The Journal of ExtraCorporeal Technology最新文献_第8页

Cardiopulmonary Bypass in the Sickle Cell Anemia Patient using Profound Hypothermia and Circulatory Arrest: A Case Report 镰状细胞性贫血患者在深度低温和循环停止下的体外循环:1例报告

The Journal of ExtraCorporeal Technology Pub Date : 1998-09-01 DOI: 10.1051/ject/1998303135

V. W. Longnecker, M. Hartley, F. M. Dingmann, S. Jamieson, J. Kriett, D. Kapelanski

引用次数: 3

Does Hyperfibrinolytic Activity Occur During Cardiopulmonary Bypass from Blood Exposed to Pleural Surfaces? 体外循环时血液暴露于胸膜表面是否会发生高纤溶活性?

The Journal of ExtraCorporeal Technology Pub Date : 1998-09-01 DOI: 10.1051/ject/1998303120

M. L. Pierce, A. Stammers, M. S. Dickes, Kimberly J Taft, D. Beck, C. C. Jones

{"title":"Does Hyperfibrinolytic Activity Occur During Cardiopulmonary Bypass from Blood Exposed to Pleural Surfaces?","authors":"M. L. Pierce, A. Stammers, M. S. Dickes, Kimberly J Taft, D. Beck, C. C. Jones","doi":"10.1051/ject/1998303120","DOIUrl":"https://doi.org/10.1051/ject/1998303120","url":null,"abstract":"During cardiac surgery with cardiopulmonary bypass (CPB), fibrinolytic activity may be stimulated when blood exposed to pleural surfaces is suctioned into the extracorporeal circuit (ECC). The purpose of this study was to determine the effect of reinfused blood exposed to pleural surfaces on systemic fibrinolytic activity. Following Institutional Animal Care Utilization Committee approval, 120 ml of blood was drawn from the femoral artery of 4 pigs and placed in both pleural cavities, where it remained for 120 min during CPB. After this time, the exposed blood was suctioned back into the ECC. Blood samples were drawn at the following times: 40 min prior to median sternotomy, 30 and 90 min during CPB, and 30 min post-suction. Tests performed on the samples included thromboelastography (TEG), D-dimer (DD), fibrin degradation products (FDP), fibrinogen concentration, activated clotting time (ACT), hematocrit, and platelet count. TEG index decreased significantly in the circuit following suction (5.28 ± 0.45 vs. 0.98 ± 1.86, p < 0.0007), while fibrinolytic activity increased (6.25 ± 1.50%) in the ECC when compared to pleural blood (2.17 ± 1.04%, p < 0.01). The DD and FDP were both elevated in the systemic circulation following suction of the pleural blood, although statistical significance was not achieved. The ACT was significantly elevated in the pleural fluid during CPB (707 ± 213) compared with the ECC (378 ± 32, p < .003), which may indicate an accelerated consumption of coagulation factors. In conclusion, blood exposed to pleural surfaces may have increased fibrinolytic activity, but systemic hyperfibrinolysis was not seen.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133298781","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}

引用次数: 0

Pulmonary Implications of Filtering Various Mediators of Morbidity Found in Salvaged Blood 在回收的血液中发现过滤各种疾病介质的肺意义

The Journal of ExtraCorporeal Technology Pub Date : 1998-09-01 DOI: 10.1051/ject/1998303108

D. Webb, C. P. Altenbern, C. Tritt, F. Downey, D. Minkel

{"title":"Pulmonary Implications of Filtering Various Mediators of Morbidity Found in Salvaged Blood","authors":"D. Webb, C. P. Altenbern, C. Tritt, F. Downey, D. Minkel","doi":"10.1051/ject/1998303108","DOIUrl":"https://doi.org/10.1051/ject/1998303108","url":null,"abstract":"Leukocyte reduction of residual circuit blood following cardiopulmonary bypass (CPB) has been demonstrated to improve lung function and reduce the inflammatory response after surgery. In this study, the effect of lipid/leuko-reduction of salvaged blood on pulmonary function and the inflammatory response was examined. Fifteen patients undergoing elective cardiac surgery were randomly assigned to a lipid/leuko-reduced group or a control group. In addition, all residual circuit blood was transferred to the autotransfusion cell-processing device at the end of CPB to contribute a significant portion of the final washed product. In the lipid/leuko-reduced group (N = 10), all processed blood was passed through a lipid globule, C3a, microaggregate pre-filter, followed by a leukocyte removing filter. In the control group (N = 5), all processed blood was filtered using a 40/150 f.lil1 dual screen transfusion filter. The lipid/leuko-reduced group showed a significant decrease in pulmonary shunt fraction following reinfusion, whereas the control group did not. The lipid/leuko-reduced group also showed a trend towards decreased pulmonary vascular resistance and a blunting of the leukocytosis that develops following the reinfusion of salvaged blood and CPB, although these trends were not statistically significant. There were no statistical differences between the two groups with respect to oxygenation index or circulating red blood cells following reinfusion. These results suggest that lipid/leuko-reducing salvaged blood improves postoperative lung function and is efficacious.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1998-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124282067","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}

