scholarly journals Soluble Human Complement Receptor 1 Limits Ischemic Damage in Cardiac Surgery Patients at High Risk Requiring Cardiopulmonary Bypass

Circulation ◽  
2004 ◽  
Vol 110 (11_suppl_1) ◽  
pp. II-274-II-279 ◽  
Author(s):  
H. L. Lazar
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
High Risk ◽  
Complement Receptor ◽  
Ischemic Damage ◽  
Human Complement ◽  
Complement Receptor 1

scholarly journals A human complement receptor 1 polymorphism that reduces Plasmodium falciparum rosetting confers protection against severe malaria

2003 ◽  
Vol 101 (1) ◽  
pp. 272-277 ◽  
Author(s):  
I. A. Cockburn ◽  
M. J. Mackinnon ◽  
A. O'Donnell ◽  
S. J. Allen ◽  
J. M. Moulds ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Severe Malaria ◽  
Complement Receptor ◽  
Human Complement ◽  
Complement Receptor 1

Absence of Beneficial Effect of Acute Normovolemic Hemodilution Combined with Aprotinin on Allogeneic Blood Transfusion Requirements in Cardiac Surgery

2002 ◽  
Vol 96 (2) ◽  
pp. 276-282 ◽  
Author(s):  
Laurent Höhn ◽  
Alexandre Schweizer ◽  
Marc Licker ◽  
Denis R. Morel
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
High Risk ◽  
Blood Transfusion ◽  
Allogeneic Blood ◽  
Surgical Patients ◽  
Control Group ◽  
Acute Normovolemic Hemodilution ◽  
Normovolemic Hemodilution ◽  
Normal Cardiac Function

Background The efficacy of acute normovolemic hemodilution (ANH) in decreasing allogeneic blood requirements remains controversial during cardiac surgery. Methods In a prospective, randomized study, 80 adult cardiac surgical patients with normal cardiac function and no high risk of ischemic complications were subjected either to ANH, from a mean hematocrit of 43% to 28%, or to a control group. Aprotinin and intraoperative blood cell salvage were used in both groups. Blood (autologous or allogeneic) was transfused when the hematocrit was less than 17% during cardiopulmonary bypass, less than 25% after cardiopulmonary bypass, or whenever clinically indicated. Results The amount of whole blood collected during ANH ranged from 10 to 40% of the patients' estimated blood volume. Intraoperative and postoperative blood losses were not different between control and ANH patients (total blood loss, control: 1,411 +/- 570 ml, n = 41; ANH: 1,326 +/- 509 ml, n = 36). Allogeneic blood was given in 29% of control patients (median, 2; range, 1-3 units of packed erythrocytes) and in 33% of ANH patients (median, 2; range, 1-5 units of packed erythrocytes; P = 0.219). Preoperative and postoperative platelet count, prothrombin time, and partial thromboplastin time were similar between groups. Perioperative morbidity and mortality were not different in both groups, and similar hematocrit values were observed at hospital discharge (33.7 +/- 3.9% in the control group and 32.6 +/- 3.7% in the ANH group; nonsignificant) Conclusions Hemodilution is not an effective means to lower the risk of allogeneic blood transfusion in elective cardiac surgical patients with normal cardiac function and in the absence of high risk for coronary ischemia, provided standard intraoperative cell saving and high-dose aprotinin are used.

scholarly journals Elective transfer from cardiopulmonary bypass to centrifugal blood pump support in very high-risk cardiac surgery

2007 ◽  
Vol 133 (2) ◽  
pp. 577-578 ◽  
Author(s):  
Stephen Westaby ◽  
Lognathen Balacumaraswami ◽  
Betsy J. Evans ◽  
Gabriele B. Bertoni ◽  
Xu Y. Jin ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
High Risk ◽  
Blood Pump ◽  
Centrifugal Blood Pump ◽  
Very High

scholarly journals Do continuous forms of intra-operative ultrafiltration enhance recovery after adult cardiac surgery with cardiopulmonary bypass? A protocol for systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Joel Bierer ◽  
David Horne ◽  
Roger Stanzel ◽  
Mark Henderson ◽  
Leah Boulos ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
High Risk ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Inflammatory Syndrome ◽  
Adult Cardiac Surgery

