L. Samuels, J. S. Havdala, M. S. Kaufman, R. Morris, S. Brockman
Left ventricular aneurysms (LVA) are most commonly the result of a large transmural myocardial infarction, usually in the distribution of an occluded left anterior descending coronary artery. We investigated a case at Allegheny University Hospitals, Hahnemann Division, Philadelphia, PA, involving the use of the Abiomed BVS 5000 ventricular assist device (VAD) for LVA repair. The patient was successfully weaned from cardiopulmonary bypass using the Abiomed BVS Left Ventricular Assist Device (LVAD). The LVAD was successfully removed on the fourth postoperative day. In summary, we report the successful support of the myocardium with the Abiomed BVS 5000 Ventricular Assist Device after left ventricular aneurysmectomy. We favor mechanical over high dose inotropic support of the myocardium with a V AD in postcardiotomy patients with severe ventricular dysfunction.
{"title":"Use of the Abiomed BVS 5000 Ventricular Assist Device for Myocardial Support Following Left Ventricular Aneurysmectomy: Case Report","authors":"L. Samuels, J. S. Havdala, M. S. Kaufman, R. Morris, S. Brockman","doi":"10.1051/ject/1997293158","DOIUrl":"https://doi.org/10.1051/ject/1997293158","url":null,"abstract":"Left ventricular aneurysms (LVA) are most commonly the result of a large transmural myocardial infarction, usually in the distribution of an occluded left anterior descending coronary artery. We investigated a case at Allegheny University Hospitals, Hahnemann Division, Philadelphia, PA, involving the use of the Abiomed BVS 5000 ventricular assist device (VAD) for LVA repair. The patient was successfully weaned from cardiopulmonary bypass using the Abiomed BVS Left Ventricular Assist Device (LVAD). The LVAD was successfully removed on the fourth postoperative day. In summary, we report the successful support of the myocardium with the Abiomed BVS 5000 Ventricular Assist Device after left ventricular aneurysmectomy. We favor mechanical over high dose inotropic support of the myocardium with a V AD in postcardiotomy patients with severe ventricular dysfunction.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"190 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120957916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Stammers, S. Huffman, A. Alonso, L. Fristoe, G. Hill, Dana Casebeer, R. P. Diego, Zuorui Song
Aprotinin has been shown to effectively attenuate cardiopulmonary bypass (CPB) induced coagulopathies. Because aprotinin is a serine protease inhibitor, it may exert additional properties that reduce the risks associated with extracorporeal flow. The purpose of this study was to prospectively evaluate the antiinflammatory effects of aprotinin with specific emphasis on pulmonary function. After Institutional Review Board approval, 20 patients undergoing first time coronary artery bypass grafting were randomly assigned to receive either a full dose regimen of aprotinin (APR, n=8), or volumetric equal control (CTR, n= 12). Biological markers of inflammation and coagulation were measured at 3 time periods: immediately prior to drug administration, at chest closure, and at 24 hours post cardiotomy, and included total complement, polymorphonuclear neutrophil (PMN) elastase, Factor XII, protein C, protein S, fibrin split products (FSP), D-dimers. Pulmonary function was assessed throughout intensive care unit (ICU) stay. There were no differences observed between groups in either preoperative, surgical, anesthesia or perfusion parameters. Twenty-four hour chest tube drainage in the APR group was significantly less than that observed in CTR patients (435.1±169.6 vs. 944.0±585.1, p<.02). Patients receiving aprotinin received significantly lower transfusions of red blood cells, platelets, and fresh frozen plasma. Upon entry into the ICU the CTR group had significantly higher mean airway pressures (8.3±1.5 vs. 10.8±2.9 em H2O, p<.03), higher PaCO2 levels (37.1±4.8 vs. 43.3±7.1 mmHg, p<.04), and higher FIO2 settings (0.63±0.18 vs. 0.75±0.20, p=.l6). Postoperative FSP and D-dimers were significantly lower in the APR treated patients. In conclusion, the use of aprotinin resulted in significant improvements to postoperative patient outcomes as assessed by transfusion requirements, blood loss, coagulation markers and pulmonary function.
