2 edition of Perioperative myocardial protection: a clinical trial of blood and crystalloid cardioplegia. found in the catalog.
Perioperative myocardial protection: a clinical trial of blood and crystalloid cardioplegia.
Stephen Edward Fremes
Written in English
|The Physical Object|
|Number of Pages||128|
evaluation of the relative effectiveness of multi-dose crystalloid and cold blood potassium cardioplegia in coronary artery bypass surgery: A non-randomized match pair analysis. Ann Thorac Surg , Lichtenthal PR, Loeb JM, Sanders JH: Nifedipine and Angina study. Letter to the Editor, N Eng J Med , File Size: KB. Controversy exists concerning the most appropriate sequence of anastomoses in coronary artery bypass grafting (CABG) procedures. While the more commonly employed method of distal coronary anastomoses first has withstood a long clinical experience, a recent study and several cardiac surgical groups have suggested that construction of the proximal anastomoses first offers certain Cited by:
Often, arterial blood is simultaneously mixed with crystalloid-based cardioplegia solution (often in a blood-to-crystalloid ratio) to produce blood cardioplegia. A source of oxygen, air, and sometimes carbon dioxide, with appropriate flow meters and blenders, supplies ventilating gas to the oxygenator, usually through an in-line anesthetic. Blood versus crystalloid cardioplegia for myocardial protection of donor hearts during transplantation: A prospective, randomized clinical trial: Luciani GB: J Thorac Cardiovasc Surg: Factors influencing outcome after emergency surgical repair of acute type A aortic dissection: Santini F: G Ital Cardiol:
Blood glucose should be controlled between mmol/l. Dextrose must be given with insulin infusions. The anaesthetist is expected to work together with the perfusionist to ensure optimum care for the patient during and on separation from cardiopulmonary bypass. . Performs perioperative autologous blood collection and administration (PABCA) utilizing the autoLog cell washer (Medtronic Inc.) Manages the extracorporeal circulation and myocardial protection during cardiopulmonary bypass Operate and maintain the extra-corporeal equipment and circuit during clinical procedures Administer blood /5(43).
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Custodiol cardioplegia is attractive for minimally invasive cardiac surgery, as a single dose provides a long period of myocardial protection. Despite widespread use in Europe, there is little data confirming its efficacy compared with conventional (blood or crystalloid) by: The preliminary clinical experience with antegrade/retrograde cardioplegia is summarized, and these results have led to adoption of these techniques of blood cardioplegia as the preferred method.
Clinical results of blood versus crystalloid cardioplegic protection. As described previously, several clinical studies in the literature report superior perioperative myocardial protection in patients receiving blood cardioplegia, as opposed to crystalloid cardioplegia.
In this investigation cold oxygenated dilute blood cardioplegia was associated with superior results in every measure used to assess the degree of myocardial protection (mortality, perioperative infarction, the need for postoperative intraaortic balloon support, and the need for atrioventricular pacing).Cited by: Download Citation | Myocardial Protection in Children | The combination of hypothermia and potassium-based cardioplegic arrest has become the most common method of myocardial protection in the.
Abstract. Many investigations have shown the superiority of cold blood cardioplegia (BCP) to crystalloid cadioplegic solutions (CCP) in myocardial protection, especially in cardiac operations with a long ischemic time, in order to perform the distal coronary anastomoses on a quiescient, bloodless by: 4.
Fremes SE, Christakis GT, Weisel RD, et al. A clinical trial of blood and crystalloid cardioplegia. J Thorac Cardiovasc Surg ;– Schaper J, Walter P, Scheld H, et al. The effects of retrograde perfusion of cardioplegic solution in cardiac operations.
J Thorac Cardiovasc Surg ;– Dr. Yau. In response to your question about cold crystalloid cardioplegia, we found that cold blood cardioplegia provided better myocardial metabolic and ventricular function recovery than cold crystalloid cardioplegia in a prospective randomized trial (J THORAC CARDIOVASC SURG ;).Cited by: Clinical steps for myocardial protection with use of crystalloid cardioplegia 1.
