The Annals of thoracic surgery
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The female gender is an independent predictor of adverse outcome after conventional coronary artery bypass grafting using cardiopulmonary bypass. The aim of this study is to assess the effect of the female gender on the outcome after off-pump coronary artery bypass (OPCAB) surgery. ⋯ In OPCAB, the female gender is not an independent predictor of MINAO, MAJAO, or PLOS.
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Clinical Trial
Aprotinin reduces operative closure time and blood product use after pediatric bypass.
The use of aprotinin in children undergoing cardiopulmonary bypass is controversial. We hypothesized that aprotinin would reduce blood product use and operative closure time in selected pediatric patients. ⋯ Aprotinin reduced operative closure time and blood product exposure in pediatric patients undergoing cardiopulmonary bypass who were 6 months of age or less or underwent a repeat sternotomy.
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Multicenter Study
Neutrophil CD11b upregulation during cardiopulmonary bypass is associated with postoperative renal injury.
Renal injury remains a persistent complication of cardiopulmonary bypass (CPB) that, when sufficient to require dialysis, increases mortality eight-fold. The high prevalence of renal failure in sepsis and adult respiratory distress syndrome has been linked to the systemic inflammatory response associated with those disorders. We hypothesized that components of the inflammatory response to CPB may similarly contribute to post-CPB acute renal injury. ⋯ Upregulation of the neutrophil adhesion receptor CD11b and high circulating neutrophil numbers are associated with acute renal injury after CPB, suggesting a contribution by activated neutrophils to the pathophysiology of this complication.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prophylactic dialysis in patients with renal dysfunction undergoing on-pump coronary artery bypass surgery.
Preoperative creatinine values higher than 2.5 mg/dL are associated with markedly increased risk for both mortality and morbidity in patients undergoing coronary artery bypass surgery. We aimed to determine the effects of prophylactic perioperative hemodialysis on operative outcome in patients with nondialysis-dependent moderate renal dysfunction. ⋯ Preoperative creatinine levels higher than 2.5 mg/dL, increase the risk of mortality and the development of acute renal failure and prolong the length of hospital stay after on-pump coronary artery bypass surgery. Perioperative prophylactic hemodialysis decreases both operative mortality and morbidity in these high-risk patients.
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Randomized Controlled Trial Clinical Trial
Comparative effects of propofol versus fentanyl on cerebral oxygenation state during normothermic cardiopulmonary bypass and postoperative cognitive dysfunction.
The purpose of this study was to examine the comparative effects of propofol and fentanyl on cerebral oxygenation during normothermic cardiopulmonary bypass and postoperative cognitive dysfunction. ⋯ Propofol preserved cerebral oxygenation state estimated by jugular venous oxygenation during cardiopulmonary bypass compared with the fentanyl group. However, propofol did not affect postoperative cognitive dysfunction.