{"title":"The Antiinflammatory Effects of Aprotinin in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass","authors":"A. Stammers, S. Huffman, A. Alonso, L. Fristoe, G. Hill, Dana Casebeer, R. P. Diego, Zuorui Song","doi":"10.1051/ject/1997293114","DOIUrl":"https://doi.org/10.1051/ject/1997293114","url":null,"abstract":"Aprotinin has been shown to effectively attenuate cardiopulmonary bypass (CPB) induced coagulopathies. Because aprotinin is a serine protease inhibitor, it may exert additional properties that reduce the risks associated with extracorporeal flow. The purpose of this study was to prospectively evaluate the antiinflammatory effects of aprotinin with specific emphasis on pulmonary function.\u0000After Institutional Review Board approval, 20 patients undergoing first time coronary artery bypass grafting were randomly assigned to receive either a full dose regimen of aprotinin (APR, n=8), or volumetric equal control (CTR, n= 12). Biological markers of inflammation and coagulation were measured at 3 time periods: immediately prior to drug administration, at chest closure, and at 24 hours post cardiotomy, and included total complement, polymorphonuclear neutrophil (PMN) elastase, Factor XII, protein C, protein S, fibrin split products (FSP), D-dimers. Pulmonary function was assessed throughout intensive care unit (ICU) stay.\u0000There were no differences observed between groups in either preoperative, surgical, anesthesia or perfusion parameters. Twenty-four hour chest tube drainage in the APR group was significantly less than that observed in CTR patients (435.1±169.6 vs. 944.0±585.1, p<.02). Patients receiving aprotinin received significantly lower transfusions of red blood cells, platelets, and fresh frozen plasma. Upon entry into the ICU the CTR group had significantly higher mean airway pressures (8.3±1.5 vs. 10.8±2.9 em H2O, p<.03), higher PaCO2 levels (37.1±4.8 vs. 43.3±7.1 mmHg, p<.04), and higher FIO2 settings (0.63±0.18 vs. 0.75±0.20, p=.l6). Postoperative FSP and D-dimers were significantly lower in the APR treated patients.\u0000In conclusion, the use of aprotinin resulted in significant improvements to postoperative patient outcomes as assessed by transfusion requirements, blood loss, coagulation markers and pulmonary function.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133962803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Donald S. Wilson, J. Hokama, G. Lai, G. Gorman, N. Susa, J. Copeland, P. McDonagh
Earlier, we reported that in-vitro incubation of blood for ten minutes with the perfluorocarbon (PFC) emulsion Fluosol increased leukocyte activation as determined by adhesion to nylon fiber. In this study, we examined if in-vivo treatment with these PFC emulsions affected the expression of the leukocyte adhesion protein CD11b (primarily found on PMNs) and the generation of leukocyte-derived reactive oxygen species (ROS, oxygen free radicals). Rats were anesthetized and catheterized. Three groups were studied: 1) a phosphate buffered saline (PBS) control group (n=6), 2) a group treated with Fluosol emulsion (1.08g PFC/kg, n=6) and 3) a group treated with perflubron emulsion (1.08g PFC/kg, n=6). Blood samples were taken before and 10, 20, 40 and 60 minutes after treatment for hematology and analysis of PMN CD11b expression and ROS production using flow cytometry. We found that Fluosol caused significant increases in both neutrophil surface expression of CD11b and ROS generation (p<0.05, ANOVA). In the Fluosol group, the peak responses in PMN CD11b expression and ROS production were observed ten minutes after treatment. In contrast, treatment with perflubron emulsion did not cause a significant increase in CD11b expression nor an increase in ROS production at any time after treatment. These findings suggest that Fluosol causes a transient PMN activation in-vivo. The activation of circulating PMNs, in-vivo, is sufficient to significantly enhance oxygen derived free radical production. The lack of a PMN response to perflubron emulsion in-vivo suggests that this agent is not likely to induce a leukocyte-mediated inflammatory response.
