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Oxygen consumption cardiopulmonary bypass

Carole Hamilton, Denise Marin, Frank Weinbrenner, Branka Engelhardt, Dow Rosenzweig, Ulrich Beck, Pavel Borisov, Stephen Hohe
BACKGROUND: There is no acceptable method of testing oxygen transfer performance in membrane oxygenators quickly and easily during cardiopulmonary bypass. Pre-clinical testing of oxygenators is performed under controlled situations in the laboratory, correlating oxygen transfer to blood flow using 100% oxygen. This laboratory method cannot be used clinically as oxygen transfer values vary significantly at each blood flow and the FiO2 is not kept at 1. Therefore, a formula was developed which corrects the existing FiO2 to attain a PaO2 of 150 mmHg: the corrected FiO2 at 150 mmHg...
September 5, 2016: Perfusion
Samuele Baldasseroni, Alessandra Pratesi, Sara Francini, Rachele Pallante, Riccardo Barucci, Francesco Orso, Costanza Burgisser, Niccolò Marchionni, Francesco Fattirolli
OBJECTIVES: To assess the effect of cardiac rehabilitation (CR) and identify predictors of changes in functional capacity with CR in a consecutive series of older adults with a recent cardiac event. DESIGN: Observational. SETTING: In-hospital CR unit. PARTICIPANTS: Individuals aged 75 and older referred to an outpatient CR Unit after an acute coronary event (unstable angina pectoris, acute myocardial infarction) or cardiac surgery (coronary artery bypass grafting, heart valve replacement or repair) (N = 160, mean age 80 ± 4)...
August 2016: Journal of the American Geriatrics Society
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
Yuan Zhang, Yanning Qian, Hongguang Bao, Hongwei Shi, Jianwei Zhou
The present study was to examine the effect of stellate ganglion block (SGB) on bilateral regional cerebral oxygen saturation (rSO2) and postoperative cognitive function. Eighty patients undergoing selective coronary artery bypass graft with cardiopulmonary bypass (CPB) were randomly and equally divided into two groups. The patients in group S were given right SGB with ropivacaine, while the patients in group C were injected with normal saline. We compared the bilateral rSO2 after SGB. Minimum Mental State Examination (MMSE), Visual Verbal Learning Test (VVLT), and Digital Span Test (DST) were applied to observe the effect on cognitive function...
February 2016: Sheng Wu Yi Xue Gong Cheng Xue za Zhi, Journal of Biomedical Engineering, Shengwu Yixue Gongchengxue Zazhi
Ying-Hsuan Tai, Kuang-Yi Chang, Shu-Wei Liao, Kwei-Chun Chung, Chun-Che Shih, Shung-Tai Ho, Chih-Cherng Lu, Mei-Yung Tsou
PURPOSE: The aim of the study was to evaluate the effects of high-dose nitroglycerine (NTG) on glucose metabolism, tissue oxygenation and postoperative recovery in cardiac surgical patients. METHODS: Cardiac surgical patients in the retrospective survey were classified into two groups based on the NTG regimen. NTG group had intravenous loading of NTG (infusion rate 10-20 mg/h with total dose of ≥0.5 mg/kg) starting at rewarming of cardiopulmonary bypass (CPB) (n = 101), and control group had no intravenous loading of NTG (n = 151)...
October 2016: Journal of Anesthesia
Johannes Blumenstein, Suzanne de Waha, Holger Thiele
Percutaneous mechanical circulatory support devices, such as intra-aortic balloon pump (IABP), active left ventricular assist devices (LVAD) or extracorporeal life support (ECLS), are treatment options for selected patients in cardiogenic shock, undergoing cardiopulmonary resuscitation, or high-risk percutaneous coronary intervention and coronary artery bypass grafting. Potential benefits include the maintenance of organ function and the reduction of intracardiac pressures, volumes, and oxygen consumption. On the other hand, they are invasive, resource intensive, and can be associated with serious complications...
May 17, 2016: EuroIntervention
Sarah Brant, Cyonna Holmes, Michael Cobert, LaShondra Powell, John Shelton, Michael Jessen, Matthias Peltz
BACKGROUND: Machine perfusion is a promising strategy for donor heart preservation, but delivery of perfusate through the aorta may be limited by aortic valve incompetence. We hypothesized that retrograde machine perfusion preservation through the coronary sinus avoided this issue and allowed for recovery of donor hearts after long-term storage. METHODS: Canine hearts were procured after arrest with 1 liter University of Wisconsin Machine Perfusion Solution (UWMPS) and preserved for 14 hours by static hypothermic storage (Static group, n = 5) or retrograde machine perfusion through the coronary sinus (RP group, n = 5)...
