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Publish Date: 1993/05/01
Volume: 7, Issue: 5, Pages: 225-229
Abstract
Systemic hypothermia is used almost universally in cardiac surgerySince 1987 2817 patients have had normothermic cardiopulmonary bypassNCPB warm body bladder temperature 36 degrees C with cold bloodcardioplegic arrest cold heart 8 degrees14 degrees C during openheart surgery No patients were denied this technique regardless of agecondition or severity of surgery Clinical Characteristics in Patients Agerange 1684 years mean 66 male/female ratio 31 pump time min 24183mean 91 crossclamp time min 15148 mean 68 types of surgery coronaryartery bypass n = 2214 valvular n = 489 and miscellaneous aneurysmstumors arrhythmias congenital etc n = 114 One thousand andsixtynine 1069 patients had urgent coronary artery bypass graftingCABG The ejection fraction was less than 040 in 843 patients 30 Thethirtyday operative mortality for the entire group was 17 48/2817patients CABG = 1 23/2214 patients valvular = 3 15/489 patientsand miscellaneous 9 10/114 patients Postoperative complications wereperioperative myocardial infarction 34 patients = 12 postoperativebleeding requiring reexploration 37 patients = 13 stroke 27 patients= 1 and mediastinal infection 21 patients = 07 During NCPB WARMsystemic vascular resistance was extremely low cardiac output was high andit was easier to wean patients from the pump No intraaortic balloon pumpwas used during this period Pulmonary complications and coagulopathy wereextremely rare These results provide reassurance that NCPB WARM incombination with cold cardioplegic arrest provides excellent myocardial andtotal body protection during cardiac surgery and is particularly suitablefor highrisk patients
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