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Mannitol cardiac surgery

Luis M Pereira, Gregory S Matte, Peter Lutz, Alana Arnold, Al Patterson
Background: The del Nido cardioplegia solution (dNCS) was originally developed for pediatric cardiac surgery, being now also used for adult patients. Hospital pharmacies frequently resort to internal dNCS production which has led to an increase in the need for validated parameters for compounding and storage. Objective: This report defines in-house production standards, as well as the stability of dNCS under optimal storage conditions. Methods: All ingredients were sterile and United States Pharmacopeia (USP)/National Formulary (NF) certified...
December 2017: Hospital Pharmacy
Radhakrishnan Muthuchellappan, Ramesh V J, Umamaheswara Rao Ganne S, Thennarasu K, Anjana Jacob, Sripathy G, Bhadrinarayan V, Mohanvelu K
Blood pressure (BP), a surrogate of cardiac output (CO), is also dependent on systemic vascular resistance (SVR). But SVR is not routinely monitored in daily clinical practice. We hypothesise that the time difference between the peripheral arterial waveform and the finger plethysmographic waveform (time lag index - TLi) could indicate the systemic vascular resistance. In this study, we correlated TLi with the systemic vascular resistance measured by minimally invasive CO monitor (pulse contour analysis). SVR changes in response to administration of mannitol were studied...
January 2018: Journal of Medical Engineering & Technology
Lachlan F Miles, Timothy G Coulson, Carlos Galhardo, Florian Falter
BACKGROUND: Regional patterns of practice in cardiopulmonary bypass remain poorly understood with conflicting evidence regarding the best choices in pump priming preferences with respect to colloid and crystalloid and different types of fluid within these categories. In light of the variation in the literature, we hypothesized there would be considerable regional differences in cardiopulmonary bypass practice, particularly with respect to the type of fluid used to prime the extracorporeal circuit...
December 2017: Anesthesia and Analgesia
Ahmed S Bux, Merry L Lindsey, Hernan G Vasquez, Heinrich Taegtmeyer, Romain Harmancey
We investigated the isolated working rat heart as a model to study early transcriptional remodeling induced in the setting of open heart surgery and stress hyperglycemia. Hearts of male Sprague Dawley rats were cold-arrested in Krebs-Henseleit buffer and subjected to 60 min normothermic reperfusion in the working mode with buffer supplemented with noncarbohydrate substrates plus glucose (25 mM) or mannitol (25 mM; osmotic control). Gene expression profiles were determined by microarray analysis and compared with those of nonperfused hearts...
January 1, 2017: Physiological Genomics
Sara L Zettervall, Dominique B Buck, Peter A Soden, Jack L Cronenwett, Phillip P Goodney, Mohammad H Eslami, Jason T Lee, Marc L Schermerhorn
OBJECTIVE: Significant regional variation in surgical rates has been identified following multiple surgical procedures. However, limited data have examined the regional variability in patient selection and treatment of abdominal aortic aneurysms (AAAs). This study aimed to evaluate regional variation in patient selection, perioperative management, and operative approach for the repair of AAAs. METHODS: All patients undergoing open repair or endovascular aneurysm repair (EVAR) of an AAA in the Vascular Quality Initiative from 2009 to 2014 were identified...
October 2016: Journal of Vascular Surgery
Emine Bilge Narin, Ilhan Oztekin, SeherDeniz Oztekin, Betul Ogutmen
OBJECTIVES: To compare the effects of different routes and timings of administration of dopamine and mannitol used to alleviate the adverse effects of prolonged cardiopulmonary bypass (CPB) on renal functions in coronary artery surgery. METHODS: Group I (n: 25 patients): Mannitol 1 g/kg was added into the priming solution for CPB. Group II (n: 25 patients): IV dopamine was administered at a dose of 2 μg/kg/min during the time period between anesthesia induction and end of surgery...
September 2015: Pakistan Journal of Medical Sciences Quarterly
Sinai C Zyblewski, Paul J Nietert, Eric M Graham, Sarah N Taylor, Andrew M Atz, Carol L Wagner
OBJECTIVES: To evaluate intestinal barrier function in neonates undergoing cardiac surgery using lactulose/mannitol (L/M) ratio measurements, and to determine correlations with early breast milk feeding. STUDY DESIGN: This was a single-center, prospective, randomized pilot study of 27 term-born neonates (≥ 37 weeks gestation) requiring cardiac surgery who were randomized to 1 of 2 preoperative feeding groups: nil per os (NPO) or trophic (10 mL/kg/day) breast milk feeds...