{"title":"Perflubron Emulsion Does Not Cause Neutrophil (PMN) Activation In- Vivo.","authors":"Donald S. Wilson, J. Hokama, G. Lai, G. Gorman, N. Susa, J. Copeland, P. McDonagh","doi":"10.1051/ject/1997293123","DOIUrl":"https://doi.org/10.1051/ject/1997293123","url":null,"abstract":"Earlier, we reported that in-vitro incubation of blood for ten minutes with the perfluorocarbon (PFC) emulsion Fluosol increased leukocyte activation as determined by adhesion to nylon fiber. In this study, we examined if in-vivo treatment with these PFC emulsions affected the expression of the leukocyte adhesion protein CD11b (primarily found on PMNs) and the generation of leukocyte-derived reactive oxygen species (ROS, oxygen free radicals). Rats were anesthetized and catheterized. Three groups were studied: 1) a phosphate buffered saline (PBS) control group (n=6), 2) a group treated with Fluosol emulsion (1.08g PFC/kg, n=6) and 3) a group treated with perflubron emulsion (1.08g PFC/kg, n=6). Blood samples were taken before and 10, 20, 40 and 60 minutes after treatment for hematology and analysis of PMN CD11b expression and ROS production using flow cytometry. We found that Fluosol caused significant increases in both neutrophil surface expression of CD11b and ROS generation (p<0.05, ANOVA). In the Fluosol group, the peak responses in PMN CD11b expression and ROS production were observed ten minutes after treatment. In contrast, treatment with perflubron emulsion did not cause a significant increase in CD11b expression nor an increase in ROS production at any time after treatment. These findings suggest that Fluosol causes a transient PMN activation in-vivo. The activation of circulating PMNs, in-vivo, is sufficient to significantly enhance oxygen derived free radical production. The lack of a PMN response to perflubron emulsion in-vivo suggests that this agent is not likely to induce a leukocyte-mediated inflammatory response.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132318576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
PhD Scott I. Merz, PhD J. Patrick Montoya, MD W. Anthony Lee, MD Srinivas Kalla, MD Robert H Bartlett
An automatic control system was devised that regulates gas exchange during cardiopulmonary bypass (CPB). The Automated Extracorporeal Gas Exchange System (AEGES) controls the blood flow rate and/or the flow of gas to the oxygenator in order to meet user-defined setpoints for PO2 and PCO2 of blood drained from the patient while maintaining safe pressures in the CPB circuit and/or the patient’s circulation. Venous blood gases were used as the basis for control because they reflect the amount of oxygen/CO2 consumed/produced by the patient given the present rate of delivery via CPB. In the event of an alarm or upon the perfusionist’ s command, AEGES reverts to manual control of blood flow and/or sweep flow. AEGES was tested in a hypothermia model of CPB in sheep, where it successfully regulated PO2 and PCO2 within 5% of setpoint during cooling from 38 to 25°C. In order to control the blood gases to setpoints of PO2=45 mmHg and PCO2=40 mmHg in the venous drainage, AEGES reduced blood flow from 2.4 to 1.6 L/min and sweep flow from 2.2 to 0.7 L/min. AEGES is intended to act as a tool for the perfusionist to assist in maintaining consistent blood gas conditions. AEGES can be integrated with other control systems (e.g., reservoir level control and blood temperature control), further automating the CPB procedure; however, in no way could this system replace the perfusionist.
