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1.
Wiad Lek ; 60(1-2): 10-4, 2007.
Artículo en Polaco | MEDLINE | ID: mdl-17607962

RESUMEN

We observed acute, postoperative renal failure requiring dialysis in 33 patients from the entire group of adult patients who received cardiac surgery in 2004 in The Silesian Center for Heart Diseases in Zabrze. Over 50% of these were qualified for emergency operation. During the early postoperative period all of the examined patients had cardiac failure and circulatory insufficiency requiring high doses of catecholamine and intraaortic balloon pump support. In the analyzed group of patients the frequency of multi-organ failure was high (neurologic dysfunction, the need for prolonged mechanical ventilation, mesenteric ischemia). Hemodiafiltration was used as a renal replacement therapy with the dialisate volume not exceeding 11/h. The volume of ultrafiltrate was regulated on the basis of fluid overload and directed to optimize intravascular filling. The average start of hemofiltration was the 3rd postoperative day and was continued for 5 days. The mortality rate in the analyzed group was 81.8%. The renal function substitution based on hemodiafiltration performed in the way described above is easy to start, easy to manage, generates low costs, nevertheless its efficacy is low.


Asunto(s)
Lesión Renal Aguda/etiología , Lesión Renal Aguda/terapia , Procedimientos Quirúrgicos Cardíacos/efectos adversos , Procedimientos Quirúrgicos Cardíacos/mortalidad , Hemodiafiltración , Lesión Renal Aguda/mortalidad , Anciano , Femenino , Cardiopatías/cirugía , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Insuficiencia Multiorgánica/etiología , Insuficiencia Multiorgánica/mortalidad , Insuficiencia Multiorgánica/prevención & control , Polonia , Complicaciones Posoperatorias/mortalidad , Análisis de Regresión , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia
2.
Med Wieku Rozwoj ; 10(4): 1055-65, 2006.
Artículo en Polaco | MEDLINE | ID: mdl-17426372

RESUMEN

UNLABELLED: THE AIM of the study was to show first results of newborn life threatening respiratory failure treatment with extracorporeal membrane oxygenation (ECMO) in Poland. MATERIAL: Nine newborns were treated with extracorporeal membrane oxygenation in Silesian Center for Heart Diseases. Newborns were born in 38 week of gestational age (36-41 weeks) with mean birth weight of 3490 g. Reasons for the referral were: meconium aspiration syndrome, infection, and pulmonary hypertension. Each newborn fulfilled an Extracorporeal Life Support Organization (ELSO) criteria for extracorporeal membrane oxygenation. RESULTS: seven out of nine of patients treated with extracorporeal membrane oxygenation survived. Full clinical stabilization was reached about 6th hour of treatment. Mean extracorporeal oxygenation time was 162 hours. For eight newborns veno-venous method was applied and for one newborn veno-arterial method. Roller pump was used in 7 cases and centrifugal pomp in one case. Five newborns had uneventful treatment. During extracorporeal membrane oxygenation therapy we have observed several complications: PDA, hemorrhagic complications, renal failure, arterial hypertension, septicemia, tubing rupture. CONCLUSIONS: extracorporeal oxygenation is an effective method of treatment for newborn life threatening respiratory failure. Obtained results do not differ much from Extracorporeal Life Support Organization register results. The most essential problem for extracorporeal membrane oxygenation therapy is correct qualification, early referral, safe transportation as well as the development of centers providing ECMO treatment.


Asunto(s)
Oxigenación por Membrana Extracorpórea , Insuficiencia Respiratoria/terapia , Peso al Nacer , Femenino , Edad Gestacional , Humanos , Recién Nacido , Infecciones/complicaciones , Infecciones/terapia , Masculino , Síndrome de Aspiración de Meconio/terapia , Oxígeno/uso terapéutico , Síndrome de Circulación Fetal Persistente/complicaciones , Síndrome de Circulación Fetal Persistente/terapia , Polonia , Insuficiencia Respiratoria/etiología , Resultado del Tratamiento
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