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https://www.readbyqxmd.com/read/29199541/impact-of-temperature-on-the-narcotrend-index-during-hypothermic-cardiopulmonary-bypass-in-children-with-sevoflurane-anesthesia
#1
Nils Dennhardt, Christiane Beck, Dietmar Boethig, Sebastian Heiderich, Alexander Horke, Sebastian Tiedge, Martin Boehne, Robert Sümpelmann
BACKGROUND: During cardiopulmonary bypass (CPB) in children, anesthesia maintained by sevoflurane administered via the oxygenator is increasingly common. Anesthetic uptake and requirement may be influenced by the non-physiological conditions during hypothermic CPB. Narcotrend-processed EEG monitoring may, therefore, be useful to guide the administration of sevoflurane during this phase. OBJECTIVE: The objective of this prospective, clinical, observational study was to assess the correlation between body temperature, Narcotrend Index (NI) and administered sevoflurane in children during CPB...
May 2018: Perfusion
https://www.readbyqxmd.com/read/28663640/sonographic-evaluation-of-internal-jugular-vein-diameter-and-cross-sectional-area-measurements-in-correlation-with-left-ventricular-end-diastolic-area-as-a-tool-for-perioperative-assessment-of-volume-status-in-pediatric-patients-undergoing-cardiac-surgery
#2
Wafaa Mohamed Elsadek, Amal Hanfy Abo Elaela, Heba Mohamed Nassar, Mohamed Maher Kamel, Ahmed Abdelaziz Mohamed, Hassan Mohamed Ali
AIM: The aim of this study is to compare the ultrasound estimation of the cross-sectional area (CSA) and diameter of internal jugular vein (IJV) with left ventricular end diastolic area (LVEDA) for the assessment of intravascular volume in pediatric patients during cardiac surgery. PATIENTS AND METHODS: The CSA and diameter of the left IJV were defined, using ultrasound machine, and compared with LVEDA, estimated by transesophageal echo, in four times intervals (immediately after induction [T1], before the start of cardiopulmonary bypass [CPB] [T2], immediately after weaning of CPB [T3], and at the end of surgery before transfer to the Intensive Care Unit [T4]) as a tool for intravascular volume assessment in 16 pediatric patients undergoing cardiac surgery...
April 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28456774/lung-protection-in-cardio-pulmonary-bypass
#3
A Salameh, W Greimann, M Vollroth, S Dhein, M Bahramsoltani, I Dahnert
Since the invention of the heart-lung machine paediatric cardiac surgery developed rapidly. For correction of complex cardiac malformations the application of a cardio-pulmonary bypass (CPB) has become indispensable but possible negative effects of this technique should not be neglected. Especially, both bypassed organs i.e. heart and lung are not perfused during the procedure and therefore are threatened by ischemia and reperfusion injury. Additionally, CPB was developed with a non-pulsatile flow but there are clinical observations that pulsatile flow might be superior with improved patient outcomes...
February 2017: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28298664/the-impact-of-roller-pump-vs-centrifugal-pump-on-homologous-blood-transfusion-in-pediatric-cardiac-surgery
#4
COMPARATIVE STUDY
Bharat Datt, Moui B Nguyen, Gary Plancher, Mark Ruzmetov, Michael O'Brien, Alicia Kube, Hamish M Munro, Kamal K Pourmoghadam, William M DeCampli
Centrifugal pumps are considered to be less destructive to blood elements (1) when compared to roller pumps. However, their large prime volumes render them unsuitable as arterial pumps in heart lung machine (HLM) circuitry for children. In November of 2014, the circuit at Arnold Palmer Hospital, a Biomedicus BP-50 with kinetic assist venous drainage (KAVD) and 1/4″ tubing was converted to a roller pump in the arterial position with gravity drainage. Vacuum-assisted venous drainage (VAVD) was mounted on the HLM as a backup, but not used...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27879647/neuroprotective-strategies-during-cardiac-surgery-with-cardiopulmonary-bypass
#5
REVIEW
Aida Salameh, Stefan Dhein, Ingo Dähnert, Norbert Klein
Aortocoronary bypass or valve surgery usually require cardiac arrest using cardioplegic solutions. Although, in principle, in a number of cases beating heart surgery (so-called off-pump technique) is possible, aortic or valve surgery or correction of congenital heart diseases mostly require cardiopulmonary arrest. During this condition, the heart-lung machine also named cardiopulmonary bypass (CPB) has to take over the circulation. It is noteworthy that the invention of a machine bypassing the heart and lungs enabled complex cardiac operations, but possible negative effects of the CPB on other organs, especially the brain, cannot be neglected...
