TY - JOUR. T1 - Thrombography reveals thrombin generation potential continues to deteriorate following cardiopulmonary bypass surgery despite adequate hemostasis. AU - Wong, Raymond K.. AU - Sleep, Joseph R.. AU - Visner, Allison J.. AU - Raasch, David J.. AU - Lanza, Louis A.. AU - DeValeria, Patrick A.. AU - Torloni, Antonio S.. AU - Arabia, Francisco A.. PY - 2011/3/1. Y1 - 2011/3/1. N2 - The intrinsic and extrinsic activation pathways of the hemostatic system converge when prothrombin is converted to thrombin. The ability to generate an adequate thrombin burst is the most central aspect of the coagulation cascade. The thrombin-generating potential in patients following cardiopulmonary bypass (CPB) may be indicative of their hemostatic status. In this report, thrombography, a unique technique for directly measuring the potential of patients blood samples to generate adequate thrombin bursts, is used to characterize the coagulopathic profile in post-CPB patients. Post-CPB hemostasis is ...

Prospective randomized trial of normothermic versus hypothermic cardiopulmonary bypass on cognitive function after coronary artery bypass graft surgery.

Cardiopulmonary bypass (CPB) induces hemodilutional anemia, which frequently requires the transfusion of blood products. The objective of this study was to evaluate oxygen delivery and consumption and clinical outcome in low risk patients who were allocated to an hematocrit (Hct) of 20% versus 25% during normothermic CPB for elective coronary artery bypass graft (CABG) surgery. This study was a prospective, randomized and controlled trial. Patients were subjected to normothermic CPB (35 to 36°C) and were observed until discharge from the intensive care unit (ICU). Outcome measures were calculated whole body oxygen delivery, oxygen consumption and clinical outcome. A nonparametric multivariate analysis of variance for repeated measurements and small sample sizes was performed. In a total of 54 patients (25% Hct, n = 28; 20% Hct, n = 26), calculated oxygen delivery (p = 0.11), oxygen consumption (p = 0.06) and blood lactate (p = 0.60) were not significantly different between groups. Clinical outcomes

TY - JOUR. T1 - Pulmonary perfusion with L-arginine ameliorates post-cardiopulmonary bypass lung injury in a rabbit model. AU - Chao, Yin Kai. AU - Wu, Yi Cheng. AU - Yang, Kun Ju. AU - Chiang, Ling Ling. AU - Liu, Hui Ping. AU - Lin, Pyng Jing. AU - Chu, Yen. PY - 2011/5/15. Y1 - 2011/5/15. N2 - Background: Post-cardiopulmonary bypass (CPB) lung injury is the combination of whole body inflammatory response and local ischemia-reperfusion (IR) injury. We investigated the benefit of pulmonary perfusion with L-arginine in protection against post-CPB lung injury. Methods: New Zealand white rabbits (n = 50, weight, 2.5-2.8 kg) were divided into five groups (n = 10 each): sham (sham sternotomy), CPB (CPB without pulmonary perfusion), perfusion (CPB with pulmonary perfusion), L-arginine (CPB with perfusion + L-arginine), and L-NAME (CPB with perfusion + L-NAME). The duration of CPB was 60 min followed by 2 h of reperfusion. Pulmonary perfusion was performed every 20 min through the pulmonary artery ...

TY - JOUR. T1 - Phenylephrine increases cerebral blood flow during low-flow hypothermic cardiopulmonary bypass in baboons. AU - Schwariz, Arthur E.. AU - Minanov, Oktavijan. AU - Stone, J. Gilbert. AU - Adams, David C.. AU - Sandhu, Aqeel A.. AU - Pearson, Mark E.. AU - Kwiatkowski, Pawel. AU - Young, William L.. AU - Michler, Robert E.. PY - 1996/8/23. Y1 - 1996/8/23. N2 - Background: Although low-flow cardiopulmonary bypass (CPB) has become a preferred technique for the surgical repair of complex cardiac lesions in children, the relative hypotension and decrease in cerebral blood flow (CBF) associated with low flow may contribute to the occurrence of postoperative neurologic injury. Therefore, it was determined whether phenylephrine administered to increase arterial blood pressure during low-flow CPB increases CBF. Methods: Cardiopulmonary bypass was initiated in seven baboons during fentanyl, midazolam, and isoflurane anesthesia. Animals were cooled at a pump flow rate of 2.5 1 · min -1 · m ...

