Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 47.728
Filtrar
3.
Zhongguo Yi Liao Qi Xie Za Zhi ; 45(1): 37-41, 2021 Feb 08.
Artigo em Chinês | MEDLINE | ID: mdl-33522174

RESUMO

This paper introduced a liver normothermic machine perfusion repair and assessment system. This system consists of a liver normothermic machine perfusion device, a fluorescence imaging system and a tissue oxygen detector. The normothermic machine perfusion device can continuously perfuse the donor liver and monitor and control the perfusion parameters in real time. The fluorescence imaging system can detect the indocyanine green metabolized by the liver to evaluate the microcirculation and the metabolism function of hepatocytes. The tissue oxygen detector can monitor the change of oxygen partial pressure of liver tissue in real time to evaluate the state of cell oxygen consumption.


Assuntos
Transplante de Fígado , Humanos , Fígado , Doadores Vivos , Preservação de Órgãos , Perfusão
4.
Eur J Med Res ; 26(1): 15, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33546770

RESUMO

BACKGROUND: Hypothermic machine perfusion (HMP) improves the quality of donor livers for transplantation, both in animal models and in clinical practice. Treatment with SP600125, an inhibitor of c-Jun N-terminal kinase (JNK), can suppress the JNK signaling pathway to alleviate donor liver ischemia-reperfusion injury (IRI). We performed the present study with the objective of exploring the protective effects exerted by a combination of HMP and SP600125 on liver xenograft viability for donation after cardiac death (DCD) in a porcine model. METHODS: 54 adult BAMA mini-pigs were randomly assigned to 5 groups, including sham, cold storage for 4 h (CS 4 h), CS 4 h + SP600125, CS 2 h + HMP 2 h, and CS 2 h + HMP 2 h + SP600125 groups. Donor livers in the CS 4 h and CS 4 h + SP600125 groups were conventionally cold preserved for 4 h, whereas donor livers in the CS 2 h + HMP 2 h and CS 2 h + HMP 2 h + SP600125 groups were cold preserved for 2 h and then treated with HMP for 2 h. The preservation and perfusion solutions contained SP600125 (20 µM). Follow-up was conducted for 5 days after liver transplantation to compare the surgical outcomes by means of serological examination, pathological results, and survival rate. RESULTS: The most satisfactory outcome after liver transplantation was observed in the CS 2 h + HMP 2 h + SP600125 group, which presented with minimal damage of donor livers during 5 days' follow-up. Additionally, serological examination, pathological results, and survival rate concurred in showing better results in the CS 2 h + HMP 2 h ± SP600125 group than in the CS 4 h ± SP600125 group. CONCLUSION: HMP in combination with SP600125 has hepatoprotective properties and improves the quality and viability of porcine livers collected after DCD, thus improving prognosis after liver transplantation.


Assuntos
Aloenxertos/efeitos dos fármacos , Antracenos/farmacologia , Transplante de Fígado , Preservação de Órgãos/métodos , Perfusão/métodos , Animais , Temperatura Baixa , Morte , Modelos Animais de Doenças , Traumatismo por Reperfusão/prevenção & controle , Suínos , Porco Miniatura
5.
J Vis Exp ; (167)2021 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-33491673

RESUMO

The aim of this study was to examine the distribution and origin of the calcitonin gene-related peptide (CGRP)-immunoreactive sensory nerve fibers of the cranial dura mater using immunofluorescence, three-dimensional (3D) reconstruction and retrograde tracing technique. Here, the nerve fibers and blood vessels were stained using immunofluorescence and histochemistry techniques with CGRP and fluorescent phalloidin, respectively. The spatial correlation of dural CGRP-immuoreactive nerve fibers and blood vessels were demonstrated by 3D reconstruction. Meanwhile, the origin of the CGRP-immunoreactive nerve fibers were detected by neural tracing technique with fluorogold (FG) from the area around middle meningeal artery (MMA) in the cranial dura mater to the trigeminal ganglion (TG) and cervical (C) dorsal root ganglia (DRGs). In addition, the chemical characteristics of FG-labeled neurons in the TG and DRGs were also examined together with CGRP using double immunofluorescences. Taking advantage of the transparent whole-mount sample and 3D reconstruction, it was shown that CGRP-immunoreactive nerve fibers and phalloidin-labeled arterioles run together or separately forming a dural neurovascular network in a 3D view, while the FG-labeled neurons were found in the ophthalmic, maxillary, and mandibular branches of TG, as well as the C2-3 DRGs ipsilateral to the side of tracer application in which some of FG-labeled neurons presented with CGRP-immunoreactive expression. With these approaches, we demonstrated the distributional characteristics of CGRP-immunoreactive nerve fibers around the blood vessels in the cranial dura mater, as well as the origin of these nerve fibers from TG and DRGs. From the perspective of methodology, it may provide a valuable reference for understanding the complicated neurovascular structure of the cranial dura mater under the physiological or pathological condition.


