Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 1997
The effects of pulsatile cardiopulmonary bypass on cerebral and renal blood flow in dogs.
The purpose of this study was to determine the effects of pulsatility on cerebral blood flow, cerebral metabolism, and renal blood flow over a range of cardiopulmonary bypass temperature and flow conditions. ⋯ Pulsatility has no significant effect on cerebral or renal perfusion over a broad range of cardiopulmonary bypass temperature and flow conditions. Cerebral blood flow and metabolism were functions of temperature but not pulsatility or flow rate. Renal blood flow was affected by both temperature and cardiopulmonary bypass flow rate but not by pulsatility. Finally, central nervous system perfusion may be preserved under low-flow cardiopulmonary bypass conditions by shunting of perfusion from splanchnic vascular beds.
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J. Cardiothorac. Vasc. Anesth. · Jun 1997
Randomized Controlled Trial Clinical TrialThermodilution cardiac output measurement during simultaneous volume infusion through the venous infusion port of the pulmonary artery catheter.
To determine the effect on thermodilution cardiac output (TDCO) measurements of continuous volume infusion through the right atrial venous infusion port of the pulmonary artery catheter. ⋯ Rapid continuous infusion of fluid through the venous infusion port of the pulmonary artery catheter significantly limits the accuracy of simultaneous TDCO measurements. Optimally, TDCO measurements should be avoided during rapid volume infusion.
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J. Cardiothorac. Vasc. Anesth. · Jun 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of pulsatile versus nonpulsatile perfusion on the postcardiopulmonary bypass aortic-radial artery pressure gradient.
To investigate whether the type of perfusion, pulsatile (PP) or nonpulsatile (NP), has any effect on the pressure gradient that exists between the aortic root and the radial artery after cardiopulmonary bypass (CPB). ⋯ Pulsatile perfusion had no effect on the aortic root radial artery blood pressure gradient after CPB in elective CABG surgery patients.
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J. Cardiothorac. Vasc. Anesth. · Jun 1997
Randomized Controlled Trial Clinical TrialEffect of pump flow rate on cerebral blood flow during hypothermic cardiopulmonary bypass in adults.
The purpose of this study was to examine the effect of cardiopulmonary bypass flow rate on cerebral blood flow and cerebral metabolic rate for oxygen during hypothermic (27 degrees C) cardiopulmonary bypass. ⋯ Brain oxygenation is well maintained at lower than conventional pump flow levels during CPB. There may be practical advantages to reduced flows during hypothermia, and flow reductions do not appear to adversely affect cerebral blood flow or metabolism.
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J. Cardiothorac. Vasc. Anesth. · Jun 1997
Comparative StudyRespiratory outcomes with early extubation after coronary artery bypass surgery.
Aortocoronary bypass surgery has undergone recent changes, promoting the concept of "fast tracking," in which patients are extubated and discharged postoperatively at an accelerated pace compared with previous historic patterns. Postoperative respiratory function and complications have not been previously studied in patients selected for "fast tracking." ⋯ Differences in chest radiographs in the late extubation group at the time of extubation may be related to greater use of fluids or increased airway obstruction. The rationale of early extubation is based on cost minimization to decrease hospital duration. This article suggests that respiratory physiological outcomes are not worsened in patients who are extubated and discharged early after elective aortocoronary bypass surgery.