Document Detail


Minimized cardiopulmonary bypass reduces retinal microembolization: a randomized clinical study using fluorescein angiography.
MedLine Citation:
PMID:  21172477     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: The use of minimized cardiopulmonary bypass (MCPB) circuits has recently increased in an attempt to reduce the adverse effects of CPB. This prospective randomized study aimed to determine the effects of MCPB on retinal microembolization and related inflammatory, coagulation, and endothelial markers compared with conventional extracorporeal circulation (CCPB) among patients undergoing coronary artery bypass graft surgery.
METHODS: Forty patients entered, and 37 patients completed the study. After the induction of anesthesia and immediately after the termination of CPB, standardized retinal fluorescein angiographs and digital images were obtained on both eyes and analyzed in a blinded fashion in terms of the CPB circuit. Blood samples for inflammatory, coagulation, and endothelial markers were collected at eight time points until the third postoperative day.
RESULTS: Postperfusion retinal fluorescein angiographs revealed microembolic perfusion defects in 2 of 18 in the MCPB group and in 9 of 18 in the CCPB group (p = 0.027 [11% vs. 50%, difference 39%, confidence interval: 0.087 to 0.613, p = 0.029]). Activation of polymorphonuclear leukocytes as measured with polymorphonuclear elastase was significantly decreased in the MCPB group. Other markers of inflammation, coagulation, and endothelial dysfunction increased comparably in both groups during CPB.
CONCLUSIONS: Retinal microembolization was found to be decreased after the use of minimized CPB compared with CCPB, suggesting a decreased embolic load to the brain after MCPB.
Authors:
Riikka Rimpiläinen; Nina Hautala; Juha K Koskenkari; Jussi Rimpiläinen; Pasi P Ohtonen; Pirjo Mustonen; Heljä-Marja Surcel; Eeva-Riitta Savolainen; Martti Mosorin; Tero I Ala-Kokko; Tatu Juvonen
Related Documents :
21333437 - Posterior cranial fossa morphometry in symptomatic adult chiari i malformation patients...
8639197 - Intramuscular prochlorperazine versus metoclopramide as single-agent therapy for the tr...
6978677 - Stimulation of the spinal neuraxis by biocompatible electrical current in the human.
16362647 - Managing migraine headaches experienced by patients who self-report with menstrually re...
15611567 - The progression of the penile vein: could it be recurrent?
3787387 - Patient with malignant hypertension alive after 25 years. a case report.
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  91     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2010-12-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  16-22     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Anesthesiology and Surgery, Division of Anesthesiology and Intensive Care, Oulu, Finland.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Impact of off-pump coronary artery bypass graft surgery on postoperative pulmonary complications in ...
Next Document:  Randomized flow capacity comparison of skeletonized and pedicled left internal mammary artery.