Assuntos
Peptídeo Relacionado com Gene de Calcitonina/metabolismo , Dura-Máter/metabolismo , Neurônios/metabolismo , Animais , Dura-Máter/irrigação sanguínea , Fluorescência , Imunofluorescência , Gânglios Espinais/metabolismo , Masculino , Perfusão , Faloidina/metabolismo , Ratos Sprague-Dawley , Células Receptoras Sensoriais/metabolismo , Estilbamidinas/metabolismo , Gânglio Trigeminal/metabolismo
9.
Am J Vet Res ; 82(2): 99-104, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33480277

RESUMO

OBJECTIVE: To determine the median time to maximum concentration (tmax) of amikacin in the synovial fluid of the tarsocrural joint following IV regional limb perfusion (IVRLP) of the drug in a saphenous vein of horses. ANIMALS: 7 healthy adult horses. PROCEDURES: With each horse sedated and restrained in a standing position, a 10-cm-wide Esmarch tourniquet was applied to a randomly selected hind limb 10 cm proximal to the point of the tarsus. Amikacin sulfate (2 g diluted with saline [0.9% NaCl] solution to a volume of 60 mL) was instilled in the saphenous vein over 3 minutes with a peristaltic pump. Tarsocrural synovial fluid samples were collected at 5, 10, 15, 20, 25, and 30 minutes after completion of IVRLP. The tourniquet was removed after collection of the last sample. Amikacin concentration was quantified by a fluorescence polarization immunoassay. Median maximum amikacin concentration and tmax were determined. RESULTS: 1 horse was excluded from analysis because an insufficient volume of synovial fluid for evaluation was obtained at multiple times. The median maximum synovial fluid amikacin concentration was 450.5 µg/mL (range, 304.7 to 930.7 µg/mL), and median tmax was 25 minutes (range, 20 to 30 minutes). All horses had synovial fluid amikacin concentrations ≥ 160 µg/mL (therapeutic concentration for common equine pathogens) at 20 minutes after IVRLP. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that, in healthy horses, maintaining the tourniquet for 20 minutes after IVRLP of amikacin in a saphenous vein was sufficient to achieve therapeutic concentrations of amikacin in the tarsocrural joint.


Assuntos
Amicacina , Preparações Farmacêuticas , Animais , Antibacterianos , Membro Anterior , Cavalos , Perfusão/veterinária , Líquido Sinovial
11.
Acad Radiol ; 28(1): e1-e13, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32220550

RESUMO

Computed Tomography (CT) has long been regarded as a purely anatomical imaging modality. Recent advances on CT technology and Contrast Agents (CA) in both clinical and preclinical cardiac imaging offer opportunities for the use of CT in functional imaging. Combined with modern ECG-gating techniques, functional CT has now become a reality allowing a comprehensive evaluation of myocardial global and regional function, perfusion and coronary angiography. This article aims at reviewing the current status of cardiac CT perfusion and micro-CT perfusion with established and experimental scanners and contrast agents, from clinical practice to the experimental domain of investigations based on animal models of heart diseases.


Assuntos
Doença da Artéria Coronariana , Imagem de Perfusão do Miocárdio , Animais , Angiografia por Tomografia Computadorizada , Meios de Contraste , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Coração/diagnóstico por imagem , Humanos , Perfusão , Tomografia Computadorizada por Raios X
12.
Anaesthesia ; 76(1): 54-60, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32592515