TY - JOUR. T1 - Pulsatile perfusion improves regional myocardial blood flow during and after hypothermic cardiopulmonary bypass in a neonatal piglet model. AU - Ündar, Akif. AU - Masai, Takafumi. AU - Yang, Shuang Qiang. AU - Eichstaedt, Harald C.. AU - McGarry, Mary Claire. AU - Vaughn, William K.. AU - Fraser, Charles D.. PY - 2002/1/1. Y1 - 2002/1/1. N2 - Pediatric myocardial related morbidity and mortality after cardiopulmonary bypass (CPB) are well documented, but the effects of pulsatile perfusion (PP) versus nonpulsatile perfusion (NPP) on myocardial blood flow during and after hypothermic CPB are unclear. After investigating the effects of PP versus NPP on myocardial flow during and after hypothermic CPB, we quantified PP and NPP pressure and flow waveforms in terms of the energy equivalent pressure (EEP) for direct comparison. Ten piglets underwent PP (n = 5) or NPP (n = 5). After initiation of CPB, all animals underwent 15 minutes of core cooling (25°C), 60 minutes of hypothermic CPB ...

TY - JOUR. T1 - Heparin-protamine balance after neonatal cardiopulmonary bypass surgery. AU - Peterson, J. A.. AU - Maroney, S. A.. AU - Zwifelhofer, W.. AU - Wood, J. P.. AU - Yan, K.. AU - Bercovitz, Rachel Sara. AU - Woods, R. K.. AU - Mast, A. E.. PY - 2018/10. Y1 - 2018/10. N2 - Essentials Heparin-protamine balance (HPB) modulates bleeding after neonatal cardiopulmonary bypass (CPB). HPB was examined in 44 neonates undergoing CPB. Post-operative bleeding occurred in 36% and heparin rebound in 73%. Thrombin-initiated fibrin clot kinetic assay and partial thromboplastin time best assessed HPB. Summary: Background Neonates undergoing cardiopulmonary bypass (CPB) are at risk of excessive bleeding. Blood is anticoagulated with heparin during CPB. Heparin activity is reversed with protamine at the end of CPB. Paradoxically, protamine also inhibits blood coagulation when it is dosed in excess of heparin. Objectives To evaluate heparin-protamine balance in neonates undergoing CPB by using research ...

TY - JOUR. T1 - Cerebral blood flow during low-flow hypothermic cardiopulmonary bypass in baboons. AU - Schwartz, A. E.. AU - Kaplon, R. J.. AU - Young, W. L.. AU - Sistino, J. J.. AU - Kwialkowski, P.. AU - Michler, R. E.. PY - 1994/1/1. Y1 - 1994/1/1. N2 - Background: Neurologic injury after cardiopulmonary bypass (CPB) is a frequent and devastating complication of cardiothoracic surgery. Disordered cerebral hemodynamics during CPB has been implicated as an important factor in the etiology of these injuries. Evidence of disordered cerebral hemodynamics includes reports of a progressive time-dependent decrease in cerebral blood flow (CBF) during stable full-flow CPB. Low-flow hypothermic CPB has become a preferred technique for the management of pediatric patients undergoing surgical repair of complex cardiac lesions. Because CBF is already substantially reduced with the onset of low-flow CPB, we determined if a similar progressive decline in CBF occurs during the low-flow state. Methods: After ...

TY - JOUR. T1 - Effects of coronary revascularization with or without cardiopulmonary bypass on plasma levels of asymmetric dimethylarginine. AU - Cziráki, Attila. AU - Ajtay, Zénó. AU - Németh, Ádám. AU - Lenkey, Zsófia. AU - Sulyok, Endre. AU - Szabados, Sándor. AU - Alotti, Nasri. AU - Martens-Lobenhoffer, Jens. AU - Szabó, Csaba. AU - Bode-Böger, Stefanie M.. PY - 2011/6/1. Y1 - 2011/6/1. N2 - Objectives: We measured and compared serum asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and L-arginine levels in patients undergoing coronary artery revascularization. Methods: Two groups of patients with coronary artery disease were subjected to coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB; n=20) or with off-pump CABG surgery (OPCABG; n=21). Blood samples for measurements of ADMA, SDMA, and L-arginine were withdrawn and determined by liquid chromatography-tandem mass spectrometry from the coronary sinus (CS) and from the peripheral ...

TY - JOUR. T1 - Nonpulsatile cardiopulmonary bypass disrupts the flow-metabolism couple in the brain. AU - Andersen, K.. AU - Waaben, J.. AU - Husum, B.. AU - Voldby, B.. AU - Bødker, A.. AU - Hansen, A. J.. AU - Gjedde, A.. PY - 1985. Y1 - 1985. N2 - The effect of cardiopulmonary bypass on the relationship between brain glucose consumption and regional blood flow is unknown. We measured this relationship in pigs subjected to 3 hours of pulsatile or nonpulsatile cardiopulmonary bypass at normothermia and compared the results to the relationship established in a control group of pigs. A total of 10 regions were sampled in both hemispheres of the porcine brain. In control pigs, cerebral blood flow averaged 46 ml/100 gm and the glucose consumption, 21 μmol/100 gm/min. The ratio between blood flow and glucose consumption was close to 2 ml/μmol in all regions. In pulsatile cardiopulmonary bypass both the whole-brain average and the regional values declined, so that the ratio remained the same, ...

