The Journal of extra-corporeal technology
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J Extra Corpor Technol · Mar 1997
Comparative StudyAdding hetastarch to the adult cardiopulmonary bypass prime does not affect patient outcomes.
Hespan (hetastarch), a synthetic colloid, is often used in priming cardiopulmonary bypass circuits. The purpose of this study is to determine the efficacy of adding hetastarch to the prime compared to adding no hetastarch. ⋯ There were no significant differences in change in lung compliance, weight gain, time on the ventilator, or length of stay in the intensive care unit. Adding colloids to the adult CPB prime does not improve patient outcomes over priming exclusively with crystalloids.
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J Extra Corpor Technol · Mar 1997
Blood anion gaps and venoarterial carbon dioxide gradients as risk factors in long-term extracorporeal support.
Increases in the blood anion gap (AG) and venoarterial carbon dioxide gradients [p(V-A)CO2] may indicate changes in intracellular acid concentration not demonstrated by blood gas measurements. This prospective study examines these two physiologic markers to determine their relationship to extracorporeal membrane oxygenation (ECMO) survival and duration in 100 patients. Serum electrolytes were drawn every 6 hours and the AG calculated. ⋯ Both mortality and survivors' ECMO time increase as one or both risk factors increase. Patients with increases in both risk factors have a mortality rate 8 times greater and survivors remain on ECMO almost twice as long as those without increased risk factors. Patients may benefit from a perfusion strategy that seeks to minimize the AG and p(V-A)CO2.