RESUMO

Pre-operative anaemia (haemoglobin < 13.0 g.dl-1 ) is a modifiable peri-operative risk-factor. This is screened for using formal laboratory testing. A non-invasive finger-probe sensor that can accurately measure haemoglobin is a possible alternative. This study considers the accuracy of non-invasive haemoglobin measurement using the Rad-67™ Rainbow (Masimo Corp., Irvine, CA, USA) compared with formal laboratory testing and its usefulness in detecting pre-operative anaemia. A total of 392 patients had measurements taken for non-invasive haemoglobin and perfusion index values using the Rad-67 Rainbow, alongside further peri-operative parameters and a formal laboratory haemoglobin test. Bland-Altman and sensitivity analysis showed that the limits of agreement between non-invasive and formal laboratory haemoglobin testing were between -1.95 g.dl-1 and 2.23 g.dl-1 (p < 0.001). The overall performance of non-invasive haemoglobin measurement was better in men than women (ROC 91.1% vs. 78.2%) and less biased in men, mean -0.08 (SD 1.09, 95%Cl -0.23-0.07) compared with women (mean 0.38 (SD 0.99, 95%CI 0.24-0.52)). Pre-operative anaemia was more prevalent in women than men (50.3% vs. 14.4%). The sensitivity of non-invasive anaemia detection (haemoglobin < 13 g.dl-1 ) was 66% for women and 52% for men. A non-invasive haemoglobin value of 14.0 g.dl-1 had an overall 91% sensitivity for detecting pre-operative anaemia (82% in men and 93% in women). The Rad-67 Rainbow is inadequate for the estimation of formal laboratory haemoglobin and lacks sensitivity for detecting pre-operative anaemia, especially in women. Further advancement in technology and accuracy is needed before it can be recommended as a routine pre-operative screening test.


Assuntos
Anemia/diagnóstico , Hemoglobinometria/métodos , Oximetria/métodos , Cuidados Pré-Operatórios/métodos , Adulto , Idoso , Anemia/epidemiologia , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Perfusão , Estudos Prospectivos , Curva ROC , Fatores Sexuais
13.
J Extra Corpor Technol ; 52(4): 261-265, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33343027

RESUMO

Continuous all-region perfusion has the potential to reduce total body ischemia during the Norwood procedure. This technique involves placing cannulas in the innominate artery, descending aorta, and native aortic root, thus providing continuous flow to the whole body at mild hypothermia (32-34°C) during the entire operation. However, the cannulation strategy in this approach must be optimized to achieve adequate flow rates to all vascular beds. To ensure appropriate blood flow rates to three cannulas of different caliber supplied by two inflow pumps, a benchtop evaluation of comparative flow rates through branched cannulas with variable independent perfusion pressures was conducted. Two isolated vertical columns with outlets at 10 mmHg intervals to allow for adjustable perfusion pressures were filled with expired banked packed red blood cells and fresh frozen plasma. The main arterial line was bifurcated with an 8-Fr arterial cannula inserted at the base of one column and a 4-mm (outside diameter [OD]) olive tip cannula inserted at the base of the other column. Flow rates were measured on each branch of the »â€³ arterial lines. Under experimental cardiopulmonary bypass (CPB) perfusion pressures of 30-50 mmHg on the 8-Fr arterial cannula column, the branched olive tip cannula accommodated less than 25% of total flow at total flow rates of 50-700 mL/min. This fraction is insufficient to sustain adequate lower body perfusion. However, the olive tip flow fraction was found to be sufficient for coronary blood flow (5-20 mL/kg/min) when olive tip perfusion pressures close to average neonatal diastolic blood pressures (20-60 mmHg) were tested. For all-region perfusion during the Norwood operation, primary CPB arterial flow should be divided to the head and coronary circulation with an independent pump delivering flow to the descending aorta. This should avoid cerebral over-circulation and insufficient flow to the lower body.


Assuntos
Ponte Cardiopulmonar , Procedimentos de Norwood , Aorta , Cateterismo , Perfusão
14.
J Extra Corpor Technol ; 52(4): 303-313, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33343033

RESUMO

Ex situ heart perfusion (ESHP) has proven to be an important and valuable step toward better preservation of donor hearts for heart transplantation. Currently, few ESHP systems allow for a convenient functional and physiological evaluation of the heart. We sought to establish a simple system that provides functional and physiological assessment of the heart during ESHP. The ESHP circuit consists of an oxygenator, a heart-lung machine, a heater-cooler unit, an anesthesia gas blender, and a collection funnel. Female Yorkshire pig hearts (n = 10) had del Nido cardioplegia (4°C) administered, excised, and attached to the perfusion system. Hearts were perfused retrogradely into the aortic root for 2 hours before converting the system to an isovolumic mode or a working mode for further 2 hours. Blood samples were analyzed to measure metabolic parameters. During the isovolumic mode (n = 5), a balloon inserted in the left ventricular (LV) cavity was inflated so that an end-diastolic pressure of 6-8 mmHg was reached. During the working mode (n = 5), perfusion in the aortic root was redirected into left atrium (LA) using a compliance chamber which maintained an LA pressure of 6-8 mmHg. Another compliance chamber was used to provide an afterload of 40-50 mmHg. Hemodynamic and metabolic conditions remained stable and consistent for a period of 4 hours of ESHP in both isovolumic mode (LV developed pressure: 101.0 ± 3.5 vs. 99.7 ± 6.8 mmHg, p = .979, at 2 and 4 hours, respectively) and working mode (LV developed pressure: 91.0 ± 2.6 vs. 90.7 ± 2.5 mmHg, p = .942, at 2 and 4 hours, respectively). The present study proposed a novel ESHP system that enables comprehensive functional and metabolic assessment of large mammalian hearts. This system allowed for stable myocardial function for up to 4 hours of perfusion, which would offer great potential for the development of translational therapeutic protocols to improve dysfunctional donated hearts.