Before the onset of surgery, the operating room temperature is cooled to 17° C to 19° C to avoid warming of the anterior surface of the heart by convection and radiation from highintensity lighting. Cardiopulmonary bypass is initiated at a temperature of Abstract.
Background: A major reduction in the energy demand of the myocardium results from the electromechanical arrest, and cooling contributes to a lesser degree to this reduction.
It is from this assumption that strategies of myocardial protection, utilizing warm blood cardioplegic induction, followed by cold cardioplegia with terminal warm reperfusion before removal of the aortic cross Cited by: History of myocardial protection 97 Hoelscher B.
Studies by electron microscopy on various Moores WY. The role of blood substitutes in myocardial forms of induced cardiac arrest in dog and rabbit.
protection. In: Roberts AJ, ed. Myocardial Protection in Surgery. Principal Findings: Operative deaths (2% vs. %, p = ), postoperative myocardial infarctions (10% vs. 2%, p ), shock (13% vs. 7%, p = ) and postoperative conduction defects (% vs.
%, p = ) were significantly more common in patients receiving crystalloid than those receiving blood ts receiving normothermic blood had less postoperative right. Fremes SE, Christakis GT, Weisel RD et al () A clinical trial of blood and crystalloid cardioplegia.
J Thorac Cardiovasc Surg – PubMed Google Scholar : Luigi Tritapepe, Giovanni Carriero, Alessandra Di Persio. In a multicenter trial- continuous warm blood cardioplegia Vs intermittent cold blood cardioplegia. Similar myocardial preservation (mortality, postoperative incidence of myocardial infarction, need for intraaortic balloon counterpulsation).
34 Rewarming. ltC gradient between venous blood and water. Myocardial Protection - Free download as Powerpoint Presentation .ppt), PDF File .pdf), Text File .txt) or view presentation slides online. Myocardial protection is regarded as one of the most important, yet also most controversial aspects of cardiac surgery.
There has been considerable improvement in myocardial protection strategies over recent years, utilising a variety of new approaches to treat cardiac diseases, and this text is intended to embrace the state of the art in this book summarises the state of knowledge.
or perioperative myocardial infarction (MI) be- tween patients who received warm blood or cold blood cardioplegic solution. 2 However, the occurrence of low cardiac output syndrome was significantly lower in the warm group.
Similarly, a large clinical trial that evaluated acadesine as a. then able to demonstrate that blood cardioplegia reduced the risks of urgent operations for unstable angina by reducing perioperative morbidity and mortality.
5 Therefore in this prospective, clinical trial we evaluated myocardial metabolism and ven- tricular function to determine whether subtle differ. Major advances have been made in the preservation of myocardial function during open-heart surgery since the introduction of cardioplegic arrest (Melrose et al., ).
However, despite variation in the composition of cardioplegia, myocardial protection has been based primarily on high-potassium cold cardioplegic by: Cardioplegic (and organ preservation) solutions were initially designed to protect the myocardium (cardiac myocytes) during cardiac operation (and heart transplantation).
Because of differences between cardiac myocytes and vascular (endothelial and smooth muscle) cells in structure and function, the solutions may have an adverse effect on coronary vascular by:. Mangano DT, Browner WS, Hollenberg M, et al. Association of perioperative myocardial ischemia with cardiac morbidity and mortality in men undergoing noncardiac surgery.
N Engl J Med ; Cited by: Myocardial protection was achieved by either intermittent antegrade cold crystalloid or blood cardioplegia with min intervals. Cardioplegia was given retrograde when appropriate. At the end of the surgical procedure, reperfusion of the heart was performed on an individual basis according to the patient’s general condition and time on cross Cited by: 6.
Introduction. The predominant underlying cause of coronary heart disease is atherosclerosis, which can result in myocardial infarction. Clinical interventions used to reperfuse the acutely or chronically ischaemic myocardium, include thrombolysis, percutaneous coronary angioplasty and/or coronary bypass surgery (Verma et al., ; Bolli et al., ).Cited by: