Perfusion
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Randomized Controlled Trial
Hypertonic hydroxyethyl starch solution for hypovolaemia correction following heart surgery.
The aim of the study was to evaluate the effect of hypertonic NaCl hydroxyethyl starch solution on haemodynamics and cardiovascular parameters in the early postoperative period in patients for correction of hypovolaemia after heart surgery. ⋯ HyperHaes solution had a positive effect on haemodynamic parameters and microcirculation. Oxygen transport was more effective after HyperHaes solution infusion. Higher diuresis, lower need for the infusion therapy for the first 24 hours and lower total fluid balance were determined in the HyperHaes group. No adverse effects were observed after HyperHaes solution infusion.
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Randomized Controlled Trial
Does cold blood cardioplegia solution cause deterioration in clinical pulmonary function following coronary artery bypass graft surgery?
Deterioration in pulmonary function is a common complication following coronary artery bypass graft surgery and there is still speculation to the precise causative factors thereof. Cardioplegia solution not drained by the atriocaval cannula enters the lung parenchyma unless removed by a pulmonary artery (PA) vent. The hypothesis of the present study was that cold blood cardioplegia solution damages the lung parenchyma, resulting in an observed deterioration of clinical lung function. ⋯ The data, therefore, suggest that allowing cold blood cardioplegia solution to circulate the lungs during cardiopulmonary bypass does not have any (beneficial or detrimental) effect on clinical lung function postoperatively.
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Clinical Trial
Tissue and plasma concentrations of cephuroxime during cardiac surgery in cardiopulmonary bypass--a microdialysis study.
Wound and mediastinal infections are still very serious complications of open-heart surgery, in spite of the use of prophylactic antibiotics. The use of cardiopulmonary bypass (CPB) is associated with profound physiological changes affecting the pharmacokinetic behaviour of antibiotics. The aim of this pilot study was to monitor the tissue concentrations of cephuroxime (prophylactic antibiotic) in skeletal muscle during cardiac surgery using CPB by interstitial microdialysis. These concentrations were compared with plasma concentrations of cephuroxime. ⋯ Our preliminary results show that CPB can modify the time course of cephuroxime plasma and tissue concentrations. A decrease in plasma drug concentrations occurred at the start of CPB and lasted until CPB ended. An increase in plasma concentrations corresponds to the second drug dose after CPB. The concentrations of cephuroxime in skeletal muscle (corrected by recovery) during CPB are higher than plasma concentrations. It is influenced by important changes during CPB; closely associated with hemodilution, a shift of intravascular volume, solutes and albumin to the extravascular space and inconstant protein binding of cephuroxime during operation.