Assuntos
Transplante de Coração , Animais , Feminino , Coração , Humanos , Miocárdio , Perfusão , Suínos , Doadores de Tecidos
15.
J Extra Corpor Technol ; 52(4): 332-336, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33343037

RESUMO

Early iterations of the Norwood procedure used aortic cross-clamping, myocardial arrest, and, sometimes, deep hypothermic circulatory arrest. The resulting hypothermia and prolonged ischemia caused frequent cardiac, neurologic, renal, and other end-organ dysfunctions. Our group describes a novel technique, sustained total all-region (STAR) perfusion, which circumvents these issues by providing continuous perfusion to the head, heart, and coronaries at temperatures of 32-34°C. A single DLP® straight venous cannula (Medtronic, Minneapolis, MN) is placed in the right atrium, and a DLP® pediatric arterial cannula, with a high-flow stopcock attached, is placed in the ascending aorta or innominate artery to provide flow to the head. A cardioplegia needle with walrus tubing is connected to the stopcock to provide flow to the coronary arteries. For lower body perfusion, an olive tip cannula is placed into the descending aorta lumen and attached to the 1/8″ line from the cardioplegia system which provides warm arterial blood flow. STAR perfusion allows the Norwood procedure to be completed with mild hypothermia and continuous perfusion to all vascular beds with reduced cardiopulmonary bypass as well as total operative times. This technique is successfully achieved with minimal changes to circuitry, minor modifications to heart-lung machine servoregulation and few additional cannulation disposables.


Assuntos
Ponte Cardiopulmonar , Parada Cardíaca Induzida , Aorta , Aorta Torácica , Cateterismo , Criança , Humanos , Perfusão
16.
Magy Seb ; 73(4): 153-159, 2020 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-33310918

RESUMO

Összefoglaló. A thoracoabdominalis aorta kirekesztése a gerincvelo keringésének csökkenését okozza. Az ischemia klinikailag paraparesis, paraplegia formájában jelenik meg. Ez elsosorban nyitott mutétek során jelent aligha kiszámítható szövodményt, de a modern endovascularis technikák sem oldották meg teljes mértékben ennek biztonságos kivédését - bár arányát jelentosen mérsékelték. A javuló eredmények számos tényezore vezethetok vissza, mint a keringés kirekesztési idejének csökkentése, a gerincvelo-funkció és metabolismus ellenorzése. Mesterséges keringésjavító direkt és indirekt eljárások, liquor drainage, hutés mellett a collateralis keringés javítását szolgáló prekondicionáló módszerek kerültek bevezetésre. Kísérletes munkánkban 25-30 kg testsúlyú kutyákon vizsgáltuk - más paraméterek mellett - a distalis perfusio növelésének, a liquornyomás csökkentésének, illetve ezek kombinációjának protektív hatását egyórás thoracoabdominalis aortakirekesztés során. Dolgozatunkban a kísérleti állataink neurológiai végállapotát a keringési paraméterek és szöveti perfusio és a reperfusio változásainak összefüggésein keresztül tárgyaljuk. Megállapítottuk, hogy distalis gerincvelo reperfusiós hyperaemiája szorosan összefügg a neurológiai károsodás mértékével. Summary. Clamping of the thoracoabdominal aorta reduces perfusion of the spinal cord significantly, which clinically may present as paraparesis or paraplegia - devastating and unpredictable complications of open thoracoabdominal aortic surgery. Introduction of monitoring of evoked potentials and/or biochemical markers, methods increasing distal arterial pressure, indirect procedures enhancing residual flow (like liquor drainage), drugs, and use of hypothermia contributed to achieve better outcome. Preconditioning of spinal cord circulation is also a promising method. New endovascular techniques for thoracoabdominal aortic aneurysms and dissections reduced surgical trauma significantly. Despite all these progressions spinal cord ischemic damage is still a significant risk. To address this problem we carried out an experimental work using a canine model focusing on the protective effect of distal arterial perfusion, spinal fluid drainage, and their combination in a one hour setting of thoracoabdominal aortic clamping. In this paper we publish our data of circulatory and specific perfusion parameters of the spinal cord during and after declamping in correlation of final neurologic outcome.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Aneurisma da Aorta Torácica/cirurgia , Procedimentos Endovasculares/métodos , Isquemia/cirurgia , Paraplegia/complicações , Medula Espinal/cirurgia , Animais , Constrição , Cães , Perfusão , Medula Espinal/irrigação sanguínea
17.
J Extra Corpor Technol ; 52(4): 319-326, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33343035