Abstract Background Cardiac surgery with cardiopulmonary bypass (CPB) is associated with a systemic inflammatory syndrome that adversely impacts cardiopulmonary function and can contribute to prolonged postoperative recovery. Intra-operative ultrafiltration during CPB is a strategy developed by pediatric cardiac specialists, aiming to dampen the inflammatory syndrome by removing circulating cytokines and improving coagulation profiles during the cardiac operation. Although ultrafiltration is commonly used in the pediatric population, it is not routinely used in the adult population. This study aims to evaluate if randomized evidence supports the use of continuous intra-operative ultrafiltration to enhance recovery for adults undergoing cardiac surgery with CPB. Methods This systematic review and meta-analysis will include randomized controlled trials (RCT) that feature continuous forms of ultrafiltration during adult cardiac surgery with CPB, specifically assessing for benefit in mortality rates, invasive ventilation time and intensive care unit length of stay (ICU LOS). Relevant RCTs will be retrieved from databases, including MEDLINE, Embase, CENTRAL and Scopus, by a pre-defined search strategy. Search results will be screened for inclusion and exclusion criteria by two independent persons with consensus. Selected RCTs will have study demographics and outcome data extracted by two independent persons and transferred into RevMan. Risk of bias will be independently assessed by the Revised Cochrane Risk-of-Bias (RoB2) tool and studies rated as low-, some-, or high- risk of bias. Meta-analyses will compare the intervention of continuous ultrafiltration against comparators in terms of mortality, ventilation time, ICU LOS, and renal failure. Heterogeneity will be measured by the χ2 test and described by the I2 statistic. A sensitivity analysis will be completed by excluding included studies judged to have a high risk of bias. Summary of findings and certainty of the evidence, determined by the GRADE approach, will display the analysis findings. Discussion The findings of this systematic review and meta-analysis will summarize the evidence to date of continuous forms of ultrafiltration in adult cardiac surgery with CPB, to both inform adult cardiac specialists about this technique and identify critical questions for future research in this subject area. Systematic review registration This systematic review and meta-analysis is registered in PROSPERO CRD42020219309 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020219309). 

scholarly journals Folding and conformational studies on SCR1-3 domains of human complement receptor 1

1996 ◽  
Vol 9 (10) ◽  
pp. 877-884 ◽  
Author(s):  
Nicola S. Clark ◽  
Ian Dodd ◽  
Danuta E. Mossakowska ◽  
Richard A.G. Smith ◽  
Michael G. Gore
Keyword(s):  
Complement Receptor ◽  
Human Complement ◽  
Conformational Studies ◽  
Complement Receptor 1

scholarly journals The effect of SANGUINATE® (PEGylated carboxyhemoglobin bovine) on cardiopulmonary bypass functionality using a bovine whole blood model of normovolemic hemodilution

Perfusion ◽  
2019 ◽  
Vol 35 (1) ◽  
pp. 19-25
Author(s):  
Bryan T Romito ◽  
Mandy M McBroom ◽  
Dawn Bryant ◽  
Jacob Gamez ◽  
Akeel Merchant ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
High Risk ◽  
Blood Transfusion ◽  
Whole Blood ◽  
Oxygen Carrier ◽  
Hemoglobin Concentration ◽  
Arterial Line ◽  
Pump Speed ◽  
Normovolemic Hemodilution

Background: Cardiac surgery using cardiopulmonary bypass carries a high risk of bleeding and need for blood transfusion. Blood administration is associated with increased rates of morbidity and mortality. Perioperatively, strategies are often employed to reduce blood transfusions in high-risk patients or in situations where blood transfusion is contraindicated. Normovolemic hemodilution is a blood conservation technique used during cardiac surgery that involves replacement of blood with fluids. SANGUINATE® (PEGylated carboxyhemoglobin bovine) is a novel hemoglobin-based oxygen carrier that can deliver oxygen effectively to tissues in the presence of severe hypoxia. The use of a hemoglobin-based oxygen carrier during hemodilution may augment tissue oxygen delivery and reduce blood transfusion. Methods: Six standardized cardiopulmonary bypass runs simulating normovolemic hemodilution using varying proportions of bovine whole blood and SANGUINATE were performed. Pump speed, flow rate, line pressures, hemoglobin concentration, oxygenation, and degree of anticoagulation were assessed at regular intervals. Membrane oxygenators and arterial line filters were inspected for evidence of clotting following each run. Results: Increases in the pressure drop across the membrane oxygenator were detected during runs 5 and 6. Median activated clotting time values were able to be maintained at goal during the runs, and SANGUINATE did not appear to be thrombogenic. Hemoglobin concentration decreased following the addition of SANGUINATE. Oxygenation was maintained during all runs that included SANGUINATE. Conclusion: SANGUINATE does not impact the performance of the cardiopulmonary bypass circuit in a bovine whole blood model. The results support further evaluation of SANGUINATE in the setting of normovolemic hemodilution and cardiopulmonary bypass.

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