sung Kim, Jin-Tae Kim
This study was performed to evaluate the feasibility of intraoperative point-of-care trans-fontanellar cerebral ultrasonography (TFCU) to obtain blood flow velocity (BFV) reference values at the internal carotid arteries (ICAs) and peri-callosal part of the anterior cerebral artery (pACA) during pediatric cardiac surgery under cardiopulmonary bypass (CPB). TFCU was performed at three time points (after induction of anesthesia, during CPB, after CPB) in 35 infants. BFV was measured at both ICAs and pACA through the anterior fontanelle with an ultrasound sector probe...
December 21, 2015: Journal of Clinical Monitoring and Computing
Giuseppe Fuda, André Denault, Alain Deschamps, Denis Bouchard, Annik Fortier, Jean Lambert, Pierre Couture
BACKGROUND: A central-to-radial arterial pressure gradient may occur after cardiopulmonary bypass (CPB), which, in some patients, may last for a prolonged time after CPB. Whenever there is a pressure gradient, the radial artery pressure measure may underestimate a more centrally measured systemic pressure, which may result in a misguided therapeutic strategy. It is clinically important to identify the risk factors that may predict the appearance of a central-to-radial pressure gradient, because more central sites of measurements might then be considered to monitor systemic arterial pressure in high-risk patients...
March 2016: Anesthesia and Analgesia
Sarah W Franklin, Fania Szlam, Janet D Fernandez, Traci Leong, Kenichi A Tanaka, Nina A Guzzetta
BACKGROUND: Bleeding is a serious complication after pediatric cardiopulmonary bypass (CPB) that is associated with an increase in perioperative morbidity and mortality. Four-factor prothrombin complex concentrates (4F-PCCs) have been used off-label to supplement transfusion protocols for bleeding after CPB in adults; however, data on their use in neonates are limited. In this study, we hypothesized that 4F-PCCs administered ex vivo to neonatal plasma after CPB will increase thrombin generation...
April 2016: Anesthesia and Analgesia
Hüseyin Şaşkın, Cagri Duzyol, Kazım Serhan Ozcan, Rezan Aksoy, Mustafa Idiz
BACKGROUND: Treatment method in patients with coronary artery disease undergoing coronary bypass surgery with accompanying carotid artery disease is still a hot topic among clinicians. This study is designed to investigate if there is an effect on myocardial infarction, cerebrovascular events and mortality during postoperative period of simultaneous carotid endarterectomy with coronary bypass surgery compared to staged carotid artery stenting before coronary bypass surgery. METHODS: 102 patients (79 male, 23 female) who underwent simultaneous carotid endarterectomy with coronary bypass surgery or staged carotid artery stenting with coronary bypass surgery in the same center with the same surgical team were divided into 2 groups and retrospectively reviewed...
2015: Heart Surgery Forum
Shaun Mendel
Interdisciplinary education offerings between students of cardiovascular science and nurse anesthesia are uncommon despite the collaborative nature of these disciplines. The dual purpose of this article is to describe a method for interdisciplinary simulation and to report survey responses provided by participants. An interdisciplinary simulation session using concurrent use of the cardiopulmonary bypass simulator and the emergency care simulator is described. Interdisciplinary perceptions before and after the event were surveyed using the revised Interdisciplinary Education Perception Scale...
December 2014: Journal of Extra-corporeal Technology
Puyu Yang, Jun Zhang, Yanna Li, Hui Wang, Jun Zheng
OBJECTIVE: To evaluate the clinical characteristics of aortic dissection in pregnant patients with Marfan syndrome and the maternal and fetal outcomes in cardiovascular surgery. METHODS: Seven pregnant women with Marfan syndrome with aortic dissection were identified, who were treated in Beijing Anzhen Hospital Affiliated to Capital Medical University between January 2012 and September 2014. Patient charts were reviewed for cardiovascular surgery, occurrence of complications, clinical features and the maternal and fetal outcomes...
May 2015: Zhonghua Fu Chan Ke za Zhi
Giuseppe Santarpino, Vito G Ruggieri, Giovanni Mariscalco, Karl Bounader, Cesare Beghi, Theodor Fischlein, Francesco Onorati, Giuseppe Faggian, Giuseppe Gatti, Aniello Pappalardo, Marisa De Feo, Ciro Bancone, Andrea Perrotti, Sidney Chocron, Magnus Dalen, Peter Svenarud, Antonino S Rubino, Carmelo Mignosa, Riccardo Gherli, Francesco Musumeci, Angelo M Dell'Aquila, Eeva-Maija Kinnunen, Fausto Biancari
Salvage coronary artery bypass grafting (CABG) is often performed for cardiogenic shock on compassionate basis without clinical data justifying this aggressive approach. The aim of this study was to analyze early and intermediate outcomes after salvage CABG. We retrospectively reviewed the data of 85 patients who underwent salvage CABG at 11 European cardiac surgery centers. Salvage CABG was defined according to the EuroSCORE criteria, that is, a procedure performed in patients requiring cardiopulmonary resuscitation (external cardiac massage) en route to the operating theater or before induction of anesthesia...
October 15, 2015: American Journal of Cardiology
Hamish Mace, Nicholas Lightfoot, Stuart McCluskey, Rita Selby, Debashis Roy, Tarik Timoumi, Keyvan Karkouti
OBJECTIVE: To assess the validity of fibrinogen assay of rotational thromboelastometry (FIBTEM)-derived estimates of fibrinogen in samples collected during cardiopulmonary bypass in cardiac surgical patients by comparison to Clauss method fibrinogen concentration. DESIGN: Retrospective observational study. SETTING: Single university hospital center. PARTICIPANTS: Human participants. INTERVENTIONS: Retrospectively obtained laboratory assays including rotational thromboelastometry (ROTEM) and Clauss fibrinogen assay...
January 2016: Journal of Cardiothoracic and Vascular Anesthesia
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