Perfusion
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Randomized Controlled Trial Clinical Trial
Clinical experience with heparin-coated cardiopulmonary bypass circuits.
The extensive area of contact between blood and synthetic surfaces during cardiopulmonary bypass results in the activation of the kallikrein, the complement and the clotting and fibrinolytic systems. This results in white cell activation and a whole body inflammatory response. Pulmonary neutrophil sequestration is also known to occur during cardiopulmonary bypass and has been associated with pulmonary damage. ⋯ The preliminary results suggest a reduction in pulmonary neutrophil sequestration (p greater than 0.05) and the generation of thrombin antithrombin complexes (p less than 0.05). Retinal microembolism was not significantly different in the two groups nor was the postoperative blood loss. Thus, heparin-coated cardiopulmonary bypass circuits do not reduce pulmonary neutrophil sequestration, retinal microembolism or postoperative blood loss.
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The surgical treatment of giant intracranial aneurysms can be aided by using cardiopulmonary bypass to provide hypotension under hypothermic conditions. Cardiopulmonary techniques need to be modified to deal with the problems that arise during this type of neurosurgery.
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Review Historical Article
Extracorporeal membrane oxygenation (ECMO): prolonged bedside cardiopulmonary bypass.