Advances in Extra-corporeal Perfusion Therapies最新文献_第2页

Utility of Modified Ultrafiltration in Congenital Heart Disease Patients Operated with Cardiopulmonary Bypass 改良超滤在先天性心脏病患者体外循环手术中的应用

Advances in Extra-corporeal Perfusion Therapies Pub Date : 2018-11-05 DOI: 10.5772/intechopen.77122

P. Curi-Curi, J. Calderón-Colmenero, Samuél Ramírez-Marroquín, J. Cervantes-Salazar

{"title":"Utility of Modified Ultrafiltration in Congenital Heart Disease Patients Operated with Cardiopulmonary Bypass","authors":"P. Curi-Curi, J. Calderón-Colmenero, Samuél Ramírez-Marroquín, J. Cervantes-Salazar","doi":"10.5772/intechopen.77122","DOIUrl":"https://doi.org/10.5772/intechopen.77122","url":null,"abstract":"Modified ultrafiltration is used in cardiac surgery with cardiopulmonary bypass in order to diminish systemic inflammatory response syndrome. We aimed to show its utility for removing pro-inflammatory agents in operated pediatric patients with congenital heart disease and its impact at operative care. A clinical case-control trial was designed, including patients with simple congenital heart disease operated on with cardiopulmonary bypass in a 1-year period. We randomized them to a problem group (with modified ultrafiltration, n = 15) and a control group (without it, n = 16), and blood samples to measure interleukins (6 and 10); 3d and 4d complement fraction concentrations were taken at the following times: baseline, before cardiopulmonary bypass, after it, after modified ultrafiltration, and from the ultrafiltration concentrate. Operative clinical end points of success were defined as hemodynamic stability, absence of morbidity, and lack of mortality. We observed a higher significant interleukin 6 concentration in the problem group patients at baseline, as well as a higher removal of this pro-inflammatory agent at the ultrafiltration concentrate. Modified ultrafiltration has a positive impact over simple congenital heart disease surgery with cardiopulmonary bypass because of removing interleukin 6. We recommend its routine use when hemodynamic conditions are favorable.","PeriodicalId":366209,"journal":{"name":"Advances in Extra-corporeal Perfusion Therapies","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124043313","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

Holder System for External Pumps Positioned Remote from the CPB Console: 23 Years’ Experience 固定器系统外部泵定位远程CPB控制台:23年的经验

Advances in Extra-corporeal Perfusion Therapies Pub Date : 2018-11-05 DOI: 10.5772/INTECHOPEN.77121

U. Borrelli, M. Detroux, R. Nottin, S. Nikis, Pierre Nakers

{"title":"Holder System for External Pumps Positioned Remote from the CPB Console: 23 Years’ Experience","authors":"U. Borrelli, M. Detroux, R. Nottin, S. Nikis, Pierre Nakers","doi":"10.5772/INTECHOPEN.77121","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.77121","url":null,"abstract":"Since 1995, our objective is to set up the extracorporeal circulation (ECC) in a manner that is both safe and versatile with a holder system which makes possible to install the oxygenator and vacuum-assisted venous drainage (VAVD) hard-shell venous reservoir (HSVR) together with the external pumps, at a distance from the cardiopulmonary bypass (CPB) console but at the same height as the patient’s shoulder. The aim is to reduce the effects of ECC by reducing surface of air/blood, blood/materials contact, the dead space of the system and priming volume of the circuit. Our ECC systems have a biocompatible sur- face treatment, the oxygenator and HSVR are adapted to the patient (body surface area, pathologies, etc.) and circuit includes short 3/8 in arterial and venous line (adult patients). We introduced into routine VAVD, retrograde autologous priming (RAP), including arterial line, arterial filter and antegrade autologous priming of the venous line (VAP) before the start of ECC. To confirm this development strategy of the ECC, we conducted a series of studies that have permitted to demonstrate the positive impact on postoperative out - comes of patients. Since September 2007, our objective was attained through the creation of a holder system (System U. Borrelli).","PeriodicalId":366209,"journal":{"name":"Advances in Extra-corporeal Perfusion Therapies","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133029885","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

Use of ECMO in Sepsis and Septic Shock ECMO在脓毒症和感染性休克中的应用

Advances in Extra-corporeal Perfusion Therapies Pub Date : 2018-11-05 DOI: 10.5772/INTECHOPEN.77120

K. D. Decker

引用次数: 1

Long-Term Outcome of High-Risk Percutaneous Coronary Interventions with Extracorporeal Membrane Oxygenation Support for Patients Without Cardiogenic Shock 无心源性休克的高危经皮冠状动脉介入治疗体外膜氧合支持的远期疗效

Advances in Extra-corporeal Perfusion Therapies Pub Date : 2018-04-04 DOI: 10.5772/INTECHOPEN.75881

Vladimir I. Ganyukov, Roman S. Tarasov, Ivan E. Vereshchagin, Dmitry L. Shukevich

{"title":"Long-Term Outcome of High-Risk Percutaneous Coronary Interventions with Extracorporeal Membrane Oxygenation Support for Patients Without Cardiogenic Shock","authors":"Vladimir I. Ganyukov, Roman S. Tarasov, Ivan E. Vereshchagin, Dmitry L. Shukevich","doi":"10.5772/INTECHOPEN.75881","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.75881","url":null,"abstract":"Percutaneous coronary intervention (PCI) has evolved into the high-risk category in the past 2 decades. Endovascular patients are on average sicker than in the past due to increased age, complex anatomy, reduced global left ventricular systolic function and a greater frequency of surgical refusal. Extracorporeal membrane oxygenation (ECMO) can be taken into account for the management of extremely high-risk PCI without any hemodynamic instability. The rationale for the use of ECMO includes a lower risk of hemodynamic collapse which leads to low perfusion episodes minimization. In the evi- dence based on ECMO-assisted high-risk PCI, there are no randomized clinical trials but only observational studies and case reports. In this paper, we describe one-year long- term results of ECMO support for PCI in patients without hemodynamic disturbances. 23, n = 30). It was a single-center registry, which compared 12-month outcomes. Inclusion significant multivessel coronary disease and/or stenosis of the left main coronary artery (LMCA) ≥50%. The PCI + ECMO group of NSTE-ACS patients had an intermediate risk of adverse cardiovascular outcomes (mean GRACE score 117.3 ± 19.4, mean EuroScore II 4.3 ± 3.9%), and a high SYNTAX Score: 33.3 ± 8.3. Significant LMCA stenosis was diagnosed in 60.7% of patients. Every third patient had diabetes mellitus, a prior myocardial infarction was observed in 56.4% cases, peripheral artery disease was diagnosed in 60.7% of patients of the study population. High-risk PCI was defined as having two of the three parameters: (1) left ventricular ejection fraction less than 35%; (2) a large amount of myocardium at risk (Jeopardy Score 8 and more [ 2 ]) and (3) complex PCI. An indication for high-risk PCI was based on the heart team decision for those patients, who were not for some types of revascularization (CABG or PCI) and who had two of the three parameters of high-risk PCI.","PeriodicalId":366209,"journal":{"name":"Advances in Extra-corporeal Perfusion Therapies","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131196413","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

Extracorporeal Membrane Oxygenation Support for Post- Cardiotomy Cardiogenic Shock 体外膜氧合支持心脏切开术后心源性休克

Advances in Extra-corporeal Perfusion Therapies Pub Date : 2018-04-03 DOI: 10.5772/INTECHOPEN.76217

T. Murashita

引用次数: 1