体外循环过程中温度管理对小儿室间隔缺损矫正术临床疗效的影响

H. Golab, M. Wijers, M. Witsenburg, G. Bol-Raap, E. Cruz, A. Bogers
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引用次数: 1

摘要

28°C的中度低温在体外循环(CPB)心脏手术中被广泛接受。然而,最近几项研究表明,常温或“微温”旁路技术可能改善心脏手术患者的临床结果。为了评估旁路温度管理策略在小儿室间隔缺损矫正术中的效果,将26例体重小于10 kg的患者随机分为两个治疗组:1组,亚低温,患者在旁路术中冷却至鼻咽温度32℃;2组,28°C中度低温。记录临床参数,术前、术中、术后24小时采集血样。两组患者的总体特征及术中变量均相似。CPB和鱼精蛋白治疗后的血液学数据显示,32°C组活化的部分凝血活蛋白时间显著延长(p < 0.05);然而,出血量的差异没有达到显著性。我们的研究表明,两种灌注温度同样有利于CPB的这种类型的心内手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Effect of Temperature Management During Cardiopulmonary Bypass on Clinical Outcome in Pediatric Patients Undergoing Correction of Ventricular Septal Defect
Moderate hypothermia of 28°C is widely accepted in cardiac surgery with cardiopulmonary bypass (CPB). Recently, however, several studies suggested that normothermic or “tepid” bypass techniques may improve the clinical outcome for patients undergoing cardiac operations. To assess the effect of bypass temperature management strategy in pediatric patients undergoing correction of ventricular septal defect, 26 patients with body weight under 10 kg were randomly assigned to two treatment groups: Group 1, mild hypothermia, patients cooled to nasopharyngeal temperature of 32°C during the bypass; or Group 2, moderate hypothermia of 28°C. Clinical parameters were recorded, and blood samples were obtained just before, during, and 24 hours after operation. All the population characteristics and intraoperative variables were similar in the two groups. Hematologic data after CPB and protamine administration revealed a significantly (p < .05) longer activated partial thromboplastin time in the 32°C group; however, the difference in blood loss did not reach significance. Our study shows that both perfusion temperatures equally well facilitated CPB for this type of intracardiac surgery.
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