Texas Heart Institute journal
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We examined the influence of the addition of dextrose to crystalloid cardiopulmonary bypass priming solution. Ten patients received only lactated Ringer's solution during the perioperative period and as their cardiopulmonary bypass priming solution, while ten others, managed identically in all other respects, received only 5% dextrose in lactated Ringer's solution (D5LR). ⋯ Postoperative hemoglobin was significantly lower in the group receiving lactated Ringer's solution (-14%) but not in the patients receiving D5LR (-6%). We conclude that the addition of dextrose to a crystalloid priming solution decreases intraoperative fluid requirements and helps restore precardiopulmonary bypass hemoglobin without the need for diuretics or blood products.
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During an 11-year period ending January 1, 1985, 352 patients had insertions of an intraaortic balloon pump (IABP) as an adjunct to medical or surgical therapy. Group I, 175 patients, could not be weaned from cardiopulmonary bypass and required intraaortic balloon pump (IABP). Thirty-nine patients (22%) died in the operating room. ⋯ Left ventricular dysfunction, myocardial infarction, and timely insertion of IABP are the primary determinants of survival. Approximately one-third of patients who required IABP will die. More involved techniques for mechanical support of the failing circulation, such as ventricular assist device or total artificial heart, may increase survival.