SEARCH · PubMed Health

Results for “Extracorporeal Circulation”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources

PubMed1999

Recovery from lymphocytopenia following extracorporeal circulation: simple indicator to assess surgical stress.

This study investigated whether the lymphocyte count is a useful indicator to assess surgical damage following extracorporeal bypass. In Study 1, to investigate the correlation between extracorporeal circulating time (ECCT) and lymphocyte counts, 40 elective CABG patients were studied retrospectively. The lymphocyte recovery ratio (LRR), which represented the actual lymphocyte count divided by the preoperative lymphocyte count, was determined preoperatively, and on postoperative day (POD) 1, POD 3, and POD 5. In Study 2, the correlation between the interleukin-8 (IL-8) level and LRR was examined prospectively in elective CABG patients (n = 20). We measured the LRR and serum IL-8 levels preoperatively and during extracorporeal circulation (ECC) at 5 min, at the end of ECC, and 1, 3, and 12 h following ECC termination. Study 1 showed that the LRR decreased until POD 1 and gradually increased thereafter. The LRR had a negative correlation with the ECCT. In Study 2, the IL-8 level demonstrated a time course opposite to that of the LRR; it increased until 3 h after ECC termination and declined thereafter. There was a significant negative correlation between the LRR on POD 3 and the IL-8 level at 3 h after ECC termination. In summary, long-term ECC induced significant and prolonged lymphocytopenia. The LRR had a negative correlation with IL-8. These results indicated that the LRR may represent the degree of surgical stress following ECC; therefore, the counting of lymphocytes can be a quite useful bedside monitor to assess surgical damage and prognosis.

Coronary Artery Bypass↗

PubMed2002

[Resuscitation of a patient with deep hypothermia using extracorporeal circulation].

The case-history describes successful resuscitation of a young man who was found after 15 hours following attempted suicide (intoxication with carbamazepine) in deep hypothermia (19 degrees C) with cardiac arrest. For rewarming the patient extracorporeal circulation was used. The patient was successfully disconnected from the extracorporeal circulation, relieved of the shock incl. severe rhabdomyolysis and intoxication with carbamazepine and discharged to domiciliary treatment without suffering from a neurological deficiency.

Adult↗

PubMed2003

Heart surgery with extracorporeal circulation leads to platelet activation at the time of hospital discharge.

OBJECTIVE: Heart surgery with extracorporeal circulation has a marked effect on platelet function and coagulation accounting for abnormal blood loss and allegedly a low incidence of thromboembolic complications. Little is known about platelet function at the time of hospital discharge of routine patients. METHODS: Blood samples from 91 patients undergoing elective heart surgery were drawn before surgery and prior to discharge. Thirty-seven patients underwent coronary artery surgery and 54 an aortic valve implantation. The mean age of patients was 69+/-9 years. Fifty patients were male and 41 female. Platelet function was evaluated using plasma beta-thromboglobulin quantification in enzyme-linked immunosorbent assay. In addition, flow cytometric analysis of platelet-monocyte conjugates and platelet-neutrophil conjugates was performed. RESULTS: The platelet count before discharge was significantly increased (265+/-86 vs. 212+/-61 x 10(9)/l preoperatively). beta-Thromboglobulin was significantly increased (176+/-127 vs. 79+/-70 ng/ml preoperatively) and flow cytometry proved a significant increase in monocyte-platelet aggregates (8.3+/-5.4% vs. 5.3+/-2.6% preoperatively) indicating platelet activation at the time of hospital discharge. There were no significant differences among the three subgroups coronary surgery, mechanical valve insertion and biological valve insertion. CONCLUSIONS: Heart surgery with extracorporeal circulation leads to significant platelet activation and a reactive increase in platelet count before discharge. This is in contrast to the reduced platelet function immediately postoperatively.

Adult↗

PubMed2003

Anesthetic management for clipping a giant basilar artery aneurysm with moderate hypothermia, extracorporeal circulation assistance, and propofol infusion.

