The Annals of thoracic surgery
-
Randomized Controlled Trial Clinical Trial
Biocompatibility of silicone-coated oxygenator in cardiopulmonary bypass.
This study was designed to analyze the biocompatibility of silicone-coated oxygenators using inflammatory response as the outcome measure, and to investigate whether the silicone-coated oxygenators perform better in terms of postoperative organ dysfunction. ⋯ Silicone-coated oxygenators are biocompatible and prevent postoperative organ dysfunction.
-
Comparative Study
Arginine vasopressin in the treatment of 50 patients with postcardiotomy vasodilatory shock.
The barroreflex-mediated secretion of arginine vasopressin has been found to be defective in a variety of vasodilatory shock states, such as postcardiotomy shock, and administration of the hormone markedly improves vasomotor tone and blood pressure. The high incidence of vasodilatory shock in patients undergoing left ventricular assist device (LVAD) implantation makes this population an ideal model in which to assess the risks and benefits of vasopressin. ⋯ We have demonstrated vasopressin at low doses to be a safe and an effective vasopressor in 50 patients with postcardiotomy vasodilatory shock.
-
Membranous tracheal lacerations are a serious complication of endotracheal intubation. Smaller tears are often better managed with a conservative treatment. Larger ruptures, especially when associated with important manifestations, need an early surgical repair. ⋯ This is a reliable, quick, and safe approach to a rare but insidious complication of general anesthesia. It avoids lateral and posterior dissection of the trachea, reducing the risk of a recurrent laryngeal nerve injury.
-
Comparative Study
Long-term follow-up of pediatric cardiac patients requiring mechanical circulatory support.
The present study examines the long-term outcome of pediatric patients with cardiac disease who required mechanical circulatory support with extracorporeal membrane oxygenation or ventricular assist devices. ⋯ The long-term survival and cardiac functional status of pediatric cardiac patients requiring mechanical circulatory support is favorable. Extracorporeal membrane oxygenation supported patients demonstrate higher rates of neurologic impairment than patients supported with ventricular assist devices. Poor neurologic outcomes are associated with institution of support in younger patients with more complex congenital heart disease.
-
End-stage renal disease is known to be an important risk factor complex for cardiac operations performed with cardiopulmonary bypass. ⋯ These data are comparable with those in the literature and possibly suggest that both indications and referral for surgical intervention have been delayed in patients who have end-stage renal disease combined with coronary artery disease, valve disease, or both. The delay may contribute to the relatively high perioperative mortality.