November 21, 2016: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/27473158/modulation-of-immunologic-response-by-preventive-everolimus-application-in-a-rat-cpb-model
#6
Antonio Pinto, Annika Jahn, Moritz Benjamin Immohr, Alexander Jenke, Laura Döhrn, Markus Kornfeld, Artur Lichtenberg, Payam Akhyari, Udo Boeken
Everolimus (EVL) is widely used in solid organ transplantation. It is known to have antiproliferative and immunosuppressive abilities via inhibition of the mTOR pathway. Preventive EVL administration may lower inflammation induced by cardiopulmonary bypass (CPB) and reduce systemic inflammatory response syndrome (SIRS). After oral loading with EVL 2.5 mg/kg/day (n = 11) or placebo (n = 11) for seven consecutive days, male Wistar rats (400-500 g) were connected to a miniaturised heart-lung-machine performing a deep hypothermic circulatory arrest protocol...
October 2016: Inflammation
https://www.readbyqxmd.com/read/27226328/vavd-vacuum-may-cause-bubble-transgression-in-membrane-oxygenators
#7
K Nygaard, A S Thiara, C Tronstad, M A Ringdal, A E Fiane
BACKGROUND: Vacuum-assisted venous drainage (VAVD) is widely used to enhance venous blood return from patients undergoing cardiopulmonary bypass (CPB). This vacuum can accidentally reach the oxygenator of the heart-lung machine and draw gas bubbles into the blood. This is known as bubble transgression (BT) and may cause air emboli in the arterial blood line. In order to avoid BT and minimize the risk of patient injury, knowledge of oxygenator tolerance to vacuum load is critical. Thus, the main aim of this thesis was to investigate how much vacuum a membrane oxygenator can withstand before BT appears...
May 25, 2016: Perfusion
https://www.readbyqxmd.com/read/27192987/selenium-pretreatment-for-mitigation-of-ischemia-reperfusion-injury-in-cardiovascular-surgery-influence-on-acute-organ-damage-and-inflammatory-response
#8
Holger Steinbrenner, Esra Bilgic, Antonio Pinto, Melanie Engels, Lena Wollschläger, Laura Döhrn, Kristine Kellermann, Udo Boeken, Payam Akhyari, Artur Lichtenberg
Ischemia/reperfusion injury (IRI) contributes to morbidity and mortality after cardiovascular surgery requiring cardiopulmonary bypass (CPB) and deep hypothermic circulatory arrest (DHCA). Multi-organ damage is associated with substantial decreases of blood selenium (Se) levels in patients undergoing cardiac surgery with CPB. We compared the influence of a dietary surplus of Se and pretreatment with ebselen, a mimic of the selenoenzyme glutathione peroxidase, on IRI-induced tissue damage and inflammation. Male Wistar rats were fed either a Se-adequate diet containing 0...
August 2016: Inflammation
https://www.readbyqxmd.com/read/27134304/removal-of-gross-air-embolization-from-cardiopulmonary-bypass-circuits-with-integrated-arterial-line-filters-a-comparison-of-circuit-designs
#9
COMPARATIVE STUDY
James A Reagor, David W Holt
Advances in technology, the desire to minimize blood product transfusions, and concerns relating to inflammatory mediators have lead many practitioners and manufacturers to minimize cardiopulmonary bypass (CBP) circuit designs. The oxygenator and arterial line filter (ALF) have been integrated into one device as a method of attaining a reduction in prime volume and surface area. The instructions for use of a currently available oxygenator with integrated ALF recommends incorporating a recirculation line distal to the oxygenator...
