Perfusion
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Continuous retrograde hypothermic low flow cerebral perfusion (CRCP) with deep hypothermic systemic circulatory arrest (DHSCA) during aortic arch surgery was employed in six patients, aged 21-79 years. From August 1991 to November 1992, five of these patients were operated for ascending and arch aortic dissection type I, and one patient was operated for an aneurysm extending from the ascending aorta into the arch. Cardiopulmonary bypass (CPB) technology included a centrifugal pump and low-dose aprotinin. ⋯ Postoperatively, one patient died of cardiac failure. The other five patients regained full consciousness without neurological deficits, as defined by the Glasgow coma score, within 48 hours after the operation. Neither did we see other major organ complications.(ABSTRACT TRUNCATED AT 250 WORDS)
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The decision to employ haemofiltration and/or haemodialysis is based on various criteria depending on institutional protocol. Cardiac surgical patients, especially those with renal failure, often require fluid and electrolyte intervention. In the past haemodialysis patients were closely monitored and often delayed for surgery depending on their electrolyte status. ⋯ Although haemofiltration has been used successfully in the management of hypervolaemia and anaemia due to haemodilution, the rate of uraemic toxins and solute removal may not be adequate. The use of haemodialysis helps in the treatment of these difficult and often unpredictable cases. The type of dialysate and method of administration has simplied the technique of haemodialysis, during CPB, allowing effective solute and toxin removal while being able to control the amount of fluid removed.