引用次数: 9

Successful Bridge to Transplantation with the Abiomed BVS 5000 Ventricular Assist Device Following Double Valve Replacement: A Case Report 双瓣膜置换术后使用Abiomed BVS 5000心室辅助装置成功过渡到移植:一例报告

The Journal of ExtraCorporeal Technology Pub Date : 1998-06-01 DOI: 10.1051/ject/199830291

L. Samuels, M. Kauffman, R. Morris, M. Strong, S. Brockman

引用次数: 1

Urethral Perfusion for Cryoablation of the Prostate 尿道灌注在前列腺冷冻消融中的应用

The Journal of ExtraCorporeal Technology Pub Date : 1998-03-01 DOI: 10.1051/ject/19983016

S. Huffman, J. Newberry, L. Fristoe, A. Stammers, M. Grune

{"title":"Urethral Perfusion for Cryoablation of the Prostate","authors":"S. Huffman, J. Newberry, L. Fristoe, A. Stammers, M. Grune","doi":"10.1051/ject/19983016","DOIUrl":"https://doi.org/10.1051/ject/19983016","url":null,"abstract":"Cryosurgery is an emerging treatment method for prostate cancer patients that may expand the scope of practice for perfusionists. Because of the low temperatures needed to cryogenically destroy cancerous tissue, damage to the urethra and bladder may cause incontinence and impotence. As a result of this associated morbidity, an extracorporeal circuit was constructed by the perfusionists at the University of Nebraska Medical Center (Omaha, NE). This urethral perfusion circuit provides a way to maintain normothermic urethral and bladder temperatures during cryogenic procedures, thus preventing trauma to the urethra and bladder. Five patients with a mean age of 73.3 ± 3.0 years diagnosed with localized prostate cancer (Stage A, B, C) were offered cryosurgery using urethral perfusion to treat their cancer. After induction of general anesthesia, a specially designed urethral catheter was inserted. Quarter-inch tubing was attached to barbed connections on the catheter and the free ends were then attached to the circuit. This extracorporeal circuit consisted of a heater/cooler, a twin roller pump, a cardioplegia heat exchanger, and temperature and pressure monitoring devices at the inlet and outlet sites on the catheter. Normal saline was circulated through the tubing of the urethral perfusion circuit to maintain flow rates of 200-400 ml/min, with the circuit pressure not exceeding 300 mmHg. Average urethral perfusion time was 139.3 ± 17.7 minutes. Inlet temperature of the catheter was kept at 42° C to maintain an average bladder temperature of 38.2 ± 2.3° C. All of the patients tolerated the procedure well and were ambulating without assistance on postoperative day one. With the exception of one patient with acute postoperative anuria, patients were discharged on the first postoperative day. Cryosurgery of prostate cancer using urethral perfusion has the potential to serve as a unique practice opportunity for perfusionists.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121312419","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}

引用次数: 0

Conversion to Biventricular Pulsatile Assist as a Bridge to Cardiac Transplantation : A Case Report 转换为双心室脉动辅助作为心脏移植的桥梁:1例报告

The Journal of ExtraCorporeal Technology Pub Date : 1998-03-01 DOI: 10.1051/ject/199830135

D. Ruby, J. L. Lester

引用次数: 1

Application of Polygeline in Pediatric Cardiac Surgery 聚乙烯在小儿心脏外科中的应用

The Journal of ExtraCorporeal Technology Pub Date : 1998-03-01 DOI: 10.1051/ject/199830120

