The Journal of extra-corporeal technology
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J Extra Corpor Technol · Dec 2006
Heparin sensitivity test for patients requiring cardiopulmonary bypass.
Anticoagulation for the open heart surgery patient undergoing cardiopulmonary bypass (CPB) is achieved with the use of heparin. The industry standard of activated clotting time (ACT) was used to measure the effect of heparin. The commonly acceptable target time of anticoagulation adequacy is 480 seconds or greater. ⋯ Testing of patient blood before the time of incision for sensitivity to heparin is a way to avoid a delay that can be critical in the care of the patient. Commercial tests are available, but efficacy data are limited, and they lead to added inventory expense. This method of titrating a diluted heparin additive, mixed with patient blood in a familiar ACT test, has proven to be an inexpensive and reliable test to predict patient's sensitivity to heparin.
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J Extra Corpor Technol · Dec 2006
Perfusion techniques for pulmonary thromboendarterectomy under deep hypothermia circulatory arrest: a case series.
Pulmonary thromboendarterectomy (PTE) is a complicated surgical procedure that is an effective treatment in reducing pulmonary artery pressure and pulmonary vascular resistance for chronic thromboembolic pulmonary hypertension. Chronic thromboembolic pulmonary hypertension usually results from incomplete lysis of a large organized thrombus in the main pulmonary artery and secondary branches, leading to pulmonary hypertension, right ventricular failure, and subsequent death because of heart failure. Between March 1997 and April 2005, 30 PTE operations were performed in Fuwai Hospital, Beijing, China. ⋯ PTE is an effective treatment for chronic thromboembolic pulmonary hypertension. The key to success is to adopt synthesized measures to protect the vital organ under deep hypothermic circulatory arrest (DHCA) from ischemia and reperfusion injury. Appropriate patient selection, perioperative management, improved techniques, and experience can optimize outcome.