{"title":"Automatic Control of Gas Exchange During Cardiopulmonary Bypass","authors":"PhD Scott I. Merz, PhD J. Patrick Montoya, MD W. Anthony Lee, MD Srinivas Kalla, MD Robert H Bartlett","doi":"10.1051/ject/1997293139","DOIUrl":"https://doi.org/10.1051/ject/1997293139","url":null,"abstract":"An automatic control system was devised that regulates gas exchange during cardiopulmonary bypass (CPB). The Automated Extracorporeal Gas Exchange System (AEGES) controls the blood flow rate and/or the flow of gas to the oxygenator in order to meet user-defined setpoints for PO2 and PCO2 of blood drained from the patient while maintaining safe pressures in the CPB circuit and/or the patient’s circulation. Venous blood gases were used as the basis for control because they reflect the amount of oxygen/CO2 consumed/produced by the patient given the present rate of delivery via CPB. In the event of an alarm or upon the perfusionist’ s command, AEGES reverts to manual control of blood flow and/or sweep flow.\u0000AEGES was tested in a hypothermia model of CPB in sheep, where it successfully regulated PO2 and PCO2 within 5% of setpoint during cooling from 38 to 25°C. In order to control the blood gases to setpoints of PO2=45 mmHg and PCO2=40 mmHg in the venous drainage, AEGES reduced blood flow from 2.4 to 1.6 L/min and sweep flow from 2.2 to 0.7 L/min.\u0000AEGES is intended to act as a tool for the perfusionist to assist in maintaining consistent blood gas conditions. AEGES can be integrated with other control systems (e.g., reservoir level control and blood temperature control), further automating the CPB procedure; however, in no way could this system replace the perfusionist.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"160 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132535397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Samuels, M. S. Kaufman, R. Morris, S. Brozena, C. Twomey, S. Brockman
The purpose of this investigation is to identify the factors influencing the outcome of the Novacor left ventricular assist system (LV AS) as a bridge to transplant. Novacor LV ASs were placed for transplant candidates refractory to medical therapy. All LV ASs were performed on cardiopulmonary bypass without aortic cross clamping. Postoperative care was instituted per protocol. From October 9, 1993, to October 29, 1996, 17 Novacor LV ASs were placed as a bridge to transplantation. There were I 5 male and 2 female patients. The mean age was 52 years (16-66 years). The mean time interval from listing for orthotopic heart transplantation (OHT) to LV AS insertion was 55 days (1-307 days). The mean cardiopulmonary bypass time was 108 minutes (53-300 minutes). Ten (59%) patients were subsequently transplanted. Prior to transplant, seven (41%) patients expired of neurologic sequellae, right ventricular failure, or sepsis syndrome. The mean duration of LVAS support to transplantation was 31 days (1-76 days). The average blood loss for the first 24 hours was 4096 ml (500-16,105 ml). Eight patients remain alive at a mean follow-up of 13 months (1-22 months). Two patients expired of heart failure following transplantation. Preoperative cardiogenic shock and infection result in poor outcome following LV AS insertion. Severe right ventricular (RV) dysfunction requires prompt RV AD placement. Correction of preoperative coagulopathy and meticulous hemostasis are critical.
