European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Aug 2004
Randomized Controlled Trial Clinical TrialThe effect of leucodepletion on leucocyte activation, pulmonary inflammation and respiratory index in surgery for coronary revascularisation: a prospective randomised study.
Leucocyte activation is central to end-organ damage that occurs during cardiac surgery under cardiopulmonary bypass (CPB). Exhaled nitric oxide (NO) increases in inflammatory lung conditions and has been proposed as a marker of pulmonary inflammation during CPB. This study examined the effect of leucodepletion on leucocyte activation, pulmonary inflammation and oxygenation in patients undergoing coronary revascularisation. ⋯ Leucodepletion reduces the numbers of circulating activated leucocytes and the pulmonary inflammation during CPB. This appears to limit lung injury and improve oxygenation in low-risk patients undergoing CABG surgery. Larger numbers of patients are required to evaluate the effect of continuous arterial line leucodepletion on the clinical outcome.
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Eur J Cardiothorac Surg · Aug 2004
Emergency thoracotomy in the pre-hospital setting: a procedure requiring clarification.
The aim of this study is to investigate the influence of Emergency Thoracotomy (ET) on mortality in a group of patients suffering from severe thoracic trauma requiring Helicopter Emergency Medical Service (HEMS) transfer to hospital. This is not clearly defined especially when thoracotomy takes place in the pre-hospital setting. ⋯ Our study has shown that when confounding variables are accounted for, ET is not a predictor of mortality following severe chest trauma. This implies that in a well-selected group of patients it may be a significant and life-saving procedure.
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Eur J Cardiothorac Surg · Aug 2004
Effects of the patent false lumen on the long-term outcome of type B acute aortic dissection.
To determine the most effective treatment, we performed a detailed comparative study of the clinical course of patients with type B aortic dissection with a patent or thrombosed false lumen who did not undergo surgery in the acute period. We examined the effect of patency of the false lumen on outcome. ⋯ Patency of the false lumen is a strong independent prognostic factor for type B aortic dissection. Location of the most dilated aortic segment at the distal arch is a significant risk factor in the patients with a patent false lumen.
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Eur J Cardiothorac Surg · Aug 2004
Hypophosphatemia following open heart surgery: incidence and consequences.
Significant hypophosphatemia (SH) is common after major surgery and may be associated with considerable morbidity, including respiratory and cardiac failure. The contribution of SH to these complications after cardiac surgery is not well defined. ⋯ SH was common after open-heart surgery and was associated with an increased incidence of important complications. We suggest that phosphate levels be routinely measured immediately after surgery and appropriate therapy instituted.
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Eur J Cardiothorac Surg · Aug 2004
Case ReportsLeft ventricular assist device (LVAD) enables survival during 7 h of sustained ventricular fibrillation.
We describe the case of a patient implanted with a DeBakey left ventricular assist device (LVAD) as bridge to transplant who survived 7 h of ventricular fibrillation. He was successfully converted into a stable sinus rhythm.