Perfusion
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Randomized Controlled Trial
Does 6% hydroxyethyl starch 130/0.4 impact differently on blood glucose than 4% gelatin in patients receiving open heart surgery?
To investigate whether starch-based colloid may impact differently on blood glucose than a gelatin-based colloid in adult patients receiving open heart surgery. ⋯ With the data available, we could not prove that starch-based colloid (HES130) had a different impact on intra-operative blood glucose than a gelatin-based colloid in adult patients receiving open heart surgery.
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Randomized Controlled Trial
Milrinone, a phosphodiesterase III inhibitor, prevents reduction of jugular bulb saturation during rewarming from hypothermic cardiopulmonary bypass.
Inadequate cerebral oxygen balance during cardiopulmonary bypass may cause neuropsychological dysfunction. Milrinone, a phosphodiesterase III inhibitor, augments cerebral blood flow by direct vasodilatation. We conducted a prospective, randomized study in patients undergoing cardiac surgery with cardiopulmonary bypass to clarify the clinical efficacy of milrinone in the imbalance of cerebral oxygen supply and demand during the rewarming period of cardiopulmonary bypass. ⋯ Milrinone suppresses the reduction of SjO(2) and improves the balance of cerebral oxygen supply and demand during the early rewarming period of hypothermic cardiopulmonary bypass.
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Randomized Controlled Trial
Beneficial effects of using a minimal extracorporeal circulation system during coronary artery bypass grafting.
In this study, we assessed clinical results by using a minimal extracorporeal circuit (MECC) and compared it to a conventional cardiopulmonary bypass (CPB) system in patients undergoing coronary artery bypass grafting (CABG) procedures. ⋯ In conclusion, the MECC system is a safe alternative for patients who undertake extracorporeal circulation (ECC) for CABG surgery. Lower transfusion requirements and less damage to red cells may further promote the use of MECC systems, especially in higher risk patients.
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Randomized Controlled Trial
Active or passive bio-coating: does it matters in extracorporeal circulation?
Two types of surface coating for cardiopulmonary bypass (CPB) are used: bioactive (heparin, nitric oxide) and biopassive (albumin, polyethyleneoxide (PEO), phosphorylcholine). When haemocompatible coatings are combined with the separation of pleuro-pericardial aspiration, attenuation of both the coagulation and complement cascades, as well as better platelet preservation, has been demonstrated. This study wants to investigate if the combination of a bioactive with a biopassive coating (unfractionated heparin embedded in a phosphorylcholine matrix) combines the beneficial effects of both approaches. ⋯ Based on our results, there is no additional benefit in combining phosphorylcholine with unfractionated heparin in elective patients undergoing coronary artery bypass grafting (CABG). Massive haemodilution leads to enhanced complement activation.
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Randomized Controlled Trial
Perioperative blood conservation strategies in pediatric patients undergoing open-heart surgery: impact of non-autologous blood transfusion and surface-coated extracorporeal circuits.
The aim of this study was to explore the relative clinical and biomaterial effects of blood transfusions (Tx) and novel low-prime, surface-coated circuitry on perioperative outcome in a pediatric population undergoing cardiac surgery with cardiopulmonary bypass (CPB). ⋯ Allogenic Tx amplifies the CPB-related inflammatory response. It is feasible to do congenital procedures safely without Tx for patients weighing >10 kg by using combined blood management strategies.