{"title":"The Novacor Left Ventricular Assist System: Lessons Learned","authors":"L. Samuels, M. S. Kaufman, R. Morris, S. Brozena, C. Twomey, S. Brockman","doi":"10.1051/ject/1997293132","DOIUrl":"https://doi.org/10.1051/ject/1997293132","url":null,"abstract":"The purpose of this investigation is to identify the factors influencing the outcome of the Novacor left ventricular assist system (LV AS) as a bridge to transplant. Novacor LV ASs were placed for transplant candidates refractory to medical therapy. All LV ASs were performed on cardiopulmonary bypass without aortic cross clamping. Postoperative care was instituted per protocol. From October 9, 1993, to October 29, 1996, 17 Novacor LV ASs were placed as a bridge to transplantation. There were I 5 male and 2 female patients. The mean age was 52 years (16-66 years). The mean time interval from listing for orthotopic heart transplantation (OHT) to LV AS insertion was 55 days (1-307 days). The mean cardiopulmonary bypass time was 108 minutes (53-300 minutes). Ten (59%) patients were subsequently transplanted. Prior to transplant, seven (41%) patients expired of neurologic sequellae, right ventricular failure, or sepsis syndrome. The mean duration of LVAS support to transplantation was 31 days (1-76 days). The average blood loss for the first 24 hours was 4096 ml (500-16,105 ml). Eight patients remain alive at a mean follow-up of 13 months (1-22 months). Two patients expired of heart failure following transplantation. Preoperative cardiogenic shock and infection result in poor outcome following LV AS insertion. Severe right ventricular (RV) dysfunction requires prompt RV AD placement. Correction of preoperative coagulopathy and meticulous hemostasis are critical.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124338489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The occurrence of any gastrointestinal (GI) complication concurrent with cardiac surgery may greatly increase a patient’s morbidity and mortality. The most frequently discussed GI complication associated with cardiac surgery is hemorrhage from peptic ulcerations and the exacerbation of this condition through heparinization. However, there are consequences of other GI problems which the clinical perfusionist needs to be aware of. This paper presents a case of a 65 year old female undergoing routine coronary artery bypass grafting. Although this patient was an uric, an excessive amount of fluid loss and replacement occurred. This paper reviews the case management and the eventual diagnosis of acute peritonitis as a result of perforated Meckel’s diverticulum and describes the subsequent surgical intervention for repair of the perforation.
{"title":"Massive Volume Loss During Cardiopulmonary Bypass and its Association with Meckel’s Diverticulum","authors":"T. Buzzelli, R. Trittipoe","doi":"10.1051/ject/199729145","DOIUrl":"https://doi.org/10.1051/ject/199729145","url":null,"abstract":"The occurrence of any gastrointestinal (GI) complication concurrent with cardiac surgery may greatly increase a patient’s morbidity and mortality. The most frequently discussed GI complication associated with cardiac surgery is hemorrhage from peptic ulcerations and the exacerbation of this condition through heparinization. However, there are consequences of other GI problems which the clinical perfusionist needs to be aware of. This paper presents a case of a 65 year old female undergoing routine coronary artery bypass grafting. Although this patient was an uric, an excessive amount of fluid loss and replacement occurred. This paper reviews the case management and the eventual diagnosis of acute peritonitis as a result of perforated Meckel’s diverticulum and describes the subsequent surgical intervention for repair of the perforation.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121414179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A comparative review is made of the four most common asanguineous solutions used for the priming of cardiopulmonary bypass equipment. Increasing health care costs and concerns over the administration of blood derived products has cardiac programs examining their practice of using albumin as a routine part of the priming solution for bypass. Emphasis is being placed on the use of crystalloids with synthetic colloids, or crystalloids alone, as the priming agents for extracorporeal circulation. However new evidence has shown that the use of these solutions, without the addition of albumin, may be associated with the development of a cold induced agglutination. The data reviewed suggests that the ideal priming fluid may still not be available and recommendations are made.