A 65-year-old female patient underwent surgery to clip a giant basilar artery aneurysm with closed-chest extracorporeal circulation using femorofemoral bypass. Moderate hypothermia (27 degrees C-30 degrees C), retention of spontaneous circulation, and propofol infusion (3-5 mg. kg(-1). h(-1)) were used under general anesthesia. Blood outflow via femoral vein was sufficient to maintain cardiopulmonary bypass and to induce hypothermia. Hemodynamics were controlled with dopamine and noradrenaline. In this case, extracorporeal circulation under moderate hypothermia was used to assist rather than substitute for spontaneous circulation, and spontaneous circulation was maintained at all times. We think that this method had advantages over deep hypothermic circulatory arrest with regard to intraoperative risks and postoperative complications.

Aged↗

PubMed2004

Extracorporeal circulation in non-cardiac surgery.

Tradition and experience of cardiopulmonary bypass in the hand of cardiac surgeons Led to several spin-offs of this extracorporeal technique. Acute organ support is realized for situations of failing cardiac output, circulatory arrest respectively, of pulmonary failure and of drowning. Extracorporeal circulation is a promising adjunct to aim in better surgical technique and treatment in neurosurgery, thoracic aortic surgery, complex Lung resection, tumor surgery and procedures where safe organ perfusion must be ascertained. Chemotherapy and hyperthermia in limb carcinoma is highly successful if performed with the help of extracorporeal circulation. Progression in transcutaneous cannulation technique makes application of machinery easy and from operation facilities independent. Replacement of Long lasting periods of chest compression for heart massage is a future perspective if circulation is maintained by transcutaneously adapted miniaturized heart-lung-machine. Long lasting traumatizing mechanical ventilation of a severely diseased lung maybe replaced by extracorporeal lung assistance to give better chances for the lung to recover. Thoughts for these new interdisciplinary duties of cardio surgical units were discussed in the committee for the Symposium for the Future of Cardiac Surgery.

Cardiopulmonary Bypass↗

PubMed1999

Extracorporeal circulation before and after ultrasonographic evaluation of the ascending aorta.

BACKGROUND: To further gain insight into atheroembolization mechanisms epiaortic two-dimensional echocardiographic evaluation before extracorporeal circulation and after decannulation may be helpful. METHODS: Epiaortic two-dimensional echocardiography was performed before cannulation and after decannulation in 188 (124 men) patients (mean age, 67.7 years; range, 43 to 86 years) undergoing operation with extracorporeal circulation for ischemic heart disease during 1996. RESULTS: After decannulation, a new intimal lesion was recognized in 10 of 188 patients (5.3%): mobile type in 5 patients (3 ending with a stroke [60%], 2 having brain computed tomographic scans compatible with embolism), intimal tear in 2, and intimal irregularity in 3 patients. Stroke occurred in a significantly smaller number of patients (2 of 178 [1.1%]; p < 0.001) without new lesions. CONCLUSIONS: Clamp- or cannula-induced new lesions, especially of mobile type, are often complicated by postoperative stroke. Aggressive surgical technique modifications may need to be considered to avoid creating new lesions, particularly of the mobile type.

Adult↗

PubMed1984

[Perioperative cefamandole prevention in aortocoronary bypass operations: the course of serum levels in extracorporeal circulation].

Antibiotic prophylaxis with 2 g Cefamandole at induction of anaesthesia was performed in 12 male patients undergoing aortocoronary bypass surgery. Caused by hemodilution, there was a marked decrease of serum concentration at the beginning of extracorporeal circulation, from 110.96 +/- 40.29 mcg/ml to 70.89 +/- 34.65 mcg/ml within 10 min. During extracorporeal circulation, elimination was as fast as before and after perfusion. 240 min after application, mean serum concentrations of 16.80 +/- 9.32 mcg/ml were measured. Failure of antibiotic prophylaxis in operations exceeding 4 h might be due to unadaequate antibiotic concentrations, beyond the minimal inhibitory concentration for the pathogens, reported to cause infections after cardiac operations.

