| Clinical evaluation of normothermic cardiopulmonary bypass and cold cardioplegia. | |
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MedLine Citation:
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PMID: 11803324 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: To evaluate the validity of normothermic cardiopulmonary bypass (CPB) associated with topical hypothermia and cold cardioplegia technique. METHODS: In a clinical prospective trial, a consecutive series of 100 patients, homogeneous for demographics, clinical and operative data, undergoing coronary artery bypass surgery were randomized for hypothermic CPB (rectal temperature 28-32 degrees C group A, 50 patients) and normothermic CPB (rectal temperature 35-37 degrees C, group B, 50 patients). In both groups of patients cold crystalloid cardioplegic solution and topical hypothermia was used. RESULTS: During CPB group B patients had lower systemic vascular resistance (p=0.0001); they needed a significant (p=0.0001) increase in vasocostrictive. At the removal of aortic cross-clamp, a spontaneous sinus rhythm resumed in 48% of patients in group A and in 95% of group B patients (p=0.001). To disconnect CPB, vasoconstrictive drugs were used in 10% of patients in group B and in none of patients in group A (p=0.0001); vasodilating drugs were infused in 96% of patients in group A and in 40% of patients in group B (p=0.0001). In the immediate postoperative period, positive inotropic agents were used in 67% of patients in group A and in 22% of patients in group B (p= 0.0003); group B patients showed a more physiological rewarming, reduced periods of mechanical ventilation and an easier regulation of the volemia. CONCLUSIONS: In our clinical experience the technique of cold heart and warm body proved to be safe and effective in simplifying surgical procedures and facilitating postoperative management. |
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Authors:
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G Nappi; M Torella; G Romano |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Validation Studies |
Journal Detail:
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Title: The Journal of cardiovascular surgery Volume: 43 ISSN: 0021-9509 ISO Abbreviation: J Cardiovasc Surg (Torino) Publication Date: 2002 Feb |
Date Detail:
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Created Date: 2002-01-22 Completed Date: 2002-05-03 Revised Date: 2009-11-11 |
Medline Journal Info:
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Nlm Unique ID: 0066127 Medline TA: J Cardiovasc Surg (Torino) Country: Italy |
Other Details:
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Languages: eng Pagination: 31-6 Citation Subset: IM |
Affiliation:
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Department of Cardiac Surgery, Second University of Naples Medical School, V. Monaldi Hospital, Naples, Italy. Gianantonio.Nappi@unina2.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Blood Pressure / physiology Cardiopulmonary Bypass* Cold Temperature* Coronary Artery Bypass* Coronary Artery Disease / physiopathology, surgery* Coronary Circulation / physiology Female Heart Arrest, Induced* Humans Hypothermia, Induced* Male Middle Aged Prospective Studies Vascular Resistance / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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