The Journal of ExtraCorporeal Technology最新文献_第9页

Use of the Abiomed BVS 5000 Ventricular Assist Device for Myocardial Support Following Left Ventricular Aneurysmectomy: Case Report 左室动脉瘤切除术后使用Abiomed BVS 5000心室辅助装置进行心肌支持:病例报告

The Journal of ExtraCorporeal Technology Pub Date : 1997-09-01 DOI: 10.1051/ject/1997293158

L. Samuels, J. S. Havdala, M. S. Kaufman, R. Morris, S. Brockman

引用次数: 0

The Antiinflammatory Effects of Aprotinin in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass 抑酶蛋白在心脏手术合并体外循环患者中的抗炎作用

The Journal of ExtraCorporeal Technology Pub Date : 1997-09-01 DOI: 10.1051/ject/1997293114

A. Stammers, S. Huffman, A. Alonso, L. Fristoe, G. Hill, Dana Casebeer, R. P. Diego, Zuorui Song

{"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}

引用次数: 12

Perflubron Emulsion Does Not Cause Neutrophil (PMN) Activation In- Vivo. 全氟乳剂在体内不会引起中性粒细胞(PMN)活化。

The Journal of ExtraCorporeal Technology Pub Date : 1997-09-01 DOI: 10.1051/ject/1997293123

Donald S. Wilson, J. Hokama, G. Lai, G. Gorman, N. Susa, J. Copeland, P. McDonagh

{"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}

引用次数: 4

Automatic Control of Gas Exchange During Cardiopulmonary Bypass 体外循环中气体交换的自动控制

The Journal of ExtraCorporeal Technology Pub Date : 1997-09-01 DOI: 10.1051/ject/1997293139

PhD Scott I. Merz, PhD J. Patrick Montoya, MD W. Anthony Lee, MD Srinivas Kalla, MD Robert H Bartlett

{"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}

引用次数: 2

The Novacor Left Ventricular Assist System: Lessons Learned Novacor左心室辅助系统:经验教训

The Journal of ExtraCorporeal Technology Pub Date : 1997-09-01 DOI: 10.1051/ject/1997293132

L. Samuels, M. S. Kaufman, R. Morris, S. Brozena, C. Twomey, S. Brockman

{"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}

引用次数: 4

Massive Volume Loss During Cardiopulmonary Bypass and its Association with Meckel’s Diverticulum 体外循环期间大量容量损失及其与梅克尔憩室的关系

The Journal of ExtraCorporeal Technology Pub Date : 1997-03-01 DOI: 10.1051/ject/199729145

T. Buzzelli, R. Trittipoe

引用次数: 0

A Comparative Review of Crystalloid, Albumin, Pentastarch and Hetastarch as Perfusates for Cardiopulmonary Bypass 晶体、白蛋白、五瓣心弓和七瓣心弓作为体外循环灌注液的比较研究

The Journal of ExtraCorporeal Technology Pub Date : 1997-03-01 DOI: 10.1051/ject/199729130

G. Myers

引用次数: 6

A Review of Cardiopulmonary Bypass in Neonates, Infants, and Young Children 新生儿、婴儿和幼儿的体外循环研究综述

The Journal of ExtraCorporeal Technology Pub Date : 1997-03-01 DOI: 10.1051/ject/199729149

R. Jonas, Martin J. Elliott

引用次数: 0

Cardiopulmonary Bypass Factors Affecting the Development Of Choreoathetosis in Pediatric Patients 影响小儿舞蹈病发展的体外循环因素

The Journal of ExtraCorporeal Technology Pub Date : 1997-03-01 DOI: 10.1051/ject/199729111

J. Ecklund, V. Phelps, K. Holden, J. Riley, F. Crawford, R. Sade

{"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}

引用次数: 2

Tables for Estimating Dilutional Hematocrits and Blood Flow Rates from Total Blood Volume and Body Surface Area Formulae 根据总血容量和体表面积公式估算稀释红细胞压积和血流速率的表格

The Journal of ExtraCorporeal Technology Pub Date : 1997-03-01 DOI: 10.1051/ject/199729136

B. Searles, C. E. O'leary

引用次数: 1