Adult↗

PubMed1977

[Pulmonary complications after extracorporeal circulation. ECC lung syndrome].

Pulmonary complications after cardiac surgery under extracorporeal circulation remain frequent and sometimes grave, in spite of the great progress which has been made over the past 20 years in the methods of cardiorespiratory assistance. The authors analyse the clinical and radiological repercussions of perfusion on the lung, in 40 patients operated under ECC for coronary revascularisation. The simutaneous study of the arterial, and mixed venous blood gasses and of the alveolar gases, in 20 of these patients showed the constant occurrence of a shunt syndrome, without alveolar hypoventilation or disorders in peripheral circulatory flow. Ventilatory alcalosis, hypocapnia, hypoxemia and the rise in the alveolar arterial oxygen gradient is increased during the second post-operative day. Among the variables studied (duration of ECC, degree of hypothermia, duration of the intervention, duration of anesthesia, pleurotomy) only the latter intervened in a statistically significant manner in this study, in the increase in hypoxemia. 46 pulmonary biopsies carried out before and after ECC in 23 coronary patients were examined with the electron microscope. The initial alveolar involvement affects the septal microcirculation with signs of an increase in capillary permeability leading to an interstitial and epithelial destruction. The use of a membrane oxygenator prevents some of the alveolar lesions, as has been proved by the study of five pulmonary biopsies carried out in dogs submitted to ECC of long duration. Catherterization of the pulmonary artery carried out in 35 patients by means of a SWAN-GANZ catheter, before the intervention enabled supervision of the degree of importance and speed of the hemodynamic variations in the pulmonary circulation during the different phases of ECC (during the phase of ventricular fibrillation). The rise in the flow of left output can lead to the occurrence of negative pulmonary intravascular pressures which can be prejudicial for capillary trophicity. The syndrome of "ECC lung", a veritable "induced post-agressive lung" must be placed in the group of refractory hypoxemia of which it represents one of the most typical pictures.

Alkalosis, Respiratory↗

PubMed1987

Treatment of hypothermia by extracorporeal circulation and internal rewarming.

The treatment of accidental hypothermia by extracorporeal circulation and internal rewarming can be life saving in patients unconscious from drug overdose or victims of accidental exposure to severe cold. Advantages are the rapidity of treatment, the provision of circulatory support, and a lessened chance of rewarming collapse, since peripheral vasodilation is paralleled by an increase in cardiac output. A premature diagnosis of clinical death was averted in two patients with rectal temperatures of 25 degrees C or below, and their lives were saved by the use of this technique.

Adult↗

PubMed1995

Trypsinogen is not activated during cardiac surgery with extracorporeal circulation.

Amylase, immunoreactive cationic trypsin(ogen) and complexes of cationic trypsin and alpha 1-proteinase inhibitor were analysed in plasma samples from 41 patients following cardiac surgery with extracorporeal circulation. Postoperative hyperamylasaemia was seen in seven patients (17%). In 10 patients there were elevated levels (> 100 micrograms 1(-1)) of immunoreactive cationic trypsin(ogen) on the first postoperative day. After gelfiltration, samples from these 10 patients were analysed for trypsin-alpha 1-proteinase inhibitor complexes, with a solid-phase, double-antibody enzyme-linked immunoassay. The median preoperative level of trypsin-alpha 1-proteinase inhibitor complexes was 4.5 micrograms 1(-1) (range 3.3-11.9) and the median value on the first postoperative day was 5.5 micrograms 1(-1) (range 2.6-14). The ratio between complexes and immunoreactive trypsin(ogen) decreased (p < 0.05) showing that activation of trypsinogen did not occur. This fact argues against the development of protease-mediated subclinical pancreatitis during cardiac surgery with extracorporeal circulation.

Adult↗

PubMed1991

Intraocular pressure variations during extracorporeal circulation and some influencing factors.