March 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27134302/arterial-limb-microemboli-during-cardiopulmonary-bypass-observations-from-a-congenital-cardiac-surgery-practice
#10
Gregory S Matte, Kevin R Connor, Hua Liu, James A DiNardo, David Faraoni, Frank Pigula
Gaseous microemboli (GME) are known to be delivered to the arterial circulation of patients during cardiopulmonary bypass (CPB). An increased number of GME delivered during adult CPB has been associated with brain injury and postoperative cognitive dysfunction. The GME load in children exposed to CPB and its consequences are not well characterized. We sought to establish a baseline of arterial limb emboli counts during the conduct of CPB for our population of patients requiring surgery for congenital heart disease...
March 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27005981/implanting-permanent-left-ventricular-assist-devices-in-patients-on-veno-arterial-extracorporeal-membrane-oxygenation-support-do-we-really-need-a-cardiopulmonary-bypass-machine
#11
COMPARATIVE STUDY
Muhammad S K M Abdeen, Alexander Albert, Bujar Maxhera, Till Hoffmann, Georgi Petrov, Stephan Sixt, Elisabeth Roussel, Ralf Westenfeld, Artur Lichtenberg, Diyar Saeed
OBJECTIVES: Selected patients who failed to be weaned off temporary veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support may be considered for long-term left ventricular assist devices (LVADs). Activation of the systemic inflammatory response due to the cardiopulmonary bypass (CPB) machine and its associated deleterious effects on the coagulation system have been well documented. The aim of the study was to compare the outcome of patients receiving VAD on VA-ECMO with patients who were converted to CPB at the time of VAD implantation...
September 2016: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/26827702/proenkefalin-a-and-protachykinin-in-ischemic-neurological-complications-after-cardiac-surgery
#12
RANDOMIZED CONTROLLED TRIAL
Milan Skitek, Aleš Jerin
AIM: The evaluation of biomarkers of acute ischemic brain injury following surgical revascularization of the heart with the use of the heart-lung machine (cardiopulmonary bypass, CPB). METHODS: Twenty consecutive patients were divided into two groups: the first 10 patients received a potential neuroprotective human recombinant erythropoietin, while the remaining 10 comprised the control group. Neurological complications were monitored by measuring serum concentrations of neuropeptide proenkephalin A(PENK-A) and protachykinin A (PTA) before and in the first 5 days after surgery, comparing the neurological outcome with MRI examinations...
February 1, 2016: Medicinski Glasnik
https://www.readbyqxmd.com/read/26742385/custodial-htk-solution-for-myocardial-protection-in-cabg-patients
#13
Sompop Prathanee, Chusak Kuptanond, Worawit Intanoo, Chawalit Wongbhudha, Chananya Karunasumaeta
BACKGROUND: Many steps of myocardial preservation during open heart surgery are practical after the development of the heart-lung machine. A cardioplegia solution, infused after aortic cross clamping, is an important aspect. Two-thirds of cardioplegia solutions are an intracellular solution (such as HTK or Bretschneider solution) or extracellular solution (such as blood cardioplegia). Intracellular cardioplegia solution can provide protection for 3-4 hours after one-time infusion, which differs from extracellular cardioplegia solution requiring intermittent use every 20-30 minutes...
August 2015: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
https://www.readbyqxmd.com/read/26650574/comparative-study-on-the-migration-of-di-2-ethylhexyl-phthalate-dehp-and-tri-2-ethylhexyl-trimellitate-totm-into-blood-from-pvc-tubing-material-of-a-heart-lung-machine
#14
Elisabeth Eckert, Frank Münch, Thomas Göen, Ariawan Purbojo, Johannes Müller, Robert Cesnjevar
Medical devices like blood tubing often consist of PVC material that requires the addition of plasticizers. These plasticizers may migrate into the blood leading to an exposure of the patients. In this study the migration behavior of three different blood tubing sets (PVC material with two different plasticizers and silicone as control material) applied on a heart-lung machine standardly used for cardiopulmonary bypass (CPB) in children was studied. We analyzed the total plasticizer migration by analysis of both, the parent compounds as well as their primary degradation products in blood...
