The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Mar 1977
Comparative StudyMonitoring of cardiac output by thermodilution after open-heart surgery.
One hundred twenty-five separate cardiac output determinations were obtained after open-heart surgery in 10 patients by simultaneous use of thermodilution and dye-dilution techniques. Mean thermodilution cardiac output was 1.6 per cent greater than mean dye-dilution cardiac output (5.24 versus 5.16 L. per minute). Reproducibility of thermodilution cardiac output (coefficient of variation, 8.6 per cent) was superior to that of dye-dilution cardiac output (coefficient of variation, 12.3 per cent) for outputs ranging from 2.5 to 8.7 L. per minute (p less than 0.001). ⋯ The results indicate that thermodilution cardiac output is a valid method for determining cardiac output in the rapidly changing clinical setting following cardiopulmonary bypass. Clinical applications of this technique include evaluation of the efficacy of inotropic agents, effectiveness of intra-aortic balloon counterpulsation, and status of the low output syndrome postoperatively. Routine use in patients with Class III or IV cardiac disease appears justified.
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J. Thorac. Cardiovasc. Surg. · Mar 1977
Case ReportsRetention of pacemaker electrode complicated by Serratia marcescens septicemia. Removal with total cardiopulmonary bypass.
A case in which Serratia marcescens septicemia complicated the insertion of a transvernous pacemaker unit is reported. Appropriate antibiotic therapy and removal of the pacemaker electrode are two essential steps to achieve a complete cure in this stimulation. Open cardiotomy with total cardiopulmonary bypass provides a safe approach for withdrawal of an incarcerated electrode and is justified because of the lethal potential of systemic Serratia infections, particularly those superimposed on intracardiac prostheses.