BACKGROUND Postoperative neurocognitive deficit is prevalent after cardiac surgery. Xenon may prevent or ameliorate acute neuronal injury, but it also may aggravate injury during cardiac surgery by increasing bubble embolism. Before embarking on a randomized clinical trial to test the safety and efficacy of xenon for postoperative neurocognitive deficit, we undertook a phase I study to investig...

INTRODUCTION Although rapid response system teams have been widely adopted by many health systems, their effectiveness in reducing hospital mortality is uncertain. We conducted a meta-analysis to examine the impact of rapid response teams on hospital mortality and cardiopulmonary arrest. METHOD We conducted a systematic review of studies published from January 1, 1990, through 31 December 201...

OBJECTIVE Infants are potentially more susceptible to cell death mediated via glutamate excitotoxicity attributed to cardiopulmonary bypass. We hypothesized that ketamine, via N-methyl D-aspartate receptor blockade and anti-inflammatory effects, would reduce central nervous system injury during cardiopulmonary bypass. METHODS We randomized 24 infants, without chromosomal abnormalities, to rec...

OBJECTIVE To review studies performed in animal models that evaluated therapeutic interventions to inflammatory response and microcirculatory changes after cardiopulmonary bypass. METHODS It was used the search strategy ("Cardiopulmonary Bypass" (MeSH)) and ("Microcirculation" (MeSH) or "Inflammation" (MeSH) or "Inflammation Mediators" (MeSH)). Repeated results, human studies, non-English lan...

Cardiopulmonary bypass depends on our ability to control the coagulation system. Heparin and protamine have been used for this purpose since the introduction of cardiopulmonary bypass. Although heparin has been used as an anticoagulant since 1935 there are still some unsolved questions as regarding its structure and metabolism. 1•2 Many principles have been proposed for total heparinization, mo...

OBJECTIVE To study the incidence, outcome and potentially avoidable causes of inpatient cardiopulmonary arrests in a hospital with a "mature" rapid response system (RRS). DESIGN Retrospective observational study of all cardiopulmonary arrest events in 2005. SETTING University of Pittsburgh Medical Center Presbyterian Hospital, a 730-bed academic, urban, tertiary care adult hospital in the U...

Sixteen patients undergoing coronary revascularization requiring cardiopulmonary bypass received remifentanil 2 micrograms kg-1 or 5 micrograms kg-1 by infusion over 1 min after sternotomy but before commencing cardiopulmonary bypass, during hypothermic cardiopulmonary bypass and during cardiopulmonary bypass after rewarming. Hypothermic cardiopulmonary bypass reduced the clearance of remifenta...

1.5 CPET Protocols Cardiopulmonary exercise testing (CPET) provides a global as-1.6 Treatment of the Data sessment of the integrative exercise responses involving the pul-1.7 Validation monary, cardiovascular, hematopoietic, neuropsychological, and 1.8 Statistical Treatment of the Data skeletal muscle systems, which are not adequately reflected 2. Alternative Approach to Obtain Normal Reference...

A 63-year old, male patient presented with prosthetic valve endocarditis and developed heparin-induced thrombocytopaenia (HIT) following heparin administration for continuous veno-venous haemofiltration. Use of cardiopulmonary bypass in patients suffering from heparin-induced thrombocytopaenia is difficult and challenging. We report a novel method that allows heparin use in patients diagnosed w...