Data & statistics on Carbon dioxide transfer rate in relation to cardiopulmonary bypass times: Carbon dioxide transfer rate in relation to cardiopulmonary bypass times, Shown in piglets undergoing deep hypothermic circulatory arrest (DHCA) with or without selective cerebral perfusion (SCP). Cerebral tissue oxygenation (Pbto2) is shown as relative units (RU), normalized to before cardiopulmonary bypass baseline (BL; mm Hg). Measurements are shown at the following times: BL, before cardiopulmonary bypass baseline; Cool, cooling; CA30, 30 minutes of DHCA; eCA, end DHCA; ..., Intraoperative SctO2 course of a patient undergoing aortic arch surgery with hypothermic circulatory arrest. Note dependency of SctO2 to CO2. Insufflation of CO2 during endoscopic vein harvesting leading to increase in SctO2 as well as decline in SctO2 once mechanical ventilation was started. CPB = cardiopulmonary bypass; DHCA = deep hypothermic circulatory arrest....

The major source of morbidity following cardiopulmonary bypass (CPB) is the systemic inflammatory response (SIRS response) which leads to multiple derangements in different organ systems. To combat this, miniaturized cardiopulmonary bypass circuits (MCPBC) have been created to lessen the inflammatory response to CPB. Here we examine early outcomes following coronary artery bypass grafting (CABG) using a MCPBC system compared to conventional bypass techniques at a single institution. Methods: 60 consecutive patients undergoing elective CABG were prospectively enrolled. Nine patients underwent coronary artery bypass grafting (CABG) with conventional CPB (cCABG), 33 underwent off-pump CABG (OPCAB), and the remaining 18 patients underwent CABG with a MCPBC system. Demographics and outcomes were compared between groups and statistical analyses applied. Results: No significant difference was observed in mortality between groups, with only one death reported in total. Morbidity was also low, totaling only 6.7%

Objective: We assessed the causes of imbalance of oxygen transport by continuously measuring oxygen consumption (VO2) during hypothermic cardiopulmonary bypass (CPB) in pigs. Methods: Six pigs (17.2±1.6 kg) underwent hypothermic (32°C) CPB for 180 min with 120 min of aortic crossclamping (ACC). An AMIS 2000 mass spectrometer was adapted for the on-line measurement of VO2. Arterial lactate was measured at the beginning of CPB, the end of hypothermia, before and 10 min after ACC release, 20 min later, and at the end of CPB. Results: Arterial lactate increased from 1.8±0.7 to 5.1±1.8 mmol/L during CPB. Hypothermia reduced VO2 by 0.63±0.29 ml/min/kg per °C, but lactate increased to 4.2±1.5 mmol/L ( ...

View more ,A telephone survey of cardiac anaesthetists and perfusionists at the 29 public hospitals providing adult cardiac surgical services in Australia and New Zealand was carried out between December 2019 and January 2020. The aim was to investigate current practice with regard to selected contentious elements of anaesthetic and perfusion management during cardiopulmonary bypass; primarily relating to bypass circuit priming, blood conservation methods and point-of-care coagulation testing. There was a 100% response rate. The average number of adult public cardiopulmonary bypass cases per hospital was 508 (160-1400). For cardiopulmonary bypass cases, ten hospitals (34%) routinely used a cell saver and the remainder used a cell saver selectively. Residual blood remaining in the cardiopulmonary bypass circuit was processed using a cell saver routinely in four hospitals (14%) and selectively in 23 (79%). Acute normovolaemic haemodilution was rarely used. Retrograde autologous priming was used ...

We have emailed you at with instructions on how to set up a new password. If you do not receive an email in the next 24 hours, or if you misplace your new password, please contact:. ASA members: ...

Thank you for your interest in spreading the word about Clinical Science.. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.. ...

Measurements and results: Subjects were observed for 24 hours; during surgery, 6 and 24 hours after aortic clamp removed. During July 2012 - December 2013, there were 52 patients who became subjects. There were proportion differences between cardiac lactate and cardiac output change after cardiac surgery. Increase of cardiac lactate has a correlation with increasing levels of sTNFR-1 and IL-6 and decreasing index of Tc, ScvO2 and cardiac output. There were correlations among low index of ScvO2, high index of cardiac lactate and decrease of cardiac output. High sTNFR-1 and IL-6 were correlated to low cardiac output. Cardiac lactate, ScvO2 and MAP can be used as predictors of cardiac output change in patients with cardio-pulmonary bypass. sTNFR-1 and IL-6 levels were correlated with cardiac output changes after cardiac surgery ...

