Document Detail


Clinical evaluation of normothermic cardiopulmonary bypass and cold cardioplegia.
MedLine Citation:
PMID:  11803324     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
G Nappi; M Torella; G Romano
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Validation Studies    
Journal Detail:
Title:  The Journal of cardiovascular surgery     Volume:  43     ISSN:  0021-9509     ISO Abbreviation:  J Cardiovasc Surg (Torino)     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-01-22     Completed Date:  2002-05-03     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0066127     Medline TA:  J Cardiovasc Surg (Torino)     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  31-6     Citation Subset:  IM    
Affiliation:
Department of Cardiac Surgery, Second University of Naples Medical School, V. Monaldi Hospital, Naples, Italy. Gianantonio.Nappi@unina2.it
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MeSH Terms
Descriptor/Qualifier:
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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