The Journal of extra-corporeal technology
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J Extra Corpor Technol · Dec 2002
Review Comparative StudyCoronary artery bypass grafting: an off-pump versus on-pump review.
There has been a proliferation in the number of coronary artery bypass grafts (CABG) being performed without the use of cardiopulmonary bypass (CPB). However, the benefits of off-pump coronary artery grafting (OPCAB) are still being determined. The aim of this retrospective review was to compare the perioperative outcomes of CPB patients with OPCAB patients and to identify the patients most likely to benefit from the off-pump procedure. ⋯ Differences between either operation groups in transfusion rates were only statistically significant for the one to three grafted patients, while postoperative stays were similar for patients having four grafts. These results suggest that OPCAB is associated with a reduction in mortality and morbidity, particularly within the higher-risk patients. However, the benefits of OPCAB diminished with an increasing number of distal anastomoses performed.
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J Extra Corpor Technol · Dec 2002
Case ReportsArgatroban in adult extracorporeal membrane oxygenation.
This case report addresses the use of Argatroban, an anticoagulant and thrombin inhibitor for treatment of thrombocytopenia in an adult patient on extracorporeal membrane oxygenation (ECMO). After 5 days on ECMO, the patient showed signs of heparin-induced thrombocytopenia (HIT) with a platelet count of 20K. ⋯ Given the occurrence of HIT with heparin therapy, a need for alternate drug therapy is required for patients requiring treatment with ECMO. The use of Argatroban in adult ECMO is outlined and includes dosage, monitoring, and patient treatment.