Over a three year period we have used haemodialysis and haemofiltration in parallel with cardiopulmonary bypass in 26 patients. Impaired renal function and excessive fluid retention have been the main indications. Patients on haemodialysis programmes for end stage renal failure did not require further dialysis until at least the third postoperative day, when they could tolerate the haemodynamic disturbance of dialysis. In the other patients these techniques proved valuable in reversing the effects of haemodilution and in controlling the concentration of serum potassium. Our experience has confirmed that haemodialysis and haemofiltration in parallel with cardiopulmonary bypass are useful adjuncts in the perioperative management of patients with impaired renal function undergoing open heart surgery. The techniques are also effective in correcting the fluid retention and biochemical imbalance in patients with congestive cardiac failure, including those with heart transplants.. ...

Established as the standard reference on cardiopulmonary bypass, Dr. Gravlees text is now in its Third Edition. This comprehensive, multidisciplinary text covers all aspects of cardiopulmonary bypass including sections on equipment, physiology and pathology, hematologic aspects, and clinical applications. This edition features a new section on cardiopulmonary bypass in neonates, infants, and children and a new chapter on circulatory support for minimally invasive cardiac surgery. Other highlights include state-of-the-art information on low-volume circuits and other new equipment and discussions of outcomes data for on-pump and off-pump surgeries ...

Acute kidney injury, a prevalent complication of cardiac surgery performed on cardiopulmonary bypass (CPB), is thought to be driven partly by hypoxic damage in the renal medulla. To determine the causes of medullary hypoxia during CPB, we modeled its impact on renal hemodynamics and function, and thus oxygen delivery and consumption in the renal medulla. The model incorporates autoregulation of renal blood flow and glomerular filtration rate and the utilization of oxygen for tubular transport. The model predicts that renal medullary oxygen delivery and consumption are reduced by a similar magnitude during the hypothermic (down to 28°C) phase of CPB. Thus, the fractional extraction of oxygen in the medulla, an index of hypoxia, is increased only by 58% from baseline. However, during the rewarming phase (up to 37°C), oxygen consumption by the medullary thick ascending limb increases 2.3-fold but medullary oxygen delivery increases only by 33%. Consequently, the fractional extraction of oxygen in ...

BACKGROUND: After cardiac surgery with cardiopulmonary bypass (CPB), acquired coagulopathy often leads to post-CPB bleeding. Though multifactorial in origin, this coagulopathy is often aggravated by deficient fibrinogen levels. OBJECTIVE: To assess whether laboratory and thrombelastometric testing on CPB can predict plasma fibrinogen immediately after CPB weaning. PATIENTS / METHODS: This prospective study in 110 patients undergoing major cardiovascular surgery at risk of post-CPB bleeding compares fibrinogen level (Clauss method) and function (fibrin-specific thrombelastometry) in order to study the predictability of their course early after termination of CPB. Linear regression analysis and receiver operating characteristics were used to determine correlations and predictive accuracy. RESULTS: Quantitative estimation of post-CPB Clauss fibrinogen from on-CPB fibrinogen was feasible with small bias (+0.19 g/l), but with poor precision and a percentage of error |30%. A clinically usefu

Summary. Background: Bleeding after cardiopulmonary bypass (CPB) is a major cause of morbidity and mortality and consumes large amounts of blood. Identifying patients at increased risk of bleeding secondary to hemostatic impairment may improve clinical outcomes by allowing early intervention. Methods: This present study recruited 77 patients undergoing CPB and measured coagulation screens, coagulation factors, TEG®, Rotem® and thrombin generation (TG) before surgery and 30 min after heparin reversal. The tests were analyzed to investigate whether they identified patients at increased risk of excess bleeding (defined as , 1000 mL) in the first 24 h postoperatively. Results: Patients who bled , 1000 mL had a lower: platelet count (P , 0.02), factors (F)IX, X and XI (P , 0.005), endogenous thrombin potential (ETP) and an initial rate of TG (P , 0.02) and higher activated partial thromboplastin time (aPTT) (P , 0.001) than patients who bled , 1000 mL. Receiver operating characteristic (ROC) ...

Cyanotic congenital heart disease comprises a diverse spectrum of anatomical pathologies. Common to all, however, is chronic hypoxia before these lesions are operated upon when cardiopulmonary bypass is initiated. A range of functional and structural adaptations take place in the chronically hypoxic heart, which, whilst protective in the hypoxic state, are deleterious when the availability of oxygen to the myocardium is suddenly improved. Conventional cardiopulmonary bypass delivers hyperoxic perfusion to the myocardium and is associated with cardiac injury and systemic stress, whilst a normoxic perfusate protects against these insults.