Intraocular pressure (IOP) variations during extracorporeal circulation (ECC) and some influencing factors were studied prospectively in 38 patients undergoing cardiovascular surgery. IOPs were measured preoperatively, during EEC after 5 min, 10 min, and then every 15 min and on the first, second and third postoperative days. IOP, haematocrit, arterial perfusion pressure, partial O2 pressure, partial CO2 pressure, pH, and blood bicarbonate levels were measured simultaneously. After beginning ECC, arterial perfusion pressure and haematocrit values decreased suddenly while IOP was raised immediately. The sudden increase of blood volume at the start of ECC is the probable cause of IOP elevation. Afterwards IOP levels decreased to pre-ECC levels. We think that the drop is due to the effect of mannitol in the priming solution and hyposecretion of aqueous humor due to insufficient nutrition-oxygenation of the corpus ciliaris after the haemodynamics have stabilised.

Blood Volume↗

PubMed2000

Particles released from the Gyro C1E3 during simulated extracorporeal circulation.

Evaluation of released particles from the blood pump during extracorporeal circulation is an important aspect because the particles may cause microembolism. The Gyro C1E3 is a centrifugal blood pump that has an impeller suspended by double pivot bearings inside the housing; therefore, it is important to evaluate the released particles. The C1E3 was driven for 14 days to simulate clinical left ventricular assist device (LVAD) and percutaneous cardiopulmonary support (PCPS). Also, a roller pump was driven for 2 days as a comparison. Released particles were weighed and examined by SEM. After 14 days of pumping, the particles from the C1E3 were 238.6 microg in an LVAD condition. The particles with the roller pump were 270.2 microg after only 2 days. Average particle sizes with the roller pump and C1E3 were 3.7 and 0.6 microm, respectively. These results suggest that the Gyro C1E3 substantially reduces the risk of microembolism from released particles.

Biocompatible Materials↗

PubMed1989

[Heparinization control by activated coagulation time in cardiac surgery with extracorporeal circulation].

The authors studied 20 patients undergoing cardiac surgery with extracorporeal circulation using a protocol proposed by Bull for the control of heparinization using the activated coagulation time of whole blood proposed by Hattersley. The patients, alterations in the coagulation and in red cell values were evaluated comparing the pre-operatory values with the post-operatory ones. The activated coagulation time (ACT) was evaluated as to its variability in different periods (pre, trans, and post-surgery). All the results were compared with world literature. They conclude that it is an excellent method for the control of the monitoring of heparin therapy and neutralization with protamine sulfate, which was used in lower doses than those referred to in literature. No post-operatory complications due to alterations in the coagulation system were observed. The total doses of heparin and protamine per kilogram were, respectively, 5.85 mg and 4.34 mg. There was significant variation between the erythrocytes, the hemoglobin and the platelets (p less than 0.001). As to the prothrombin time, the partial thromboplastin time, the coagulation time and the fibrinogen, none showed significant variation. The ACT did not show significant variation between the values obtained during perfusion, and neither between the basal value and the value post-protamine, the basal and the 30 minutes post-protamine, and the post-protamine and 30 minutes post-protamine.

Blood Coagulation Tests↗

PubMedDate not supplied

Total respiratory support with tidal flow extracorporeal circulation in adult sheep.

A novel pressure gated tidal flow extracorporeal circulation (TF ECC) device was developed, and it was hypothesized that it could provide total respiratory support in apneic adult sheep without adverse hemodynamic or cardiac effects. The circuit consisted of a single lumen cannula, computer driven tubing occluders gated by circuit pressure, a nonocclusive peristaltic blood pump, a spiral coiled membrane lung, and a heat exchanger. Six paralyzed, anesthetized adult sheep were instrumented and TF ECC was instituted via cannulation of the right atrium. Total respiratory support was provided by the circuit during an apneic period of 6 hours. Echocardiography was performed with the animal instrumented (baseline) and after 2 hours of TF ECC. Circuit blood tidal volume was 172.6 +/- 18.0 cc, resulting in a TF ECC flow of 71.1 +/- 10.1 cc/kg/min. At the end of the study period, PaCO2 was 35.5 +/- 7.6 mmHg, paO2) was 91.2 +/- 30.6 mmHg, and pulmonary artery oxygen saturation (SPAO2) was 95 +/- 5%. Hemodynamic stability was maintained with no significant differences at baseline and after 6 hours in mean arterial pressure, mean pulmonary artery pressure, or heart rate noted. Echocardiographic evaluation showed preserved fractional shortening of the left ventricular (LV) septal-lateral dimension (baseline 32.4 +/- 11.4%; 2 hours 34.8 +/- 8.4%). This study demonstrates TF ECC provides total respiratory support without adverse hemodynamic effects, and preserved LV function.

