Provaznik, Zdenek and Unterbuchner, Christoph and Philipp, Alois and Foltan, Maik and Creutzenberg, Marcus and Schopka, Simon and Camboni, Daniele and Schmid, Christof and Floerchinger, Bernhard (2019) Conventional or minimized cardiopulmonary bypass support during coronary artery bypass grafting? - An analysis by means of perfusion and body mass index. ARTIFICIAL ORGANS, 43 (6). pp. 542-550. ISSN 0160-564X, 1525-1594
Full text not available from this repository. (Request a copy)Abstract
The use of minimized cardiopulmonary bypass support to reduce the side effects of extracorporeal circulation is still contradictorily discussed. This study compares perfusion operated by conventional (CCPB) and minimized (MCPB) cardiopulmonary bypass support during coronary artery bypass grafting (CABG). This study includes the data of 5164 patients treated at our department between 2004 and 2014. Tissue perfusion during cardiopulmonary bypass support and cardiac arrest was assessed by means of body mass index, hemodilution, blood pressure with corresponding pump flow and venous oxygen saturation, serum lactate, and serum pH. Hemodilution was more pronounced after CCPB: hemoglobin had dropped to 4.47 +/- 0.142 g/dL after CCPB and to 2.77 +/- 0.148 g/dL after MCPB (P = 0.0022). Despite the higher pump flow in conventional circuits (4.86-4.95 L/min vs. 4.1-4.18 L/min), mean blood pressure was higher during minimized bypass support (53 +/- 10 vs. 56 +/- 13 mm Hg [aortic clamping], 57 +/- 9 vs. 61 +/- 12 mm Hg [34 degrees C], 55 +/- 9 vs.59 +/- 11 mm Hg [aortic clamp removal], P < 0.0001) at all time points. Venous oxygen saturation remained on comparable levels of >70% during both conventional and minimized cardiopulmonary bypass support. The increase in serum lactate was more pronounced after CCPB (8.98 +/- 1.28 vs. 3.66 +/- 1.25 mg/dL, P = 0.0079), corresponding to a decrease in serum pH to acidotic levels (7.33 +/- 0.06 vs. 7.35 +/- 0.06, P < 0.0001). These effects were evident in all BMI ranges. Minimized cardiopulmonary bypass support provides efficient perfusion in all BMI ranges and is thus equivalent to conventional circuits.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ACUTE KIDNEY INJURY; MINIATURIZED EXTRACORPOREAL-CIRCULATION; INFLAMMATORY RESPONSE; CARDIAC-SURGERY; CRYSTALLOID CARDIOPLEGIA; MYOCARDIAL PROTECTION; BLOOD-TRANSFUSION; METAANALYSIS; REDUCTION; OUTCOMES; body-mass-index; coronary artery bypass grafting; extracorporeal circuit |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 07 Apr 2020 08:36 |
| Last Modified: | 07 Apr 2020 08:36 |
| URI: | https://pred.uni-regensburg.de/id/eprint/26908 |
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