Click the title to purchase the article.. Abstract:. Femoro-femoral cardiopulmonary bypass (CPB) followed by deep hypothermic circulatory arrest is one of the modalities used for ascending aortic pseudoaneurysmrepair to achieve cardiac unloading and to avoid severe hemorrhage due to the risk of rupture during the sternal entry. However, due to the limited size of the cannulas, it can be challenging to achieve total cardiopulmonary support. Therefore, despite the achievement of total cardiopulmonary support, the heart may still be able to eject antegrade blood flow that meets the retrograde blood flow from the arterial side of the CPB. The point where the blood flow meets in the aorta is called the watershed area. If the antegrade blood flow is large due to a left ventricular ejection, the watershed area will be located in the descending aorta. Therefore, if ventilation is stopped, deoxygenated blood will be ejected to the cerebral circulation. Cerebral near-infrared spectroscopy (NIRS) may be ...

OBJECTIVE: The purpose of this study was to determine whether cognitive impairment is related to cardiopulmonary bypass. METHODS: Twenty-five patients undergoing coronary artery bypass grafting without cardiopulmonary bypass were matched with 50 patients undergoing coronary artery bypass grafting with cardiopulmonary bypass. All patients received the same anesthetic regimen, and one surgeon performed all the operations. A battery of 10 standard tests of neuropsychologic function were performed before, at discharge, and 3 months after the operation. A comprehensive multidimensional measure of subjective health status was used as the primary clinical measure of functional outcome. RESULTS: The groups were similar with respect to age, sex, and ventricular function and differed only in the need for a circumflex artery graft. Both groups showed significant improvement in the comprehensive multidimensional measure of subjective health status at 3 months. At discharge most neuropsychologic tests had

TY - JOUR. T1 - Enhancement of brain pO2 during cardiopulmonary bypass using a hyperosmolar oxygen carrying solution. AU - Runge, T. M.. AU - McGinity, J. W.. AU - Frisbee, S. E.. AU - Briceno, J. C.. AU - Ottmers, S. E.. AU - Calhoon, John H. AU - Hantler, C. B.. AU - Korvick, D. L.. AU - Ybarra, J. R.. PY - 1997/5. Y1 - 1997/5. N2 - During the past decade a new syndrome has been recognized: cerebral hypoxia secondary to cardiopulmonary bypass, resulting in impairment of cognitive memory. The incidence of the syndrome appears to be no less that 30% in patients over 65 years of age undergoing cardiac surgery. There are several factors contributing to hypoxia produced by cardiopulmonary bypass. One of these factors is crystalloid pump prime and replacement solutions devoid of (1) oxygen carrying capacity and (2) devoid of protein and its colloid osmotic pressure. This shortcoming of cardiopulmonary crystalloid solutions is partially responsible for two of the three major pathologic effects of ...

To the best of our knowledge, this is the first prospective study evaluating cognitive function before and after cardiopulmonary bypass in children. We found that the relatively short period of mildly hypothermic cardiopulmonary bypass was not associated with any change in cognitive function. The results of this study differ from the findings of a previous study that showed a 9.5-point deficit in full IQ and a deficit in nonverbal information processing in subjects who underwent surgical repair of an ASD compared with subjects who underwent ASD repair via a catheter-delivered device.15 Furthermore, although the previous study showed group differences in visual-spatial skills,15 we found no evidence to indicate that visual-spatial skills deteriorate after surgical repair of an ASD. Specifically, comparisons of nonverbal and spatial information processing in our sample suggest consistency of performance over time. In fact, a small increase was seen in the postoperative test scores. Although these ...

BACKGROUNDDiabetes mellitus is an independent risk factor for early postoperative mortality and complications after coronary artery bypass grafting (CABG). We sought to compare the cardiac gene expression responses to cardiopulmonary bypass (CPB) and cardioplegic arrest (C) in patients with and without diabetes.METHODS AND RESULTSTwenty atrial myocardium samples were harvested from 5 type II insulin-dependent diabetic and 5 matched nondiabetic patients undergoing CABG, before and after CPB/C. Oligonucleotide microarray analyses of 12625 genes were performed on the 10 sample pairs using matched pre-CPB tissues as controls. Array results were validated with Northern blotting and immunoblotting. Compared with pre-CPB/C, post-CPB/C myocardial tissues revealed 851 upregulated and 480 downregulated genes with a threshold P, or =0.025 (signal-to-noise ratio, 4.04) in the diabetic group, compared with 480 upregulated and 626 downregulated genes (signal-to-noise ratio, 3.04) in the nondiabetic group ...

During conventional cardiopulmonary bypass (CPB) there is no active perfusion of the pulmonary circulation and the mechanical ventilation is ceased leaving the lungs exposed to warm ischemia. Pulmonary dysfunction is seen in varying degrees after major surgery, but more severe in cardiac surgery patients probably due to the effects of CPB. The evidence for effect and safety are limited, but active pulmonary artery perfusion during CPB could be beneficial for the patients postoperative oxygenation. Our aim was in a randomised clinical trial to assess primarily the effect of pulmonary artery perfusion during CPB on postoperative oxygenation in patients diagnosed with chronic obstructive pulmonary disease (COPD), secondarily to assess other possible benefits and harms. Furthermore, we wanted in a systematic review with meta-analyses of all randomised clinical trials to investigate the pooled effects of pulmonary artery perfusion during CPB. We planned and conducted a randomised, partly blinded, ...