Animals↗

PubMed1976

[Determination of lipids in serum and erythrocytes during surgery with extracorporeal circulation].

The changes of the lipids in serum and erythrocytes inclusively the fatty acid pattern of the phosphatids were registered at 16 patients of whose congenital heart defects were corrected with extracorporeal circulation. The differently evident changes of the lipid fractions are to relate to heparinization, hemodilution and injury of erythrocytes which is increasing in the duration of perfusion. They are discussed in their importance for clinical essential phenomenous as disturbances of the coagulation or hemolysis. From these preliminary studies is to conclude that the substitution of phosphatids is necessary at the end of or after the extracorporeal circulation.

Adolescent↗

PubMed1984

Gabexate mesilate (Foy) as an anticoagulant in extracorporeal circulation in dogs and sheep.

Gabexate mesilate (GM), a synthetic serine protease inhibitor with a short half-life time of approx. 80 sec, was applied as the exclusive anticoagulant in small scale extracorporeal circulation in narcotized dogs and sheep. The animals underwent a veno-venous bypass. As the blood was drawn out of the femoral vein, GM was infused immediately into the extracorporeal system. GM was greatly reduced because of its short half-life time before the blood reentered the animal via a brachial vein. In order to control the coagulatory state of the blood, the Activated Clotting Time (ACT), Partial Thromboplastine Time (PTT) and Recalcification Time (RT) were measured in regular intervals. In addition, a screen pressure test device was used to monitor on line during ECC the tendency of blood clotting. It was shown that the blood of the extracorporeal system was sufficiently anticoagulated by an infusion of 0.03 mg/ml/min GM. During two hours ECC, simultaneously measured ACT-values of the animals only differed up to 10 percent from the native values. Pilot studies have shown that the results of these model investigations could be successfully transferred to extracorporeal circulation with membrane oxygenators and pumps as they are clinically used.

Animals↗

PubMedDate not supplied

Vascular access for extracorporeal circulation. Resistance in double lumen cannulas.

Double lumen catheters (DLCs) currently are being used for vascular access with extracorporeal circulation. Blood flow studies were done on various DLCs connected to a circuit made of polyvinyl chloride tubing. Sheep's blood was used with all catheters at flows of 200 and 400 ml/min. The inlet and outlet pressures were measured and resistances calculated. Modified versions of the Shiley and Kendall catheters, also were tested. In both catheters, resistance was reduced with the use of perfusion adaptors. Flow through catheters, with a diameter that exceeded the Luer fitting dimension, was compromised. The modified Shiley and unmodified Kendall catheters had the lowest resistance to flow, and they thus are best suited for extracorporeal circulation.

Animals↗

PubMed1994

Endothelial injury during extracorporeal circulation: neutrophil-endothelium interaction induced by complement activation.

This study was designed to understand the physiologic intravascular and intradevice events at the cellular level following complement system activation during extracorporeal circulation. The addition of anaphylatoxin C5a or complement-activated serum into neutrophil- or endothelial cell-suspensions resulted in a dose-dependent transmembrane stimulation that was assessed by an intracellular free calcium ion mobilization technique using a calcium-sensitive photoprotein, aequorin. The adhesion and ruffle formation of neutrophils on endothelial cell monolayers were markedly enhanced when both cell types were treated with C5a or activated serum. The significance of complement activation on intravascular events during extracorporeal circulation is emphasized and discussed from the viewpoint of surface-expressed adhesion molecules.

Calcium↗