{"title":"A Comparative Review of Crystalloid, Albumin, Pentastarch and Hetastarch as Perfusates for Cardiopulmonary Bypass","authors":"G. Myers","doi":"10.1051/ject/199729130","DOIUrl":"https://doi.org/10.1051/ject/199729130","url":null,"abstract":"A comparative review is made of the four most common asanguineous solutions used for the priming of cardiopulmonary bypass equipment. Increasing health care costs and concerns over the administration of blood derived products has cardiac programs examining their practice of using albumin as a routine part of the priming solution for bypass. Emphasis is being placed on the use of crystalloids with synthetic colloids, or crystalloids alone, as the priming agents for extracorporeal circulation.\u0000However new evidence has shown that the use of these solutions, without the addition of albumin, may be associated with the development of a cold induced agglutination. The data reviewed suggests that the ideal priming fluid may still not be available and recommendations are made.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126601525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Review of Cardiopulmonary Bypass in Neonates, Infants, and Young Children","authors":"R. Jonas, Martin J. Elliott","doi":"10.1051/ject/199729149","DOIUrl":"https://doi.org/10.1051/ject/199729149","url":null,"abstract":"","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"11 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122685943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Ecklund, V. Phelps, K. Holden, J. Riley, F. Crawford, R. Sade
Choreoathetosis (CHO) in pediatric patients following cardiopulmonary bypass (CPB) has no known etiology, although several causal factors have been suggested. The infrequent occurrence in any one institution and the inability to perform prospective studies have made the etiology of CHO difficult to discover. This paper discusses a retrospective analysis of eleven cases of CHO following CPB. To form a control group for matched comparison, each of the eleven CHO patients was matched with a patient who did not develop CHO. Matching parameters included: age at operation within 10%, diagnosis (cyanotic, not cyanotic), race, gender, operation, and date of operation within 12 months. Fifteen preoperative and CPB variables were evaluated to determine differences between the CHO patients and the control patients. Statistical analysis included odds ratios for matched pairs and two sample t-tests. A p value of 0.05 was chosen to assess statistical significance. Variables found to be significantly different between the study and control groups were: lowest rectal temperature, cooling and warming rates, and lowest arterial blood temperature. From these results, it is concluded that cooling to rectal temperatures less than 15°C or a cooling rate greater than 0.4°C /min is associated with the development of CHO following CPB in these patients.
{"title":"Cardiopulmonary Bypass Factors Affecting the Development Of Choreoathetosis in Pediatric Patients","authors":"J. Ecklund, V. Phelps, K. Holden, J. Riley, F. Crawford, R. Sade","doi":"10.1051/ject/199729111","DOIUrl":"https://doi.org/10.1051/ject/199729111","url":null,"abstract":"Choreoathetosis (CHO) in pediatric patients following cardiopulmonary bypass (CPB) has no known etiology, although several causal factors have been suggested. The infrequent occurrence in any one institution and the inability to perform prospective studies have made the etiology of CHO difficult to discover. This paper discusses a retrospective analysis of eleven cases of CHO following CPB. To form a control group for matched comparison, each of the eleven CHO patients was matched with a patient who did not develop CHO. Matching parameters included: age at operation within 10%, diagnosis (cyanotic, not cyanotic), race, gender, operation, and date of operation within 12 months.\u0000Fifteen preoperative and CPB variables were evaluated to determine differences between the CHO patients and the control patients. Statistical analysis included odds ratios for matched pairs and two sample t-tests. A p value of 0.05 was chosen to assess statistical significance. Variables found to be significantly different between the study and control groups were: lowest rectal temperature, cooling and warming rates, and lowest arterial blood temperature. From these results, it is concluded that cooling to rectal temperatures less than 15°C or a cooling rate greater than 0.4°C /min is associated with the development of CHO following CPB in these patients.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"50 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133864114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper provides a historical look at the development of formulae for predicting body surface area and total blood volume. A variety of experimental methods used for the development of body surface area and total blood volume formulae are briefly reviewed. The varying results of different formulae and nomograms are considered in relation to their impact on calculations typically used for the cardiopulmonary bypass patient. Charts are provided which will aid the clinician in the determination of body surface area, relative perfusion output, total blood volume, and resultant hematocrit.
{"title":"Tables for Estimating Dilutional Hematocrits and Blood Flow Rates from Total Blood Volume and Body Surface Area Formulae","authors":"B. Searles, C. E. O'leary","doi":"10.1051/ject/199729136","DOIUrl":"https://doi.org/10.1051/ject/199729136","url":null,"abstract":"This paper provides a historical look at the development of formulae for predicting body surface area and total blood volume. A variety of experimental methods used for the development of body surface area and total blood volume formulae are briefly reviewed. The varying results of different formulae and nomograms are considered in relation to their impact on calculations typically used for the cardiopulmonary bypass patient. Charts are provided which will aid the clinician in the determination of body surface area, relative perfusion output, total blood volume, and resultant hematocrit.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129554637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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