February 2016: Chemosphere
https://www.readbyqxmd.com/read/26543252/should-air-bubble-detectors-be-used-to-quantify-microbubble-activity-during-cardiopulmonary-bypass
#15
Richard F Newland, Robert A Baker, Annette L Mazzone, Vijaykumar N Valiyapurayil
Air bubble detectors (ABDs) are utilized during cardiopulmonary bypass (CPB) to protect against massive air embolism. Stockert (Munich, Germany) ABD quantify microbubbles >300 μm; however, their reliability has not been reported. The aim of this study was to assess the reliability of the microbubble data from the ABD with the SIII and S5 heart-lung machines. Microbubble counts from the ABD with the SIII (SIII ABD) and S5 (S5 ABD) were measured simultaneously with the emboli detection and classification (EDAC) quantifier in 12 CPB procedures using two EDAC detectors and two ABDs in series in the arterial line...
September 2015: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/26491558/risk-factors-associated-with-cognitive-decline-after-cardiac-surgery-a-systematic-review
#16
REVIEW
Nikil Patel, Jatinder S Minhas, Emma M L Chung
Modern day cardiac surgery evolved upon the advent of cardiopulmonary bypass machines (CPB) in the 1950s. Following this development, cardiac surgery in recent years has improved significantly. Despite such advances and the introduction of new technologies, neurological sequelae after cardiac surgery still exist. Ischaemic stroke, delirium, and cognitive impairment cause significant morbidity and mortality and unfortunately remain common complications. Postoperative cognitive decline (POCD) is believed to be associated with the presence of new ischaemic lesions originating from emboli entering the cerebral circulation during surgery...
2015: Cardiovascular Psychiatry and Neurology
https://www.readbyqxmd.com/read/26357797/a-2013-survey-on-pressure-monitoring-in-adult-cardiopulmonary-bypass-circuits-modes-and-applications
#17
Laura Rigg, Bruce Searles, Edward Morse Darling
Pressure data acquired from multiple sites of extracorporeal circuits can be an important parameter to monitor for the safe conduct of cardiopulmonary bypass (CPB). Although previous surveys demonstrate that CPB circuit pressure monitoring is widely used, there are very little data cataloging specific applications of this practice. Therefore, the purpose of this study is to survey the perfusion community to catalog 1) primary CPB circuit site pressure monitoring locations; 2) type of manometers used; 3) pressure monitoring interface and servoregulation with pump console; and 4) the rationale and documentation associated with pressure monitoring during CPB...
December 2014: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/26046056/safe-anticoagulation-when-heart-and-lungs-are-on-vacation
#18
Marina A Dobrovolskaia, Scott E McNeil
Circulation and oxygenation of blood outside the body is commonly required during complex surgical interventions involving coronary pulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO). Both CPB and ECMO are life-supporting procedures utilizing a heart-lung machine, which subjects the blood to unphysiological conditions, potentially promoting undesirable blood coagulation. Traditionally, thrombotic complications from CPB and ECMO are resolved by heparin, an inexpensive broad spectrum anticoagulant that prevents blood clotting, but often results in bleeding...
May 2015: Annals of Translational Medicine
https://www.readbyqxmd.com/read/25951569/cardiopulmonary-perfusion
#19
N L Achorn, P C Crawford, M H Bronstein
Open heart surgery is one of the most highly technical of all modern medical techniques, and includes procedures such as coronary artery bypass grafting, cardiac valve repair or replacement, correction of congenital defects, resection of aneurysms, ablation of abnormal pathways of conduction, etc. It relies on the coordinated interaction of a heart surgeon, an anesthesiologist, several nurses and technicians, and a perfusionist. The first successful open heart surgery was performed in Philadelphia forty years ago by Dr...
October 1993: Surgical Technology International
https://www.readbyqxmd.com/read/25936714/application-of-vacuum-assisted-venous-drainage-in-heart-surgeries-for-newborns
#20
Da-wei Xi, Cheng-zhong Yu, Hai-yan Qiu
OBJECTIVE: To explore the role of cardiopulmonary bypass (CPB) with vacuum assisted venous drainage(VAVD)in the management of newborns with congenital heart diseases. METHODS: Total 15 newborns with congenital heart diseases (11 males and 4 females)underwent heart operations. Their age ranged from 2 days to 28 days [mean:(15.67 ± 2.22)days], and their body weight from 2.3 kg to 4.8 kg [mean: (3.75 ± 0.19)kg]. Sternal median incision was made to establish CPB,during which VAVD was applied for all the newborns...
April 2015: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
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