RESUMO

The development of standards and guidelines by professional societies offers clinicians guidance toward providing evidence-based care. The ultimate goals of standards and guidelines are to standardize care and improve patient safety and outcomes while also minimizing risk. The American Society of ExtraCorporeal Technology (AmSECT) currently offers perfusionists several clinical resources, primarily the Standards and Guidelines for Perfusion Practice; however, no document exists specific to pediatric perfusion. Historically, the development of a pediatric-specific document has been limited by available scientific evidence because of smaller patient populations, sample sizes, and variable techniques among congenital perfusionists. In the current setting of evolving clinical practices and increasingly complex cardiac operations, a subcommittee of pediatric perfusionists developed the Standards and Guidelines for Pediatric and Congenital Perfusion Practice. The development process included a comprehensive literature review for supporting evidence to justify new recommendations or updates to the existing AmSECT Adult Standards and Guidelines document. Multiple revisions incorporating feedback from the community led to a finalized document accepted by the AmSECT member and made available electronically in May 2019. The Standards and Guidelines for Pediatric and Congenital Perfusion Practice is an essential tool for pediatric perfusionists, serves as the backbone for institutionally based protocols, promotes improved decision-making, and identifies opportunities for future research and collaboration with other disciplines. The purpose of this article is to summarize the process of development, the content, and recommended utilization of AmSECT's Standards and Guidelines for Pediatric and Congenital Perfusion Practice. AmSECT recommends adoption of the Standards and Guidelines for Pediatric and Congenital Perfusion Practice to reduce practice variation and enhance clinical safety.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Criança , Humanos , Segurança do Paciente , Perfusão , Padrões de Referência , Sociedades Médicas , Estados Unidos
18.
J Vis Exp ; (166)2020 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-33346199

RESUMO

Currently, ex situ machine perfusion is a burgeoning technique that provides a better preservation method for donor organs than conventional static cold preservation (0-4 °C). A continuous blood supply to organs using machine perfusion from procurement and preservation to implantation facilitates complete prevention of ischemia reperfusion injury and permits ex situ functional assessment of donor livers before transplantation. In this manuscript, we provide a step-by-step ischemia-free liver transplantation protocol in which an ex situ normothermic machine perfusion apparatus is used for pulsatile perfusion through the hepatic artery and continuous perfusion of the portal vein from human donor livers to recipients. In the perfusion period, biochemical analysis of the perfusate is conducted to assess the metabolic activity of the liver, and a liver biopsy is also performed to evaluate the degree of injury. Ischemia-free liver transplantation is a promising method to avoid ischemia-reperfusion injury and may potentially increase the donor pool for transplantation.


Assuntos
Transplante de Fígado/efeitos adversos , Traumatismo por Reperfusão/etiologia , Animais , Criopreservação , Humanos , Masculino , Pessoa de Meia-Idade , Preservação de Órgãos , Perfusão , Traumatismo por Reperfusão/patologia , Soluções , Doadores de Tecidos
19.
Nat Commun ; 11(1): 5765, 2020 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-33188221

RESUMO

Lung transplantation remains the best treatment option for end-stage lung disease; however, is limited by a shortage of donor grafts. Ex situ lung perfusion, also known as ex vivo lung perfusion, has been shown to allow for the safe evaluation and reconditioning of extended criteria donor lungs, increasing donor utilization. Negative pressure ventilation ex situ lung perfusion has been shown, preclinically, to result in less ventilator-induced lung injury than positive pressure ventilation. Here we demonstrate that, in a single-arm interventional study (ClinicalTrials.gov number NCT03293043) of 12 extended criteria donor human lungs, negative pressure ventilation ex situ lung perfusion allows for preservation and evaluation of donor lungs with all grafts and patients surviving to 30 days and recovered to discharge from hospital. This trial also demonstrates that ex situ lung perfusion is safe and feasible with no patients demonstrating primary graft dysfunction scores grade 3 at 72 h or requiring post-operative extracorporeal membrane oxygenation.