Michael Manning, MD, PhD, Research Fellow and Medical Instructor in the Division of Cardiothoracic Anesthesiology was awarded a two-year $50,000 Society of Cardiovascular Anesthesiologists (SCA) Starter Grant entitled Atrial Fibrillation Following Cardiopulmonary Bypass: The Role of Angiotensin II.. Post-operative atrial fibrillation (POAF) occurs in 30-60% of cardiac surgical patients, and is associated with increased morbidity and mortality. Preventative treatment options for this significant problem are lacking, with most therapy instituted after onset of POAF when associated risks, including stroke, are highest. Evidence suggests a key role for inflammation in the genesis and perpetuation of POAF through structural changes in the atrial wall; this may serve as a point for intervention and prevention, thereby decreasing overall morbidity and mortality.. Patients who undergo cardiac surgery with cardiopulmonary bypass (CPB) experience a significant inflammatory reaction, which has been ...

Epinephrine-induced lactic acidosis following cardiopulmonary bypass. Department of Intensive Care, Royal North Shore Hospital, St. Leonards, NSW, Australia. To determine if lactic acidosis occurring after cardiopulmonary bypass could be attributed to the metabolic or other effects of epinephrine administration. Posts

OBJECTIVES A meta-analysis was conducted to investigate the effects of ulinastatin treatment on adult patients undergoing cardiac surgery under cardiopulmonary bypass (CPB). METHODS Seven electronic databases were searched for reports of randomized, controlled trials conducted up to February 2014 in which patients undergoing cardiac surgery with CPB were administered ulinastatin in the perioperative period. RESULTS Fifty-two studies with 2025 patients were retained for analysis. The results showed that the ulinastatin can attenuate the plasma levels of pro-inflammatory cytokines and enhance the anti-inflammatory cytokine levels in patients undergoing cardiac surgery with CPB. Meanwhile, the ulinastatin had a significant beneficial effect on myocardial injury. The mean differences (MD) and 95% confidence intervals (95% CI) of biochemical markers were -63.54 (-79.36, -47.72) for lactate dehydrogenase, -224.99 (-304.83, -145.14) for creatine kinase, -8.75 (-14.23, -3.28) for creatine kinase-MB, and -0

Cardiac surgery with cardiopulmonary bypass (CPB) may cause inflammatory responses, which can deteriorate the outcomes. Inflammatory cytokines, such as tumor necrosis factor (TNF)-α, interleukin (IL)-6,-8 and -10, can act as both the effector and the predictor for post-operative inflammatory responses. Plasma mitochondrial DNA (mtDNA) was found as a pro-inflammatory agent recently, which was released when cells were insulted. In the present study, we included 38 patients undergoing coronary artery bypass graft (CABG) to analyze their perioperative plasma mtDNA and levels of inflammatory cytokines. Blood samples were collected before aortic cross-clamping (T1), at the end of CPB (T2), 6 h post-CPB (T3), 12 h post-CPB (T4), and 24 h post-CPB (T5). Rt-PCR and specific ELISA kits were used to quantify the plasma mtDNA and inflammatory cytokines, respectively. Bivariate correlations analysis was used to check the correlations between plasma mtDNA and inflammatory cytokines respectively. Results shown that

The clinical importance of exercise testing and training in the healthcare management of young patients with cystic fibrosis (CF) is growing. The aim of the present study was to determine the incidence of airflow limitation following cardiopulmonary exercise testing (CPET) and heavy-intensity intermittent exercise (HIIE) in young patients with CF. Nineteen young patients with CF and respective paired-matched controls performed CPET and HIIE on separate days. Forced expiratory volume in one second (FEV1) was measured pre- and post each exercise modality. A fall in FEV1 of 10 % or greater was used to define airflow limitation. The incidence of airflow limitation was significantly greater in the CF group than in the controls following CPET (32 vs. 5 %; p = 0.03); however, no significant difference in the incidence of airflow limitation was shown following HIIE between the CF group and controls (11 vs. 16 %; p = 0.64 ...

