The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Oct 1998
Clinical Trial Controlled Clinical TrialEarly extubation after cardiac surgery: a prospective clinical trial including patients at risk.
Recent evidence suggests that early extubation after cardiac surgery can be performed without increased morbidity, resulting in economic advantages. However, most studies on this subject exclude patients with preoperative risk factors described as predictors for prolonged mechanical ventilation. The purpose of our prospective clinical trial was to decide whether early extubation is feasible independent of preoperative patient status, in particular independent of preoperative risk factors. ⋯ 1. All patients are basically suitable for early extubation, with the presence of preoperative risk factors used in this study being poor predictors of prolonged ventilation. 2. The necessity of prolonged ventilation is primarily determined by intra- or perioperative complications.
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Thorac Cardiovasc Surg · Oct 1998
Case ReportsHeparin removal after cardiopulmonary bypass in a patient with adverse reaction to protamine.
A 74-year-old man underwent elective coronary surgery under cardiopulmonary bypass. A few minutes after the protamine administration was started, he suddenly developed a severe hypotension necessitating cardiac massage and recannulation for pump assistance. ⋯ In 35 minutes ACT decreased from 480 sec to 180 sec and clots appeared in the operating field. This system provides an excellent alternative to protamine in patients with an adverse reaction to protamine.