The International journal of artificial organs
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Randomized Controlled Trial
The effect of pulsatile cardiopulmonary bypass on lung function in elderly patients.
Cardiopulmonary bypass is still a major cause of lung injury and delay in pulmonary recovery after cardiac surgery. Although it has been shown that pulsatile flow induced by intra-aortic balloon pumping is beneficial for preserving lung function, it is not clear if the same beneficial effect can be accomplished with pulsatile flow generated in the extracorporeal circuit. Therefore, we investigated the effect of pulsatile flow, produced by a centrifugal pump, on lung function in elderly patients. ⋯ Pulsatile flow does not seem beneficial to postoperative lung function in elderly patients. Moreover, pulsatile flow does not affect lung function on a subclinical level as assessed by lung biomarkers.
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This phase I study was performed to evaluate coagulation alterations during extracorporeal circulation (ECC) induced whole body hyperthermia (WBHT) in 12 patients with advanced soft tissue sarcomas. ⋯ Temporal correlation between hemostatic alterations and elevation in liver enzymes leads to the assumption that liver impairment might play a crucial role in coagulation disturbances observed during ECC-WBHT and thereafter, thus strongly supported by liver sequestration of platelets.Therefore a close monitoring of hepatic derived coagulation alterations in patients undergoing extracorporeal whole body hypothermia is warranted.
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Comparative Study
In vitro air removal characteristics of two neonatal cardiopulmonary bypass systems: filtration may lead to fractionation of bubbles.
Introduction of gaseous microemboli (GME) into the arterial line of a pediatric cardiopulmonary bypass (CPB) circuit may lead to cognitive decline and adverse outcomes of the pediatric patient. Arterial filters are incorporated into CPB circuits as a safeguard for gross air and to reduce GME. Recently, arterial filters were integrated in two neonatal oxygenators to reduce volume and foreign surface area. ⋯ The air removal properties of both systems are considered safe and reliable. Detailed GME distribution data show that the Capiox FX05 showed more small GME (<50 µm) due to fractionation of larger GME when compared to the QUADROX-i Neonatal. We may conclude that filtration may lead to fractionation.