August 2016: Journal of Heart and Lung Transplantation
M V Zatevahina, A F Farzutdinov, A A Rahimov, I M Makrushin, G Y Kvachantiradze
UNLABELLED: The purpose of the study is to examine the perioperative dynamics of strategic blood oxygen transport indicators: delivery (DO2), consumption (VO2), the coefficient of oxygen uptake (CUO2) and their composition, as well as the dynamics of blood lactate indicators in patients with ischaemic heart disease (IHD) who underwent surgery under cardiopulmonary bypass with high thoracic epidural anaesthesia (HTEA) as the main component of anesthesia. MATERIALS AND METHODS: Research was conducted in 30 patients with a critical degree of operational risk, during the correction of post-infarction heart aneurysmn using the V...
September 2015: Anesteziologiia i Reanimatologiia
Marialena Mouzaki, Steven M Schwartz, Haifa Mtaweh, Gustavo La Rotta, Kandice Mah, Joann Herridge, Glen Van Arsdell, Christopher S Parshuram, Alejandro A Floh
BACKGROUND: Optimal energy provision, guided by measured resting energy expenditure (REE), is fundamental in the care of critically ill children. REE should be determined by indirect calorimetry (IC), which has limited availability. Recently, a novel equation was developed for estimating REE derived from carbon dioxide production (Vco2). The aim of this study was to validate the accuracy of this equation in a population of critically ill children following cardiopulmonary bypass (CPB)...
February 10, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
Marek A Mak, Adam Smołka, Jan Kowalski, Alicja Kuc, Filip Klausa, Karol Kremens, Dariusz Jarek, Ryszard Bachowski, Jacek Skiba
BACKGROUND: Commonly used cardiopulmonary bypass systems with cardiotomy reservoir, oxygenator and roller pump require preoperative crystalloid filling. Radical reduction of the filling fluid volume and replacing it with patient's own blood has fundamental impact on the outcome. AIM: Comparison between the cardiopulmonary bypass filled with patient's blood, applied in Poland for the first time, and the classical system filled with crystalloids. METHODS: Non-Randomized trial in which patients undergoing coronary artery bypass grafting were divided into two groups: first operated on with a use of cardiopulmonary bypass system with patient's own blood priming and a control group operated on with standard technique...
February 22, 2016: Kardiologia Polska
J Skytte Larsson, G Bragadottir, V Krumbholz, B Redfors, J Sellgren, S E Ricksten
BACKGROUND: In the present randomized study, we evaluated the differential effects of a colloid and a crystalloid fluid on renal oxygen delivery (RD(O2)), glomerular filtration (GFR), renal oxygen consumption ((RV(O2))), and the renal oxygen supply-demand relationship (i.e., renal oxygenation) after cardiac surgery with cardiopulmonary bypass. METHODS: Thirty patients with normal preoperative renal function, undergoing uncomplicated cardiac surgery, were studied in the intensive care unit in the early postoperative period...
November 2015: British Journal of Anaesthesia
Ervin E Ševerdija, Nousjka P A Vranken, Steven Teerenstra, Yuri M Ganushchak, Patrick W Weerwind
Previous studies showed that decreased cerebral saturation during cardiac surgery is related to adverse postoperative outcome. Therefore, we investigated the influence of intraoperative events on cerebral tissue saturation in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). A total of 52 adult patients who underwent cardiac surgery using pulsatile CPB were included in this prospective explorative study. Cerebral tissue oxygen saturation (SctO2) was measured in both the left and right cerebral hemisphere...
March 2015: Journal of Extra-corporeal Technology
Shu-Chun Huang, May-Kuen Wong, Pyng-Jing Lin, Feng-Chun Tsai, Ming-Shien Wen, Chi-Tai Kuo, Chih-Chin Hsu, Jong-Shyan Wang
Hemodynamic properties affected by the passive leg raise test (PLRT) reflect cardiac pumping efficiency. In the present study, we aimed to further explore whether PLRT predicts exercise intolerance/capacity following coronary revascularization. Following coronary bypass/percutaneous coronary intervention, 120 inpatients underwent a PLRT and a cardiopulmonary exercise test (CPET) 2-12 days during post-surgery hospitalization and 3-5 weeks after hospital discharge. The PLRT included head-up, leg raise, and supine rest postures...
