a strategy employing moderate hypothermia for the replacement of the aortic arch is proposed to avoid the complications of profound hypothermic circulatory arrest. two patients underwent the complete replacement of the aortic arch using three pumps - for the brain, thoracoabdominal aorta, and heart, respectively. there were no complications and the patients were extubated uneventfully. the meth...

OBJECTIVES To demonstrate that small intestinal mucosal ischemia occurs during cardiopulmonary bypass by measuring serum diamine oxidase activity, an index of small intestinal mucosal ischemia, in perioerative patients undergoing cardiovascular surgery with and without cardiopulmonary bypass. METHODS Twelve successive patients who underwent coronary artery bypass grafting with cardiopulmonary...

background evaluation of operational risk is a consequential goal in perioperative management of patients in cardiac surgery. preoperative total lymphocyte count (ptlc) is a prognostic criterion of adverse major cardiovascular outcomes. objectives the purpose of this study was to investigate the prognostic value of ptlc as an independent predictor of postoperative morbidity and mortality in car...

OBJECTIVE Our objective was to evaluate the change in lactate level during cardiopulmonary bypass and the possible predictive value in identifying patients at high risk of morbidity and mortality after surgery for congenital cardiac disease. METHODS We prospectively studied lactate levels in 174 nonconsecutive patients undergoing cardiopulmonary bypass during operations for congenital cardiac...

BACKGROUND Pulmonary dysfunction is a known complication after cardiac surgery using cardiopulmonary bypass, ranging from subclinical functional changes to prolonged postoperative ventilation, acute lung injury, and acute respiratory distress syndrome. Whether human pulmonary arterial function is compromised is unknown. The aim of the present study was to compare the structure and function of i...

OBJECTIVE Oxidative stress contributes to myocardial ischemia-reperfusion injury. We hypothesized that administration of the antioxidant N-acetylcysteine would have beneficial effects on myocardial function after cardiopulmonary bypass and cardioplegic arrest. METHODS Anesthetized dogs (n = 18) were instrumented with myocardial ultrasonic crystals and a left ventricular micromanometer. Systol...

A comparison of the levels of serum epinephrine, norepinephrine and blood pressure was made in 25 patients undergoing aorta-coronary bypass or valve replacement who were anaesthetized with a nitrous oxide-narcotic technique. Serum epinephrine and norepinephrine were measured in arterial samples drawn pre-induction, post-induction, before cardiopulmonary bypass, two and eight minutes after initi...

OBJECTIVES Mitogen-activated protein kinases (MAPK) are important intermediates in the signal transduction pathways involved in neuronal dysfunction following cerebral ischemia-reperfusion injury. One subfamily, extracellular regulated kinase 1/2, has been heavily implicated in the pathogenesis of post-ischemic neuronal damage. However, the contribution of extracellular regulated kinase 1/2 to ...

severe inflammation after cardiopulmonary bypass with the vasculitis of the acral extremity and vertebro-basilar arterial system leads to the locked-in syndrome and blue toe syndrome. in broad terms, systemic, idiopathic, and environmental factors provoke syndromes that present with digital discoloration or the blue toe syndrome. painful digital discoloration, accompanied by ulceration, suggest...