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This research was designed to investigate the effect of pulsatile flow pattern on tissue perfusion, particularly cerebral tissue perfusion at pre-determined intervals during CPB, as well as its impacts on postoperative morbidity and mortality. Methods: This retrospective review included 134 adult patients who underwent heart surgery with cardiopulmonary bypass, according to the authors. Patients were divided based on the flow pattern used during CPB: non-pulsatile CPB group and pulsatile CPB group were grouped by age groups, according to the flow diagram used during CPB: non-pulsatile CPB group and pulsatile CPB group. Postoperative drainage, length of ventilation, and length of hospital stay were all significant, although postoperative blood urea nitrogen was noticeably lower in the non-pulsatile CPB group. Conclusion: The results of this research do not support the superiority of pulsatile flow pattern during CPB, whether in terms of cerebral oxygen saturation or postoperative mortality/morbidity. Further and larger comparative studies are required before a pulsatile blood flow pattern can be established as a common clinical technique.
Source link: https://doi.org/10.1532/hsf.2857
Aim: This research is intended to develop a model for patients undergoing cardiac surgery under cardiopulmonary bypass to help anticipate the length of intensive care. After CPB from 2016 to 2017, a total of 265 patients admitted to the ICU after CPB from 2016 to 2017 were enrolled in the study. Before surgery, each patient was evaluated for EuroSCORE II, according to their score. The length of the intensive care was determined by a binary logistic regression analysis to create a regression model to determine the predictive value of the indicators and the EuroSCORE II scoring system. Both troponin I and EuroSCORE II could influence the length of intensive care for patients undergoing cardiac surgery under CPB. Conclusions: The predictive tool, which is based on cTnI and EuroSCORE II, can accurately predict the length of intensive care of patients under CPB cardiac surgery. This predictive model may help with ICU resource planning. This predictive model can help to enhance ICU resource management.
Source link: https://doi.org/10.1532/hsf.3917
Objective: To determine the possibility and effects of minimal media lower hemisternomy for cardiac surgery in infant congenital heart disease under cardiopulmonary bypass. Methods: 170 infants with congenital heart disease in our hospital from May 2019 to October 2019 underwent surgical intervention. CPB time: In CPB time, there were no significant differences between the two groups. The operation time of a small incision group was marginally longer than expected. Among hemisternotomy patients, the time of intensive care unit and hospital stay was shorter than those with surgically poor conditions. Conclusion: The minimal media lower hemisternotomy with the sternal incision's inherent benefits may reveal the various areas of the heart, which are common cardiovascular research and surgical procedure needs, and the incision may also be extended if necessary. Lower hemisternotomy seems to be a safe, inexpensive, and versatile substitute for several surgical procedures in infants with congenital heart disease.
Source link: https://doi.org/10.1532/hsf.3577
Background Acute lung injury following cardiac transplant with cardiopulmonary bypass is a common complication. Microparticles can cause ALItion, and in patients with ALI, the incidence of ALI has increased. We and others have demonstrated that microparticles can cause ALIation, and this has also been observed. However, it's also unknown if MPs can be used to forecast ALI after cardiac surgery with CPB. MPs with ALI were smaller than the non-ALI group, but the peak number of MPs was higher. According to a multivariate logistic regression study, the number at the peak of MPs at 12 h during postoperative 12 h was an independent risk factor for ALI. 132. 65 nm with a sensitivity of 88. 0% and a negative predictive value of 92. 5% were the best cutoff value of IQR to diagnose ALI. Conclusions: The size of MPs has been shown to predict and rule out ALI after cardiac surgery with CPB, according to our study.
Source link: https://doi.org/10.3389/fcvm.2022.893609
Introduction: Children undergoing cardiac surgery are at risk for AKI and cardiac dysfunction, which could have a positive effect on outcome. Hypothesis: A non-invasive way of causing reversible lower extremity ischemia with pressure cuff inflation lessens renal and myocardial injury. Methods: A single center trial of RIPC in children undergoing heart surgery in RACHS-1 category 2 or higher, randomized, placebo controlled, double blinded trials. Results: 45 patients in the RIPC and 39 patients in the control group were aged between 3. 5 and 3. 8 years, respectively; 57 patients under 1 year of age; 35 patients under the age of 1 month. In the RIPC group, there was a tendency for a faster rate of decline, particularly for cystatin C, but the RIPC group's population was small. The odds ratio for AKI in RIPC was 0. 31 percent, adjusted for baseline creatinine. Conclusions: In an at-risk pediatric population, RIPC has been suggested that renal care in an at-risk pediatric population.
Source link: https://doi.org/10.1161/circ.144.suppl_1.11473
In patients undergoing cardiac surgery by cardiopulmonary bypass, there is little evidence for the effects of ulinastatin on renal outcomes. Methods : 413 patients aged 18-70 years who underwent cardiac surgery with CPB were evaluated from Aug 2008 to July 2019 in Fuwai Hospital, Beijing, China, and are included in this prospective cohort report. After induction of anesthesia, the ulinastatin group of 135 patients received intravenous ulinastatin. The control group was comprised of the remaining 278 patients without ulinastatin. The main result was the incidence of new-onset postoperative acute kidney injury onset. The CSANGAL Score was calculated after serum creatinine, plasma NGAL, and serum IL-6 levels were tested and determined. AKI in the ulinastatin group was significantly lower than in the control group. Conclusions: Ulinastatin has significantly reduced postope rative AKI and respiratory failure in patients undergoing cardiac surgery with CPB. However, ulinastatin did not reduce ICU and hospital stay and mortality, nor did it reduce ICU and hospital stay and mortality.
Source link: https://doi.org/10.21203/rs.3.rs-1049165/v1
Abstract of this paper The aim of this study was to determine the diagnostic value of plasma neutrophil gelatinase-associated lipocalin in adult patients after cardiac arrest requiring cardiopulmonary bypass. Using the Quality Assessment for Diagnostic Accuracy Studies 2 device, a risk of bias was determined. Using the hierarchical summary receiver operator characteristic curve model, summary results for sensitivity and specificity were calculated. When compared to earlier and later time points, pNGAL's performance in the diagnosis of AKI in the defined population was on par with earlier and later time points. In conclusion, the diagnostic value of pNGAL in this clinical setting is inconclusive, and large individual studies of representative populations of cardiac surgery patients using assays that specifically detect NGAL in its monomeric form are required.
Source link: https://doi.org/10.1038/s41598-022-10477-5
Purpose: Total blood volume estimation can have a significant effect on cardiac surgical care, including pharmacological and transfusion, hemodynamic and volume control, and perfusion equipment selection. We hypothesized that these equations fail to accurately predict individual blood volume variability. The aim of this study was to determine TBV using a dilution method and compare the results to commonly used TBV estimates. Methods: Following institutional review board approval, results were prospectively collected and analyzed for 101 patients undergoing open-heart surgery. TBV estimates were significantly smaller than Allen's formula and weight-based measurements. Conclusions: The dilution procedure for TBV estimation during CPB estimation is both applicable and reproducible in the cardiac surgical field, and it can be used to calculate TBV. Our findings show that traditional TBV testing in cardiac surgical patients by Allen's and weight-based formulaes lacks the desired precision in estimating true TBV in calculating true TBV.
Source link: https://doi.org/10.1177/0267659114550230
We analyzed a cohort of elderly people over 60 years of age CPB to see if there was a correlation between MAP during CPB and AKI after the surgery. Patients with low MAP during the CPB's program were compared to those with a high MAP of > 65 mmHg for their AKI-related conditions.
Source link: https://doi.org/10.1155/2022/7701947
During heart surgery, calcium depletion may result in children with several biochemical disorders. During cardiopulmonary bypass, calcium gluconate therapy had a positive effect on hemodynamic variables and clinical results in infants undergoing open-heart surgery, according to the aim of this research. The first group received an intravenous injection of calcium gluconate 20 min after opening the aortic clamp, and the second group was treated as a control group. Both control groups were statistically significant, while control groups were statistically significant. Conclusions This research was based on a flawed method, not systolic pressure, mean diastolic blood pressure decreased, and mean arterial pressure increased dramatically.
Source link: https://doi.org/10.1186/s43044-022-00266-w
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