Cold agglutinins are of unique relevance in cardiac surgerybecause of the use of hypothermic cardiopulmonary bypass (CPB). Cold autoimmune diseases are defined by the presence of abnormal circulating proteins (usually IgM or IgA antibodies) that agglutinate in response to a decrease in body temperature. These disorders include cryoglobulinemia and cold hemagglutinin disease.Immunoglobulin M aut...

Twenty-four patients undergoing cardiopulmonary bypass have been studied and the work of respiration was measured (1) before the incision, (2) before bypass with the thorax open, (3) after bypass, and (4) after suturing of the incision. Our results indicate that moving the thoracic wall requires 10 to 14% of the respiratory work and that little change occurs as a consequence of cardiopulmonary ...

BACKGROUND There is no consensus on which lung-protective strategies should be used in cardiac surgery patients. Sparse and small randomized clinical and animal trials suggest that maintaining mechanical ventilation during cardiopulmonary bypass is protective on the lungs. Unfortunately, such evidence is weak as it comes from surrogate and minor clinical endpoints mainly limited to elective cor...

BACKGROUND Activation of neutrophil adhesion molecules and subsequent neutrophil adhesion to vascular endothelium are key events initiating inflammatory organ dysfunction after cardiopulmonary bypass and ischemic reperfusion. OBJECTIVES We sought to characterize neutrophil integrin CD11b and L-selectin activation associated with coronary artery bypass graft surgery and to determine whether ne...

OBJECTIVE Operations coupled with cardiopulmonary bypass may provoke a systemic inflammatory response, and it has been suggested that this responses causes capillary leakage of proteins, edema formation, and even organ failure. However, capillary leak syndrome is mainly a clinical diagnosis and has not been verified as yet by actual demonstration of protein leakage from the circulation. We have...

is book aims at providing an ‘easily readable source of material for the everyday practice of clinical perfusion’. Th e information included should interest both newcomers to perfusion and also more experienced perfusion ists, anesthesiologists and surgeons. Th is 207-pages work includes 15 chapters, is well illustrated and contains a lot of tables and interesting diagrams. Th e fi rst chapters...

ethods: Male Sprague–Dawley rats were divided into four groups (each n 6): ham group, cardiopulmonary bypass group, and two N-acetylcysteine–treated ardiopulmonary bypass groups (bolus doses of 200 and 500 mg/kg in cardiopulonary bypass prime). Blood samples were collected at the beginning of cardioulmonary bypass, at the cessation of cardiopulmonary bypass, and at 2 and 12 ostoperative hours. ...

Heparin, a polyanionic glycosaminoglycan, is used routinely prior to the induction of cardiopulmonary bypass. Earlier observations in our laboratory suggested that the postoperative bleeding which occurs, despite neutralization of heparin with prdtamine, is secondary to hypothermia and dilutional anemia during bypass. An additional, potential mechanism for excessive bleeding following cardiopul...

BACKGROUND AND PURPOSE High-intensity transient signals (HITS) are the transcranial Doppler representation of both air and solid cerebral emboli. We studied the frequency of HITS associated with different surgical maneuvers during cardiopulmonary bypass for coronary artery bypass graft surgery and their association with postoperative cognitive dysfunction (POCD). METHODS We combined 356 patie...

Cardiopulmonary bypass suppresses circulating thyroid hormone levels. Although acute triiodothyronine repletion has been evaluated in adult patients after cardiopulmonary bypass, triiodothyronine pharmacokinetics and effects have not previously been studied in infants undergoing operations for congenital heart disease. We hypothesized that triiodothyronine deficiency in the developing heart aft...