Abstract
Between December 1998 and December 2001, circulatory support (CS) was used in seven patients submitted to cardiac surgery in our institution. The sample was composed of seven patients whose age varied from 32 to 78 years old (mean 51.85 years), and there were five male and two female patients. Coronary artery bypass grafting was performed in six patients and mitral valve replacement in one. Four patients presented failure of one ventricle and three had failure of both ventricles in the immediate postoperative period. The system most commonly used was the Bio-pump® centrifugal pump, used in all cases; in one case biventricular support with the Bio-pump was changed after 48 hours to a biventricular DAV-InCor® system (temporary pulsatile ventricular assist device). Intra-aortic balloon pumping was used as secondary support in four cases with the aim of delivering a pulsatile flow. The mean support time was 51 hours and 38 min/patient, the shortest time was 4 hours and 6 min, and the longest was 151 hours and 20 min. There were five deaths during CS and the cause of them all was multiple organ failure. Two patients were discharged from CS (28% removal), one was bridged to emergency heart transplant and the other recovered ventricle function (bridge to recovery). The patient bridged to recovery is now in 12 months of followup, and in New York Heart Association class II. Although the mortality index is still high (86%), we were able to bridge 28% of the patients to a more definitive treatment or status (transplant or recovery). The overall survival was 14%, but long-term survival of bridged patients is 50% and we expect to increase it in the near future. Table 1
Highlights
Cardiac surgery with cardiopulmonary bypass (CPB) is a recognized trigger of systemic inflammatory response, usually related to postoperative acute lung injury (ALI)
In 14 patients, bone marrow was harvested from iliac crest and Bone marrow-derived mononuclear cell (BM-MNC) were selected by Ficoll gradient
The objective was to evaluate the characteristics of Chest pain (CP) in patients with acute aortic dissection (AAD) admitted in a chest pain unit (CPU)
Summary
Cardiac surgery with cardiopulmonary bypass (CPB) is a recognized trigger of systemic inflammatory response, usually related to postoperative acute lung injury (ALI). Few studies exist analysing the handling of acute respiratory insufficiency with invasive mechanical ventilation (IMV) and its correlation with mortality among the elderly intensive care unit (IUC) patient population. In Brazil, most patients with TBI are managed in general ICUs. The results of the treatment of patients admitted to nonspecialized ICUs must be compared with those obtained in neurosurgical ICUs. An acute confusional state (ACS) has been a frequent finding in patients undergoing cardiac surgery (CS), which, according to the literature, has resulted in a greater number of complications and in an increase in hospitalization and length of stay in the intensive care unit (ICU). The mortality of elderly patients who are admitted to intensive care units (ICU) has been the aim of some recent studies. Drugs that modulate such phenotypic alterations may be useful in the control of these and other clinical situations
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