July 2015: Journal of Pediatrics
Katrine B Buggeskov, Janus C Jakobsen, Niels H Secher, Thomas Jonassen, Lars W Andersen, Daniel A Steinbrüchel, Jørn Wetterslev
BACKGROUND: Pulmonary dysfunction complicates cardiac surgery that includes cardiopulmonary bypass. The pulmonary protection trial evaluates effect of pulmonary perfusion on pulmonary function in patients suffering from chronic obstructive pulmonary disease. This paper presents the statistical plan for the main publication to avoid risk of outcome reporting bias, selective reporting, and data-driven results as an update to the published design and method for the trial. RESULTS: The pulmonary protection trial is a randomized, parallel group clinical trial that assesses the effect of pulmonary perfusion with oxygenated blood or Custodiol™ HTK (histidine-tryptophan-ketoglutarate) solution versus no pulmonary perfusion in 90 chronic obstructive pulmonary disease patients...
December 23, 2014: Trials
Karola Trescher, Elda Dzilic, Maximilian Kreibich, Harald Gasser, Klaus Aumayr, Dontscho Kerjaschki, Brigitte Pelzmann, Seth Hallström, Bruno K Podesser
OBJECTIVES: Currently available cardioplegic solutions provide excellent protection in patients with normal surgical risk; in high-risk patients, however, such as in emergency coronary artery bypass surgery, there is still room for improvement. As most of the cardioplegic solutions primarily protect myocytes, the addition of substances for protection of the endothelium might improve their protective potential. The nitric oxide donor, S-nitroso human serum albumin (S-NO-HSA), which has been shown to prevent endothelial nitric oxide synthase uncoupling, was added to the newly developed histidine-tryptophan-ketoglutarat (HTK-N) cardioplegia in an isolated heart perfusion system after subjecting rats to acute myocardial infarction (MI) and reperfusion...
March 2015: Interactive Cardiovascular and Thoracic Surgery
Carlo Savini, Giacomo Murana, Marco Di Eusanio, Sofia Martin Suarez, Giuliano Jafrancesco, Sebastiano Castrovinci, Andrea Castelli, Roberto Di Bartolomeo
OBJECTIVE: Minimally invasive mitral valve surgery may require a prolonged period of myocardial ischemia. Cardioplegic solutions that necessitate a single dose for adequate myocardial protection are evoked to simplify surgery and result to be appealing in this setting. The aim of this study was to assess early outcomes after minimally invasive mitral valve surgery using one single dose of histidine-tryptophan-ketoglutarate solution (HTK; Custodiol) for myocardial protection. METHODS: Between February 2003 and October 2012, a total of 49 consecutive patients underwent minimally invasive mitral valve surgery using a single dose of HTK solution for myocardial protection...
November 2014: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
M Olmos Rodríguez, J A Ballester Hernández, M T Arteta Bárcenas, A Rodríguez Cerezo, M A Vidarte Ortiz de Artiñano, C Veiga Alameda
OBJECTIVE: Assess the effectiveness of priming the extracorporeal circulation system with albumin-mannitol combined with ultrafiltration during extracorporeal circulation to reduce post-operative bleeding and transfusion requirements in heart surgery, as well as its impact on the fluid balance, coagulation and hematocrit parameters, re-operation for bleeding, ICU, and hospital length of stay. MATERIAL AND METHODS: A total of 134 patients scheduled for heart surgery were randomized to receive Ringer's lactate 1,500mL in the priming reservoir (group C), or mannitol 20% 250mL, albumin 20% 150mL and Ringer's lactate 1,100mL combined with ultrafiltration (group T)...
February 2015: Revista Española de Anestesiología y Reanimación
Karla Reichert, Helison Rafael Pereira do Carmo, Fany Lima, Anali Galluce Torina, Karlos Alexandre de Souza Vilarinho, Pedro Paulo Martins de Oliveira, Lindemberg Mota Silveira Filho, Elaine Soraya Barbosa de Oliveira Severino, Orlando Petrucci
INTRODUCTION: Myocardial preservation during open heart surgeries and harvesting for transplant are of great importance. The heart at the end of procedure has to resume its functions as soon as possible. All cardioplegic solutions are based on potassium for induction of cardioplegic arrest. OBJECTIVE: To assess a cardioplegic solution with no potassium addition to the formula with two other commercially available cardioplegic solutions. The comparative assessment was based on cytotoxicity, adenosine triphosphate myocardial preservation, and caspase 3 activity...
October 2013: Revista Brasileira de Cirurgia Cardiovascular
Yasuhisa Okamoto, Tosihiro Nohmi, Koichiro Seki, Yuki Higa
Chronic renal failure (CRF) is related to cardiac diseases. Cardiac surgery is also related to postoperative acute kidney injury (AKI). It means heart and kidney have close relationship. We analyzed recent published data to understand how to manage CRF patients undergoing cardiovascular surgeries. We compared endovascular surgery and open procedure for aortic aneurysm, especially about contrast media-related renal damage, On or Off CABG or PCI for ischemic heart disease. We also discussed the relation between cardiopulmonary bypass and AKI and the risk factors causing AKI after CPB...
November 2013: Masui. the Japanese Journal of Anesthesiology
Mario Gaudino, Claudio Pragliola, Amedeo Anselmi, Maurizio Pieroni, Stefano De Paulis, Alessandro Leone, Alberto Ranieri De Caterina, Massimo Massetti
OBJECTIVES: To clarify the reliability of the one-shot histidine-tryptophane-ketoglutarate (HTK) cardioplegia for right ventricular (RV) myocardial protection during mitral surgery, in patients with or without pre-operative RV dysfunction. DESIGN: Sixty patients undergoing isolated mitral surgery were randomized to myocardial protection with either one-shot HTK or intermittent warm blood cardioplegia (WBC). The RV function was assessed by echocardiography and hemodynamic assessment...
December 2013: Scandinavian Cardiovascular Journal: SCJ
P Giordano, G Scrascia, D D'Agostino, F Mastro, C Rotunno, M Conte, R Rociola, D Paparella
Myocardial protection during cardiac surgery can be accomplished by different cardioplegic solutions. The aim of this study was to assess myocardial damage after heart valve surgery performed with myocardial protection of a single dose of Celsior cardioplegia or with repeated cold blood cardioplegia. After the stratification of 139 valvular patients by means of matching according to cross-clamp and cardiopulmonary bypass time, 32 patients were retained for comparison (16 patients received Celsior and 16 patients received cold blood cardioplegia)...
November 2013: Perfusion
Tobias Krüger, Isabell Hoffmann, Maria Blettner, Michael Andrew Borger, Christian Schlensak, Ernst Weigang
OBJECTIVES: Cerebral protection during acute aortic dissection Type A (AADA) surgery may be affected by perfusion strategies and ischaemic protective drugs. METHODS: We analysed the impact of intraoperative barbiturate, steroid and mannitol use and adjunctive cerebral perfusion (CP), on 30-day mortality and new postoperative mortality-corrected permanent neurological dysfunction (PNDmc) in the German Registry for Acute Aortic Dissection Type A. RESULTS: Two thousand one hundred and thirty-seven AADA patients were registered over a 4-year period...
November 2013: European Journal of Cardio-thoracic Surgery
Sara Al-Hashimi, Mahvash Zaman, Paul Waterworth, Haris Bilal
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: Does the use of thiopental provide added cerebral protection during deep hypothermic circulatory arrest (DHCA)? Altogether, more than 62 papers were found using the reported search, of which 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
August 2013: Interactive Cardiovascular and Thoracic Surgery
Mirela Bojan, Harlinde Peperstraete, Marc Lilot, Laurent Tourneur, Pascal Vouhé, Philippe Pouard
BACKGROUND: The present study aimed to compare myocardial protection, as assessed by cardiac troponin-I release, and short-term outcomes between two groups of neonates undergoing the arterial switch operation (ASO) with either Custodiol cardioplegia (Custodiol HTK, Köhler Chemie GmbH, Bensheim, Germany) or repeated oxygenated warm blood cardioplegia. METHODS: A total of 218 neonates were enrolled retrospectively from February 2007 through February 2011. All analyses were stratified on the type of procedure (ASO±ventricular septal defect closure ± aortic arch repair)...
April 2013: Annals of Thoracic Surgery
K Trescher, M Hasun, A Baumgartner, W Dietl, M Wolfsberger, S Hallström, B K Podesser
AIM: The aim of this paper was to improve operative outcome during open-heart surgery in patients with failing hearts, the composition of cardioplegic solutions has to be further optimized. HTK-N46b, a novel cardioplegic solution, has been developed for efficient protection of the energy state of myocytes as well as endothelial cells. Aim of this study is the evaluation of HTK-N46b in comparison to its precursor Custodiol® (HTK) in failing rat hearts undergoing ischemia/reperfusion. METHODS: In male Sprague Dawley rats myocardial infarction (MI) was induced by LAD ligation...
June 2013: Journal of Cardiovascular Surgery
Katrine B Buggeskov, Jørn Wetterslev, Niels H Secher, Lars W Andersen, Thomas Jonassen, Daniel A Steinbrüchel
BACKGROUND: Five to thirty percent of patients undergoing cardiac surgery present with chronic obstructive pulmonary disease (COPD) and have a 2- to 10-fold higher 30-day mortality risk. Cardiopulmonary bypass (CPB) creates a whole body systemic inflammatory response syndrome (SIRS) that could impair pulmonary function. Impaired pulmonary function can, however, be attenuated by pulmonary perfusion with oxygenated blood or custodiol HTK (histidine-tryptophan-ketoglutarate) solution. METHODS/DESIGN: The Pulmonary Protection Trial (PP-Trial) randomizes 90 patients undergoing CPB-dependent cardiac surgery to evaluate whether pulmonary perfusion with oxygenated blood or custodiol HTK solution reduces postoperative pulmonary dysfunction in COPD patients...
January 31, 2013: Trials
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