An An Open-Label, Single Center, Retrospective Study to Evaluate Clinical Outcomes with Surgical Sealant in Bentall Procedures: A Cohort Study.

BACKGROUND: Cardiovascular surgery is associated with substantial risk for postoperative bleeding with increased patient morbidity and mortality. Numerous intraoperative techniques have been utilized to reduce this risk. This study was to assess postoperative bleeding-related parameters following Bentall procedures and to examine the impact of intraoperative surgical sealant application. METHOD: The medical/surgical records of 100 consecutive Bentall procedure cases were examined retrospectively for perioperative surgical sealant use and postoperative bleeding-related outcomes. RESULTS: Of the 100 patient cases, three died during the postoperative period, and 97 were evaluable. Surgical sealant was utilized in 56 patient cases (57.8%). The utilization versus no utilization of surgical sealant was associated with significant reductions in most postoperative bleeding-related parameters, including less drainage (P = .028), resternotomy for hemorrhage (P = .036), transfusion of red blood cells (P = .022 at 48 hours; P = .027 total in-hospital), transfusion of fresh frozen plasma (P = .04 at 48 hours; P = .004 total in-hospital), and a higher percentage of cases not needing blood transfusion (P = .002). The surgical sealant group had longer cardiopulmonary bypass circuit (P = .016) and aortic cross-clamp time (P = .001), with no significant between-group differences in intubation time (P = .636) or intensive care unit duration (P = .294). When excluding urgent cases or Stanford type A aortic dissections, intensive care unit duration significantly was shorter in the surgical sealant group (P = .017). Surgical sealant use was not associated with any adverse events. CONCLUSION: The application of surgical sealant to the anastomosis suture line in Bentall procedures reduces postoperative drainage, bleeding, and transfusion utilization. Further studies are warranted to investigate these benefits in prospective, randomized clinical trials.

[Desorption behaviors of 4-nitrophenol on hyper-cross-linked polymer resin NDA-701].

Desorption behaviors of loaded 4-nitrophenol (4-NP) on hyper-cross-linked polymer resin NDA-701 were studied. The molar ratio of NaOH and 4-NP desorbed (M(NAOH/4-NP)) selection experiments were carried out at two different reaction temperature(303 K and 333 K). Desorption kinetics characteristic of4-NP on NDA-701 in the batch and fixed-bed mode were examined at different reaction temperature and M(NaOH/4-NP) values. The results showed that optimal M(NaOH/4-NP) values were 1.2 and 100% 4-NP could be desorbed from NDA-701 at two different temperature. When the M(NaOH/4-NP) was lower than 1.2, the desorption efficiency increases with the increase of temperature, but the function of temperature decrease with increasing of M(NaH/4-NP) values for desorption ratio. The information indicated that desorption thermodynamic characteristic of NDA-701 was controlled by M(NaOH/4-NP) values. Desorption kinetics in the alkaline system can be well described by pseudo-second-order kinetic model, and desorption rate is increased with the increase of desorption temperatures, the k2 value increase from 0.010 g x (mmol x min)(-1) to 0.035 g x (mmol x min)(-1) when desorption temperature increase from 303 K to 333 K. Nevertheless, higher M(NaOH/4-NP) values could not promote desorption rate if only M(NaOH/4-NP) value was larger than the optimal molar ratio of NaOH and 4-NP. When M(NaOH/4-NP) values increase from 1.2 to 5.0, the k2 value increase from 0.038 g x (mmol x min)(-1) to 0.044 g x (mmol x min)(-1) merely at 333 K. the results indicated that desorption kinetic characteristic of NDA-701 was controlled by temperature. NDA-701 can be completely recovered using 2 times Bed Volume of 2% NaOH solution at the temperature of 333 K, comparing with field application, implying that more energy and cost can be saved in comparison with the actual desorption process in the industry.