2015: PloS One
Sarah A Hosgood, K Shah, M Patel, M L Nicholson
BACKGROUND: Donation after circulatory death (DCD) kidney transplants inevitably sustain a degree of warm ischaemic injury, which is manifested clinically as delayed graft function. The aim of this study was to define the effects of prolonged periods of warm ischaemic injury on renal function in a normothermic haemoperfused kidney model. METHODS: Porcine kidneys were subjected to 15, 60, 90 (n = 6 per group) and 120 min (n = 4) of in situ warm ischaemia (WI) and then retrieved, flushed with cold preservation fluid and stored in ice for 2 h...
2015: Journal of Translational Medicine
Stefan De Hert, Anneliese Moerman
During cardiac surgery with cardiopulmonary bypass, the heart is isolated from the circulation. This inevitably induces myocardial ischemia. In addition to this ischemic insult, an additional hit will occur upon reperfusion, which may worsen the extent of tissue damage and organ dysfunction. Over the years, several strategies have been developed that aim to attenuate and/or modulate the extent of this ischemia-reperfusion injury related to the episode of cardiopulmonary bypass. This article reviews the pathophysiology of myocardial injury related to cardiopulmonary bypass and summarizes potential therapeutic strategies that may modulate the extent of this myocardial injury...
June 2015: Best Practice & Research. Clinical Anaesthesiology
Sarah Baos, Karen Sheehan, Lucy Culliford, Katie Pike, Lucy Ellis, Andrew J Parry, Serban Stoica, Mohamed T Ghorbel, Massimo Caputo, Chris A Rogers
BACKGROUND: During open heart surgery, patients are connected to a heart-lung bypass machine that pumps blood around the body ("perfusion") while the heart is stopped. Typically the blood is cooled during this procedure ("hypothermia") and warmed to normal body temperature once the operation has been completed. The main rationale for "whole body cooling" is to protect organs such as the brain, kidneys, lungs, and heart from injury during bypass by reducing the body's metabolic rate and decreasing oxygen consumption...
2015: JMIR Research Protocols
Zaccaria Ricci, Roberta Haiberger, Lorenzo Tofani, Stefano Romagnoli, Isabella Favia, Paola Cogo
Multisite near infrared spectroscopy (NIRS) monitoring during pediatric cardiopulmonary bypass (CPB) has not been extensively validated. Although it might be rational to explore regional tissue saturation at different body sites (namely brain, kidney, upper body, lower body), conflicting results are currently provided by experience in children. The aim of our study was to evaluate absolute values of multisite NIRS saturation during CPB in a cohort of infants undergoing pediatric cardiac surgery to describe average differences between cerebral, renal, upper body (arm), and lower body (thigh) regional saturation...
July 2015: Artificial Organs
Javier Gil-Anton, Silvia Redondo, Diego Garcia Urabayen, Manuel Nieto Faza, Irene Sanz, Javier Pilar
The maintenance of an adequate oxygen supply to tissues after congenital heart surgery is essential for good outcomes. The objective of this study was to assess the usefulness of near-infrared spectroscopy (NIRS) for estimating central venous oxygen saturation (ScvO2) using both cerebral and renal measurements, explore its relation with cardiac output measurements and check its ability to detect low cardiac output. A prospective observational pilot study was conducted in patients weighing <10 kg undergoing cardiopulmonary bypass surgery...
August 2015: Pediatric Cardiology
Priscilla J W Bevan
Near-infrared spectroscopy (NIRS) is non-invasive, easy to use, and offers real-time monitoring of the oxygen content of cerebral tissue. An effective and user-friendly method of cerebral monitoring stands to offer a significant advance in patient care during adult cardiac surgery, particularly for surgery in which the continuity of cerebral vessels may be compromised. While the current evidence does not definitively show improvement in neurological outcomes, it can be argued that the overall risk to benefit ratio falls on the side of NIRS...
June 2015: Heart, Lung & Circulation
Alejandro A Floh, Masayuki Nakada, Gustavo La Rotta, Kandice Mah, Joann E Herridge, Glen Van Arsdell, Steven M Schwartz
OBJECTIVES: To examine the association between cardiopulmonary bypass-related systemic inflammation and resting energy expenditure in pediatric subjects following cardiac surgery. DESIGN: Single-center, prospective cohort study. SETTING: Pediatric cardiac critical care unit in Toronto, Canada. PATIENTS: Children with congenital heart disease undergoing cardiopulmonary bypass surgery. INTERVENTIONS: Resting energy expenditure was determined by indirect calorimetry and the modified Weir equation, using VO2 and VCO2 measured by in-line respiratory mass spectrometry...
May 2015: Pediatric Critical Care Medicine
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