Assuntos
Transplante de Pulmão , Pulmão/fisiopatologia , Perfusão , Doadores de Tecidos , Respiradores de Pressão Negativa , Adulto , Pressão Sanguínea , Hemodinâmica , Humanos , Pessoa de Meia-Idade , Preservação de Órgãos , Artéria Pulmonar/fisiopatologia , Resultado do Tratamento
20.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(9): 1089-1095, 2020.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33051423

RESUMO

OBJECTIVES: To investigate the effect of cardiopulmonary bypass (CPB) with different perfusion flow on carotid artery blood by using the carotid artery ultrasound. METHODS: Forty-five adult patients during Dec. 2014 to Jan. 2015 scheduled for heart valve replacement or ventricular septal defect repair were randomly divided into 3 groups (n=15) according to different perfusion flow during CPB: A Group 1 [(62±2) mL/(kg·min)], a Group 2 [(72±2) mL/(kg·min)], and a Group 3 [(82±2) mL/(kg·min)]. The diameter of the common carotid artery (CCAD), the peak velocity of the common carotid artery (CCAV),the flow of the common carotid artery (CCAF), the diameter of the internal carotid artery (ICAD), the peak velocity of the internal carotid artery (ICAV) and the flow of the internal carotid artery (ICAF) were measured at the responding time points before the anesthesia induction (T1), after the anesthesia induction (T2), 10 min into CPB (T3), 20 min into CPB (T4), 40 min into CPB (T5), 60 min into CPB(T6), 20 min after CPB ending (T7) by doppler ultrasonography, respectively. The hemoglobin (Hb) and lactic acid were compared at the time before CPB(P1),the time when temperature was decreased to the lowest during CPB (P2), the time when temperature was reheated to 35 ℃ (P3), 20 min after CPB was ended (P4), 2 hours after CPB was ended (P5) by α-steady method. The parameters of CPB and hemodynamic parameters at each time point and postoperative condition were recorded. RESULTS: There was no significant difference in Hb and lactic acid between the three groups (all P>0.05). For intra-group comparison, the Hb concentration at P2-P5 was lower than that at P1 (all P<0.05), and the Hb concentration was the lowest at P2 and P3. The level of lactic acid at P3-P5 was higher than those at P1 (all P<0.05).There were no significant differences in measurement of carotid artery between the left and right sides of the patients at T1 (all P>0.05). There was no significant difference in CCAV and CCAF among the 3 groups (both P>0.05). For intra-group comparison, the CCAV at T2-T6 was significantly lower than that at T1 (P<0.05), and higher at T7 than that at T2-T6 (all P<0.05), but it was still significantly lower than that at T1 (P<0.05). The difference of CCAF between T2-T5 and T1 was significant (all P<0.05). ICAV of G1 was lower than G3 at T3 (P<0.05). ICAV of G1 was lower than G2, and G2 was lower that G3 at T4 (both P<0.05). ICAV of G1 was lower than G2 at T6 (P<0.05). For intra-group comparison, the ICAV at T2 was significantly lower than that at T1 (P<0.05), and that at T3-T6 was significantly lower than that at T1 and T2 (all P<0.05). At T3-T6, ICAF of G1 was lower than that of G3 (all P<0.05). For intra-group comparison, ICAF at T2-T6 was significantly lower than that at T1 (all P<0.05). At T4, perfusion flow was positively correlated with CCAF, ICAV and ICAV (all P<0.05). None of the patients had obvious motor, sensory, or consciousness disturbance, and no neurological complications.There was no significant difference in postoperative hospital stay, postoperative ICU time, and postoperative extubation time among the 3 groups (all P>0.05). CONCLUSIONS: Different perfusion flows of CPB have different effects on carotids hemodynamics.There is correlation between carotids hemodynamics and perfusion flow. Carotid ultrasound examination can be used to evaluate cardiac output.


Assuntos
Ponte Cardiopulmonar , Artérias Carótidas , Adulto , Artérias Carótidas/diagnóstico por imagem , Artéria Carótida Primitiva/diagnóstico por imagem , Artéria Carótida Primitiva/cirurgia , Hemodinâmica , Humanos , Perfusão
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA