The International journal of artificial organs
-
Clinical Trial Controlled Clinical Trial
Intensive predeposit-hemodilution autologous blood donation and IOBS increase in erythropoietic levels in patients undergoing hip arthroplasty.
Erythropoietin (EPO) plasma levels were monitored during the perioperative period in 61 consecutive patients (22 males - 39 females), aged 62.5 +/- 9.5 years, scheduled for hip arthroplasty. All patients underwent intraoperative blood salvage (IOBS) and were subdivided into three different groups according to their hemoglobin levels (Hb) 24 hours postoperatively (group A: Hb < 8 g/dl; group B: Hb between 8-9 g/dl; group C: HB > or = 9 g/dl). Seventy-two hours after surgery EPO levels were significantly different in group A (135 +/- 68) compared to group C (54.3 +/- 32), with a positive correlation (p < 0.01) between Hb and EPO levels. On the basis of these results we suggest that a programmed autologous red blood cell collection aimed at obtaining the lowest hemoglobin values during the first 24 hours after surgery, may be of clinical utility in preventing homologous blood needs.
-
Comparative Study Clinical Trial Controlled Clinical Trial
Experience with uni- (LVAD) and biventricular (ECMO) circulatory support in postcardiotomy pediatric patients.
In six pediatric patients with postoperative low-output-syndrome (LOS), uni-(LVAD) and biventricular (ECMO) assist systems with Biomedicus centrifugal pump were used. ECMO was applied in 5 children aged between 3 days and 16 years, one infant with an age of 16 months was implanted with LVAD. ⋯ Analysis of vital organ functions during ECMO and LVAD support are presented and characteristics of both support systems for use in pediatric patients with postcardiotomy LOS based on worldwide experience discussed. In conclusion, both, uni- (LVAD) and biventricular circulatory support (ECMO) using Biomedicus centrifugal pump can be safely applied for management of postcardiotomy LOS even in neonates, however, ECMO support in comparison to LVAD is a more aggressive approach associated with a higher complication rate.
-
A special lung support technique is required during carinal or tracheal surgery Veno-venous extracorporeal membrane oxygenation (ECMO) has become an accepted technique for temporary lung support. Therefore, the purpose of our experiments was to evaluate the effect of veno-venous ECMO (veno-right ventricle bypass) without ventilatory support. In five mongrel dogs, two venous drainage cannula were inserted into the superior vena cava through the right jugular vein and the inferior vena cava through the right femoral vein. ⋯ The veno-right ventricle (veno-RV) bypass system was composed of a centrifugal pump and membrane oxygenator; pump flow was maintained at 88 +/- 14 ml/kg/min. Excellent hemodynamics and good oxygenation were obtained. On the basis of these results, we conclude that veno-RV bypass may be used as lung support during pulmonary surgery even though the native lung is not ventilated during the veno-RV bypass procedure.