TY - JOUR. T1 - S100B increases in cyanotic versus noncyanotic infants undergoing heart surgery and cardiopulmonary bypass (CPB). AU - Varrica, Alessandro. AU - Satriano, Angela. AU - Gavilanes, Antonio D W. AU - Zimmermann, Luc J. AU - Vles, Hans J S. AU - Pluchinotta, Francesca. AU - Anastasia, Luigi. AU - Giamberti, Alessandro. AU - Baryshnikova, Ekaterina. AU - Gazzolo, Diego. PY - 2019/4. Y1 - 2019/4. N2 - AIMS: S100B has been proposed as a consolidated marker of brain damage in infants with congenital heart disease (CHD) undergoing cardiac surgery and cardiopulmonary bypass (CPB). The present study aimed to investigate whether S100B blood levels in the perioperative period differed in infants complicated or not by cyanotic CHD (CHDc) and correlated with oxygenation status (PaO2).METHODS: We conducted a case-control study of 48 CHD infants without pre-existing neurological disorders undergoing surgical repair and CPB. 24 infants were CHDc and 24 were CHD controls. Blood samples for S100B ...

The modern era of myocardial revascularization with cardiopulmonary bypass began in 1954 when Dr. John Gibbon reported the development of the cardiopulmonary bypass machine.6 An additional seminal advance occurred with the development of coronary angiography by Mason Sones at the Cleveland Clinic in 1957, which opened the door to the elective treatment of coronary atherosclerosis by means of direct revascularization.7 Initial reports by Rene Favaloro and Donald B. Effler on their techniques to treat clinical events associated with stenotic lesions of the coronary arteries culminated in the first large series of aorto-to-coronary artery venous grafts reported in 1969.8 Simultaneously Dudley Johnson of Milwaukee published a series of 301 patients in 1969.9 The success of these techniques was soon demonstrated in larger series initiating the modern era of coronary artery surgery. ...

This study is a multi-institutional randomized double-blind placebo controlled trial of the use of glucocorticoids to improve the clinical course of neonates following cardiac surgery. Cardiopulmonary bypass (CPB) is critical to cardiac surgery, but the pathophysiologic processes engendered by CPB play an important role in post-operative recovery. The use, doses and schedule of glucocortiocoid administration to ameliorate these CPB induced processes is highly variable and without clear data to provide direction. The Primary Aim of this study is to compare the effects of intraoperative methylprednisolone to placebo on a composite morbidity-mortality outcome following neonatal CPB. Secondary Endpoints include: inotropic requirements, incidence of low cardiac output syndrome, fluid balance, ICU stay parameters, levels of inflammatory molecules, neuro-developmental outcomes, and safety parameters. The study will focus on neonates because their post-CPB clinical course is typically more severe, and ...

Studio Mouth-to-mouth: An obstacle to cardio-pulmonary resuscitation for lay-rescuers pubblicato come Lettera allEditore su Resuscitation sul numero di Dicembre 2014.. Riferimento bibliografico:. E. Baldi, D. Bertaia, S.Savastano Mouth-to-mouth: An obstacle to cardio-pulmonary resuscitation for lay-rescuers Resuscitation. 2014 Dec;85(12):e195-6. ...

xml version=1.0?,,rfc1807,,datestamp,2018-06-04T14:57:38.6619335,/datestamp,,bib-version,v2,/bib-version,,id,39473,/id,,entry,2018-04-18,/entry,,title,Heart rate dynamics during cardio-pulmonary exercise testing are associated with glycemic control in individuals with type 1 diabetes,/title,,swanseaauthors,,author,,sid,f5da81cd18adfdedb2ccb845bddc12f7,/sid,,ORCID,0000-0002-6986-6449,/ORCID,,firstname,Richard,/firstname,,surname,Bracken,/surname,,name,Richard Bracken,/name,,active,true,/active,,ethesisStudent,false,/ethesisStudent,,/author,,/swanseaauthors,,date,2018-04-18,/date,,deptcode,STSC,/deptcode,,abstract,IntroductionThis study investigated the degree and direction (kHR) of the heart rate to performance curve (HRPC) during cardio-pulmonary exercise (CPX) testing and explored the relationship with diabetes markers, anthropometry and exercise physiological markers in type 1 diabetes (T1DM).Material and methodsSixty-four people with T1DM (13 females; age: 34 ± 8 years; HbA1c: 7.8 ...

The cardio-pulmonary therapy staff provides services for children who have problems with the heart or lungs. Cardio-pulmonary therapy highlights:

The average salary for a Cardio-Pulmonary Perfusionist is $123,776. Visit PayScale to research cardio-pulmonary perfusionist salaries by city, experience, skill, employer and more.

Website. Interests: The effect of venodilation-based constant preload volume loading on hemodynamic variability in surgical patients. Crisis Management and Team Training for hospital-based resuscitation.Mechanism of radial arterial pressure changes following cardiopulmonary bypass. ...

Lacza, Zsombor and Csordás, Attila and Horváth, Eszter Mária and Pankotai, Eszter and Szabó, Csaba (2009) Mitokondriális eredetű nitrogén szabadgyökök és ATP-függő K-csatornák szerepe az organellum működésében = The involvement of mitochondrial-derived nitrogen radicals and mitoK-ATP channels in the regulation of organelle function. Project Report. OTKA. Rőth, Erzsébet and Alotti, Nasri and Lantos, János and Csordás, Attila and Papp, Lajos (1999) Oxidative stress following cardiopulmonary bypass. Journal of Molecular and Cellular Cardiology, 31. A56. ISSN 0022-2828 ...

