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1.
Thorac Cardiovasc Surg ; 55(2): 89-93, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17377860

RESUMO

BACKGROUND: We aimed to show the impact of leukodepletion on renal function in patients undergoing on-pump coronary revascularization. PATIENTS AND METHODS: Fifty patients awaiting elective on-pump coronary revascularization with normal preoperative cardiac functions and with plasma creatinine levels ranging between 1.5 and 2.0 mg/dL were prospectively randomized into two groups: on-pump CABG with (group A: n = 25) and without leukodepletion (group B, n = 25). Renal glomerular and tubular injury were assessed by urinary alpha glutathione s-transferase (GST), plasma creatinine, and blood urea nitrogen (BUN) levels. RESULTS: The patients consisted of 14 females and 36 males with a mean age of 57.6 +/- 5.3 years. In the leukodepletion group, the mean levels of creatinine, BUN and urinary GST were found to be decreased on the first, third and fifth postoperative days compared with the control group. There was no mortality. Three patients in the control group needed postoperative dialysis. CONCLUSION: Patients with renal dysfunction undergoing on-pump CABG surgery seem to benefit from leukodepletion as a measure to prevent tubular damage and renal impairment compared with a control group.


Assuntos
Injúria Renal Aguda/prevenção & controle , Ponte de Artéria Coronária , Doença das Coronárias/cirurgia , Procedimentos de Redução de Leucócitos , Injúria Renal Aguda/epidemiologia , Injúria Renal Aguda/etiologia , Injúria Renal Aguda/metabolismo , Injúria Renal Aguda/fisiopatologia , Idoso , Análise de Variância , Biomarcadores/sangue , Biomarcadores/urina , Nitrogênio da Ureia Sanguínea , Ponte de Artéria Coronária/métodos , Creatinina/sangue , Feminino , Glutationa Transferase/urina , Humanos , Incidência , Isoenzimas/urina , Masculino , Pessoa de Meia-Idade , Período Pós-Operatório , Potássio/sangue , Estudos Prospectivos , Diálise Renal , Projetos de Pesquisa , Resultado do Tratamento , Turquia , Equilíbrio Hidroeletrolítico
2.
Acta Anaesthesiol Scand ; 51(4): 434-40, 2007 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-17378781

RESUMO

BACKGROUND: We evaluated the role of pre-emptive stellate ganglion block (SGB) in preventing radial artery spasm and increasing radial artery graft patency in patients undergoing off-pump coronary artery bypass surgery. METHODS: In this prospective randomized study, 100 patients were divided into two equal groups (n= 50). In group A, SGB was achieved using 10 ml of ropivacaine and, in group B, SGB was not performed. Radial artery blood flow was measured pre- and intra-operatively. Post-operative clinical determinants (S-T segment elevation, use of inotropic agents, incidence of atrial fibrillation) were recorded. Early coronary angiography was performed. RESULTS: According to blood flowmeter measurements, the radial artery blood flow was significantly increased in patients with SGB. The incidence of atrial fibrillation, the need for inotropic agents and S-T segment elevation were all decreased in the SGB group. Angiographic intervention revealed that the incidence of graft spasm was also lower in the SGB group. CONCLUSION: Pre-emptive SGB is an effective method for increasing radial artery blood flow and preventing radial artery spasm. Complications related to radial artery spasm may be decreased and patients may have a more comfortable post-operative period with this method.


Assuntos
Ponte de Artéria Coronária/métodos , Bloqueio Nervoso/métodos , Artéria Radial/efeitos dos fármacos , Gânglio Estrelado/efeitos dos fármacos , Grau de Desobstrução Vascular/efeitos dos fármacos , Amidas/administração & dosagem , Análise de Variância , Anestésicos Locais/administração & dosagem , Doença das Coronárias/cirurgia , Vasoespasmo Coronário/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Estudos Prospectivos , Artéria Radial/diagnóstico por imagem , Artéria Radial/transplante , Radiografia , Fluxo Sanguíneo Regional/efeitos dos fármacos , Ropivacaina
3.
Pediatr Cardiol ; 26(6): 843-5, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15690232

RESUMO

Glanzmann thrombasthenia is a rare, hereditary, congenital disorder of platelet function characterized by inappropriate bleeding that is difficult to control. Recombinant activated factor VII (rFVIIa) is a new treatment that is used to stop bleeding and provide surgical support for these patients. This report describes the use of rFVIIa to prevent serious bleeding during and after open-heart surgery in a child with Glanzmann thrombasthenia.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Coagulantes/uso terapêutico , Fator VII/uso terapêutico , Cardiopatias Congênitas/cirurgia , Trombastenia/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Criança , Fator VIIa , Humanos , Masculino , Proteínas Recombinantes/uso terapêutico , Trombastenia/tratamento farmacológico
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