De-ming Zhu, Hong Chen, Wei Wang, Ying Chen

{"title":"Application of Polygeline in Pediatric Cardiac Surgery","authors":"De-ming Zhu, Hong Chen, Wei Wang, Ying Chen","doi":"10.1051/ject/199830120","DOIUrl":"https://doi.org/10.1051/ject/199830120","url":null,"abstract":"The purpose of this study was to determine the effect of using polygeline as part of the cardiopulmonary bypass solution in pediatric cardiac surgery.\u0000A total of 40 cases were divided into two groups, a polygeline group (H group, n=20) and a plasma group (P group, n=20). Operations were performed under routine extracorporeal circulation. The dose of polygeline or plasma used was calculated to maintain the patient's plasma colloid oncotic pressure at 10-12 mmHg.\u0000The results showed that in the polygeline group, no patient developed allergic or coagulation disorders even after large volumes of polygeline were used (45 ml/kg). At the initiation and completion of cardiopulmonary bypass (CPB), the concentrations of calcium were higher in the H group (1.38 ± 0.19, 1.21 ± 0.11) than those (0.72 ± 0.11, 0.95 ± 0.10) in the P group. There were no other statistically significant differences between the two groups. There were no organ problems in the patients included in the study.\u0000This study demonstrated that polygeline could be used as part of prime solution instead of plasma to keep an ideal plasma colloid oncotic pressure, reduce infections caused by blood product transfusions and lower the cost to the patients.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1998-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132486791","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}

引用次数: 1

Pumpless Extracorporeal Lung Assist 无泵体外肺辅助

The Journal of ExtraCorporeal Technology Pub Date : 1998-03-01 DOI: 10.1051/ject/199830138

A. Phillipp, R. Behr, MOt M. Rengr, Moo D M. Kaiser, Mdo Birnbaum, Abt. Kardiotechnik

引用次数: 13

Utility of In Vitro Heparin and Protamine Titration for Dosing During Cardiopulmonary Bypass Surgery 体外肝素和鱼精蛋白滴定在体外循环手术中给药的应用

The Journal of ExtraCorporeal Technology Pub Date : 1997-12-01 DOI: 10.1051/ject/1997294176

PhD M.L. Zucker, MS C.L. Barrett, BA K. Bennett, PhD F.M. LaDuca

{"title":"Utility of In Vitro Heparin and Protamine Titration for Dosing During Cardiopulmonary Bypass Surgery","authors":"PhD M.L. Zucker, MS C.L. Barrett, BA K. Bennett, PhD F.M. LaDuca","doi":"10.1051/ject/1997294176","DOIUrl":"https://doi.org/10.1051/ject/1997294176","url":null,"abstract":"Methods used to maintain a hemostatic balance during cardiopulmonary bypass surgery include the optimization of heparin and protamine dosing. Higher heparin doses have been associated with increased bleeding, while other studies have attributed reduced blood loss and transfusion requirements to lower protamine doses. We have evaluated the use of an in vitro heparin and protamine titration system and compared it to standard dosing in patients undergoing surgery requiring cardiopulmonary bypass. Based upon the principle of the Hemochron® RxDx® system, Heparin Response Tests (HRT) and Protamine Response Tests (PRT) were performed for 40 patients undergoing cardiac surgery at three hospital centers. The Activated Clotting Time (ACT) was used to monitor adequate heparin dosing prior to placing the patient on bypass, and to monitor heparin reversal after protamine dosing. The efficacy of heparin reversal was determined using the Protamine Dose Assay (PDA-O) test. All centers used standard hospital pharmaceutical preparations of heparin and protamine.\u0000Heparin and protamine RxDx dosing was compared to standard hospital practice for each site. Based on the HRT, the average heparin dose was not different from empirical dosing; however, individual differences were as high as 11,000 units. Only a single patient required a second heparin bolus prior to initiation of bypass. On average, the protamine dose predicted by the PRT was only 67% of the empirical protamine dose. The PDA-O test identified the need for additional protamine in 13% of patients. Patients administered additional protamine at the request of the surgical team, despite the presence of a normal PDA-O test, had no further decrease in ACT.\u0000In summary, the in vitro HRT and PRT system did not alter the initial heparin dose yet significantly decreased the protamine doses administered. Based on prior clinical outcome studies, this reduction is expected to have a beneficial effect on postoperative bleeding and transfusion requirements.","PeriodicalId":309024,"journal":{"name":"The Journal of ExtraCorporeal Technology","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1997-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131628483","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}

引用次数: 1

Successful Bi-Ventricular Abiomed Support in a Coronary Artery Bypass/Mitral Valve Replacement Patient 冠状动脉搭桥术/二尖瓣置换术患者成功的双心室Abiomed支持

The Journal of ExtraCorporeal Technology Pub Date : 1997-12-01 DOI: 10.1051/ject/1997294197

K. D. Swoyer, M. Martin, R. Illes

引用次数: 0