Hunan yi ke da xue xue bao = Hunan yike daxue xuebao = Bulletin of Hunan Medical University
-
Hunan Yi Ke Da Xue Xue Bao · Jan 1998
Randomized Controlled Trial Clinical Trial[The protective effects of cardiac ischemic preconditioning on lung in cardiac operation with cardiopulmonary bypass].
Twenty direct vision intracardial operation patients were divided into two groups randomly. After cardiopulmonary bypass, ten patients were treated with myocardial ischemic preconditioning. The aorta were clamped for 3 minutes and released for 3 minutes (Group IP). Another ten patients were not treated with ischemic preconditioning (Group C), only underwent 6 minutes cardiopulmonary bypass. Then the aorta were clamped and intracardial operation were done. The left atrium blood and lung tissue were collected just after thoractomy and half an hour after cardiac reperfusion in both groups. ⋯ (1) The numbers of polymorphonuclear (PMN) of the two groups were increased significantly after cardiopulmonary bypass (P < 0.01). (2) The number of PMN and SOD, PaO2 contents were significantly higher in Group IP than in Group C (P < 0.05). (3) The numbers of PMN in lung interstitum under microscopy were less in Group IP than in Group C. (4) MDA contents were less in Group IP than in Group C (P < 0.05). (5) Histological finding showed less damage in Group IP than in Group C. It is evident that cardiac ischemic preconditioning could protect lung against ischemia reperfusion injury. The possible mechanisms are that ischemic preconditioning inhibites the accumulation and activation of PMN in lung tissue and reduces the production of oxygen free radicals.
-
Hunan Yi Ke Da Xue Xue Bao · Jan 1998
[The application of low tidal volume pressure-controlled ventilation in patients with acute respiratory distress syndrome].
Low tidal volume pressure-controlled ventilation therapy was used in 32 patients with ARDS. There were resulted a lower peak inspiratory pressure (PIP) level than that of control group, thus a decline in incidence of overventilation and the overventilation induced mortality. The results suggest that low tidal volume pressure-controlled ventilation may consider as preferred ventilation mortality in management of ARDS.
-
Hunan Yi Ke Da Xue Xue Bao · Jan 1998
[The effects of hypertonic saline/mannitol resuscitation on the myocardiac contractility and blood pressure of rabbits with hemorrhagic shock].
Eighteen healthy adult male rabbits were hemorrhaged to shock and treated with hypertonic-hyperoncotic solutions in 3 groups (6 per group): hypertonic saline/dextran(HSD), hypertonic saline/mannitol(HSM) and hypertonic acetate/mannitol(HAM). The results showed that HSM. HAM and HSD could raise the left ventricular pressure(LVP), maximum change rate of LVP (+/- dp/dt max) and the arterial blood pressure of hemorrhagic shock rabbits quickly at small dose. The efficiency of HSM was better than that of HSD and HAM (P < 0.05), and the time of blood pressure rise was in accordance with that of LVP and +/- dp/dt max, which may partly explain the mechanism of shock resuscitation by hypertonic-hyperoncotic solution.
-
Hunan Yi Ke Da Xue Xue Bao · Jan 1998
Comparative Study[Effects of propofol and etomidate on cerebral oxygen supply and demand balance during middle hypothermia cardiopulmonary bypass].
Effects of propofol(Group P) and etomidate(Group E) on cerebral oxygen supply and demand balance during middle hypothermia cardiopulmonary bypass(CPB) were studied in twenty patients undergoing cardiac valve replacement. Arterial blood and jugular bulb blood were taken to analyse blood gas, and cerebral oxygen content were caculated. ⋯ During hypothermia, jugular bulb oxygen saturation(SjO2), jugular bulb blood oxygen content(CjO2) increased; cerebral oxygen extraction rate(CEO2) decreased significantly in two groups(P < 0.05). During rewarming SjO2, CjO2 were significantly decreased, CEO2 increased compared with that before rewarming and hypothermia in two gbroups (P < 0.05). In Group P, SjO2 and CjO2 were higher, CEO2 lower than those in Group E respectively during rewarming (P < 0.05). CONCULUSION: The activity of propofol reduced cerebral metabolism, cerebral oxygen consumption and CEO2 is better than that of etomidate.
-
Hunan Yi Ke Da Xue Xue Bao · Jan 1998
[Clinical analysis of early complications in 132 low body weight infants performed open-heart surgery].
A clinical analysis of early complications in 132 low body weight infants undergoing open-heart surgery is reported. There were a higher risk of early complication associated with severe illness and/or experienced a longer duration time of cardiopulmonary bypass and endotracheal tube. The total complication rate was 42.4% and the major three complications were low cardiac output, acute respiratory distress syndrome and problems from endotracheal tube (occlusion and/or in proper position of tube). The author emphasized the importance of management of endotracheal tube after operation.