TITLE

Normothermic perfusion and lung function after cardiopulmonary bypass: effects in pulmonary risk patients

AUTHOR(S)
Ranucci, M.; Soro, G.; Frigiola, A.; Menicanti, L.; Ditta, A.; Candido, G.; Tambalo, S.
PUB. DATE
September 1997
SOURCE
Perfusion;1997, Vol. 12 Issue 5, p309
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Fifty patients at risk for postoperative lung dysfunction and undergoing elective coronary revascularization have been randomly assigned to receive normothermic (36?C) perfusion with warm heart protection (NP group) or hypothermic (28?C) perfusion with cold heart protection (HP group). Lung function before and after cardiopulmonary bypass (CPB) was studied through the determination of the intrapulmonary shunt (Qs/Qt), the alveolo-arterial oxygen gradient (A-aDeltaO2), and the artero-alveolar carbon dioxide gradient (alpha-ADeltaCO2). The Qs/Qt after CPB was significantly lower in the NP group (27.1 2.6 vs 35.7 2.3) as well as the A-alpha DeltaO2; (50.2 1.5 vs 57.6 2.4); both data returned to comparable between the groups after 3 h in the intensive care unit. The a- ADeltaCO2 was significantly lower after CPB in the NP group (5.2 0.74 vs 8.2 0.8). Hospital stay and mortality were comparable in the two groups; intubation time and rate of early extubation showed a trend in favour of the NP group; the rate of patients suffering hypoxia and/or hypercapnia after extubation was significantly lower in the NP group (12%) versus the HP group (44%). Normothermia seems to exert a protective effect against lung dysfunction after CPB. The absence of a rewarming injury associated with reperfusion, a limitation of the hypothermic-induced vasoconstriction due to local cooling of the lung and a better compliance of the normothermic lung are hypothesized as beneficial effects of the 'all- warm' strategy.
ACCESSION #
7393739

 

Related Articles

  • Effects of flow types in cardiopulmonary bypass on gastric intramucosal pH. Hamulu, A.; Atay, Y.; Yagdi, T.; Discigil, B.; Bakalim, T.; Buket, S.; Bilkay, O. // Perfusion;1998, Vol. 13 Issue 2, p135 

    The aim of this study was to determine the relationship between splanchnic perfusion and oxygen consumption, and flow types in cardiopulmonary bypass (CPB), by measuring gastric intramucosal pH. Twenty patients undergoing elective open-heart surgery were prospectively randomized to receive...

  • A retrospective study on perfusion incidents and safety devices. Mejak, B.L.; Stammers, A.; Rauch, E.; Vang, S.; Viessman, T. // Perfusion;Jan2000, Vol. 15 Issue 1, p51 

    Despite the acceptance of extracorporeal circulation as an effective modality to facilitate cardiac surgery, patient outcomes can be negatively influenced by the occurrence of perfusion incidents. A perfusion survey was conducted to identify safety techniques and incidents related to...

  • The selection of priming fluids for cardiopulmonary bypass in the UK and Ireland. Lilley, Angela // Perfusion;Sep2002, Vol. 17 Issue 5, p315 

    The ideal prime for Cardiopulmonary Bypass (CPB) has never been fully established. The development of acid-base disorders during some routine cases and the possible contribution to this from priming fluids caused this hospital to question its protocol. As a result, we conducted a survey of UK...

  • Lessons from perfusion surveys. Kurusz, M. // Perfusion;1997, Vol. 12 Issue 4, p221 

    Examines surveys on perfusion done in the U.S. since 1977. Comparative data on commonly used devices or techniques that have been promoted to make cardiopulmonary bypass safer; Lessons regarding survey research in general.

  • Techniques of paediatric modified ultrafiltration: 1996 survey results. Darling, E.; Nanry, K.; Shearer, I.; Kaemmer, D.; Lawson, S. // Perfusion;1998, Vol. 13 Issue 2, p93 

    In September 1996, perfusionists from 50 paediatric open-heart surgery programmes were contacted to identify centres that are currently using the technique of modified ultrafiltration (MUF). Of the 50 centres contacted, 22 (44%) were utilizing the technique. These centres were surveyed on the...

  • Sydney Abstracts.  // Perfusion;1998, Vol. 13 Issue 2, p83 

    Presents several research abstracts on cardiovascular perfusion. 'Surface Coatings: Is there a Difference?,' by S.B. Horton, C.A. Thuys, E.B. O'Connor, R.J. Mullaly, W. Butt and T.R. Karl; 'Use of Modified Ultrafiltration in Cardiopulmonary Bypass,' by Kevin Menezes, Ravi Swami, K. Jagannath, K....

  • Assessment of Perfusion toward the Aortic Valve. Grooters, Ronald K.; Thieman, Kent C.; Schneider, Robert F.; Nelson, Mark G. // Texas Heart Institute Journal;2000, Vol. 27 Issue 4, p361 

    Presents a study which assessed a technique of perfusion toward the aortic valve during cardiopulmonary bypass. Patients and methods; Results and discussion.

  • Is increased perfusion pressure really necessary during cardiopulmonary bypass? Alhan, Cem H.; Toraman, Fevzi; Karabulut, Hasan // European Journal of Cardio-Thoracic Surgery;May2012, Vol. 41 Issue 5, p1213 

    A letter to the editor is presented in response to the article "Increased systemic perfusion pressure during cardiopulmonary bypass is associated with less early postoperative cognitive dysfunction and delirium" by M. Siepe and colleagues in the 2011 issue.

  • Letter to editor. Grist, G.; Jonas, R.A. // Perfusion;1999, Vol. 14 Issue 5, p403 

    Presents letters to the editor concerning a previous article in this magazine by Dr. Richard A. Jonas concerning pH-stat strategy for pediatric cardiopulmonary bypass, and Jonas' opinion that it is the most optimal hypothermic acid-based strategy. Study of infants undergoing extended...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics