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J. Cardiothorac. Vasc. Anesth. · Apr 2014
Randomized Controlled Trial Comparative StudyHypothermic Versus Normothermic Cardiopulmonary Bypass in Patients With Valvular Heart Disease.
- Vladimir V Lomivorotov, Vladimir A Shmirev, Sergey M Efremov, Dmitry N Ponomarev, Gleb B Moroz, Denis G Shahin, Igor A Kornilov, Anna N Shilova, Vladimir N Lomivorotov, and Alexander M Karaskov.
- Department of Anesthesiology and Intensive Care, Research Institute of Circulation Pathology, Novosibirsk, Russia.
- J. Cardiothorac. Vasc. Anesth.. 2014 Apr 1;28(2):295-300.
ObjectiveThe aim of this study was to test the hypothesis that normothermic cardiopulmonary bypass (CPB) is as effective as hypothermic CPB in terms of cardiac protection (cTnI level) and outcome in patients with valvular heart disease.DesignProspective randomized study.SettingA tertiary cardiothoracic referral center.Participants140 patients who had valvular heart disease, with/without coronary artery disease, surgically treated under CPB.InterventionsThe patients were allocated randomly to undergo either hypothermic (temperature [T], 31 °C-32 °C) or normothermic CPB (T>36 °C).Measurements And Main ResultsThe primary endpoint was the dynamics of troponin I. The secondary endpoints were ventilation time, the need for inotropic support, intensive care unit (ICU) and hospital stay durations, complications, and mortality. There were no significant intergroup differences in dynamics of troponin I. Ventilation time was significantly lower in the hypothermic group (6 (5-9) and 8 (5-12); p = 0.01).ConclusionsNormothermic CPB in patients with valvular heart disease was as effective as hypothermic perfusion in terms of myocardial protection after the surgery assessed by cTnI release. The short ventilation duration in patients who underwent hypothermic CPB needs to be confirmed in a future investigation.Copyright © 2014 Elsevier Inc. All rights reserved.
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