TY - JOUR. T1 - Potential role of endothelin receptor antagonists in the setting of cardiopulmonary bypass. T2 - Relevance to myocardial performance. AU - Ergul, Adviye. AU - Joffs, Cassandra. AU - Walker, Allyson C.. AU - Spinale, Francis G.. N1 - Funding Information: Supported in part by National Institutes of Health grants HL-45024 and HL-56603 (FGS) and American Diabetes Association award (AE) Address for correspondence: Adviye Ergul, Division of Cardiothoracic Surgery, STRB Suite 625, PO Box 250778, 114 Doughty Street, Charleston, SC 29425.. PY - 2001. Y1 - 2001. N2 - The ET ssytem is activated in cardiac surgical setting as evidenced by elevated systemic and myocardial ET-1 levels after coronary bypass grafting surgery which requires hypothermic cardioplegic arrest and cardiopulmonary bypass. Increased ET-1 may influence a number of clinical parameters in this setting. First, ET-1 may directly modulate myocardial contractile performance in the early postoperative period resulting in LV ...

The most common neurological deficits in children after surgery for congenital heart disease are fine and gross motor deficits. Recent magnetic resonance imaging studies have demonstrated a significant number of newly developed white matter (WM) lesions in infants after surgery. The present study describes region-specific WM development in the juvenile porcine brain, which is similar in developmental stage to the human newborn. Acute and long-term cellular responses to cardiopulmonary bypass in oligodendrocyte lineages and neuron-axonal elements, which are the most prominent cell populations in WM, have been observed. A uniquely susceptible cellular target of cardiopulmonary bypass-induced WM injury in the oligodendrocyte lineage, as well as maturation-dependent vulnerability of developing WM, was found. Oligodendrocyte progenitor cells, which mediate WM recovery function, are highly resistant to cardiopulmonary bypass-induced injury. Interestingly, oligodendrocyte progenitor cell number ...

The significance of acanthrocytes and red cell fragmentation was evaluated in 31 patients undergoing cardiopulmonary bypass. Seven patients served as controls, and 24 patients with valvular prosthesis were observed for a period of at least 2 weeks. In the control group minimal red cell fragmentation (2-3/10 hpf) was seen, while acanthrocytes were present only during and immediately after cardiopulmonary bypass. In seven patients with valvular replacement the results were similar to the control group. Six other patients showed increased red cell fragmentation (15/10 hpf). In three of these, red cell fragmentation disappeared by the third postoperative week, in two by ...

OBJECTIVE To investigate whether generation and liberation of bradykinin and histamine contribute to generalized edema formation in pediatric cardiopulmonary bypass surgery. DESIGN Prospective observational study. SETTING Pediatric heart surgery of a university hospital. PATIENTS Forty-one neonates, infants, and children undergoing cardiopulmonary bypass to correct congenital cardiac anomalies. INTERVENTIONS Plasma concentrations of bradykinin and histamine were determined before, during, and after cardiopulmonary bypass. Fluid balance was evaluated by control of fluid intake and output. MEASUREMENTS AND MAIN RESULTS The susceptibility to generalized edema formation increased significantly (r = -.457; p |.005) with decreasing age. Approximately three times higher plasma concentrations of bradykinin (p |.001) were found at the onset of anesthesia and during the total observation period in patients with a fluid retention of |6% of body weight compared with patients with a lower retention rate.

Extracorporeal circulation (ECC) methods are being increasingly used for mechanical support of respiratory and cardio-circulatory failure. Especially, cardiopulmonary bypass (CPB) during cardiovascular surgery, sustenance of the patient’s life by providing an appropriate blood flow and oxygen supply to principal organs. On the other hand, systemic inflammatory responses in patients undergoing cardiovascular surgery supported by CPB contribute significantly to CPB-associated mortality and morbidity. Our previous research showed that CPB causes a systemic inflammatory response and organ damage in a small animal CPB model. We have been studying the effects of hyperoxia and blood plasma substitute on CPB. In this review, we present a study focusing on the systemic inflammatory response during CPB, along with our findings.

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details ...

Coronary artery bypass grafting with extracorporal circulation is established as the golden standard. The conventional cardiopulmonary bypass (CPB) system is associated with inflammatory reaction, hemolysis, hemodilution an disturbances of the blood coagulation system. Also its well known that neurological disturbances caused by embolic material and air bubbles are potential risks of CPB. The new minimized perfusion circuit ROCsafeTM is a closed, reservoir-less, reduced prime, surface coated circuit, with optimized safety features in effectively eliminate both macro and micro air bubbles and should optimize the clinical outcome after CABG using cardiopulmonary bypass. ...