Albumin priming improves the efficiency of the Minntech HPH Jr. hemoconcentrator

Perfusion ◽  
2018 ◽  
Vol 33 (7) ◽  
pp. 520-524
Author(s):  
Jeffrey L. Burnside ◽  
Todd M. Ratliff ◽  
Ann Salvator ◽  
Ashley B. Hodge
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Study Groups ◽  
Heparin Group ◽  
Fluid Removal ◽  
Priming Volume ◽  
Priming Process ◽  
Flow Through ◽  
Group 2 ◽  
Group 1

The desired use of the HPH Jr. is optimal due to the low priming volume; however, the lower rate of volume removal necessitates utilization of a larger hemofilter. Larger hemofilters carry a higher prime volume, which is impactful in the pediatric setting. Pediatric cardiac surgery patients under 18 kilograms requiring cardiopulmonary bypass were randomly assigned to one of two study groups. Group 1 (coated) contained an HPH Jr. hemofilter that was primed with the addition of 25% albumin and heparin. Group 2 (non-coated) contained an HPH Jr. hemofilter that was primed with only Normosol-R®. After cardioplegia delivery, zero balance ultrafiltration (ZBUF) was initiated and maintained for thirty consecutive minutes. The flow through the hemofilter was standardized at 70 ml/min and the vacuum applied to the effluent line was set at -150 mmHg. Effluent fluid removal was measured at the termination of thirty minutes and compared between the groups. Group comparisons between the coated vs non-coated hemofilter groups were assessed using two-sample t-tests or the Mann-Whitney U test, when appropriate. Forty-two patients were included in the analysis. There were 22 patients who had the non-coated hemofilter and 20 patients with a coated hemofilter. The differences between the two groups are illustrated in Table 1. There was a statistically significant higher ultrafiltration volume with the coated hemofilter group (p=0.008) (Figure 1). These results illustrate the improved efficiency of the HPH Jr. with the addition of 25% albumin and heparin during the priming process.

scholarly journals Comparative evaluation of blood salvage techniques in patients undergoing cardiac surgery with cardiopulmonary bypass

Perfusion ◽  
2017 ◽  
Vol 33 (2) ◽  
pp. 105-109 ◽  
Author(s):  
Serdar Gunaydin ◽  
Craig Robertson ◽  
Ali Baran Budak ◽  
Terence Gourlay
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Blood Cells ◽  
Randomized Study ◽  
White Blood Cells ◽  
Cell Saver ◽  
Blood Salvage ◽  
Group 2 ◽  
Intraoperative Blood Salvage ◽  
Group 1

Background: The primary objective of this study was to test and compare the efficacy of currently available intraoperative blood salvage systems via a demonstration of the level of increase in percentage concentration of red blood cells (RBC), white blood cells 9WBC) and platelets (Plt) in the end product. Methods: In a prospective, randomized study, data of 80 patients undergoing elective cardiac surgery with cardiopulmonary bypass in a 6-month period was collected, of which the volume aspirated from the surgical field was processed by either the HemoSep Novel Collection Bag (Advancis Surgical, Kirkby-in-Ashfield, Notts, UK) (N=40) (Group 1) or a cell- saver (C.A.T.S Plus Autotransfusion System, Fresenius Kabi, Bad Homburg, Germany) (N=40) (Group 2). Results: Hematocrit levels increased from 23.05%±2.7 to 43.02%±12 in Group 1 and from 24.5±2 up to 55.2±9 in Group 2 (p=0.013). The mean number of platelets rose to 225200±47000 from 116400 ±40000 in the HemoSep and decreased from 125200±25000 to 96500±30000 in the cell-saver group (p=0.00001). The leukocyte count was concentrated significantly better in Group 1 (from 10100±4300 to 18120±7000; p=0.001). IL-6 levels (pg/dL) decreased from 223±47 to 83±21 in Group 1 and from 219±40 to 200±40 in Group 2 (p=0.001). Fibrinogen was protected significantly better in the HemoSep group (from 185±35 to 455±45; p=0.004). Conclusions: Intraoperative blood salvage systems functioned properly and the resultant blood product was superior in terms of red blood cell species. The HemoSep group had significantly better platelet and leukocyte concentrations and fibrinogen content.

Hypomagnesemia and low alkaline phosphatase activity in patients' serum after cardiac surgery.

1989 ◽  
Vol 35 (4) ◽  
pp. 664-667 ◽  
Author(s):  
G Lum ◽  
C Marquardt ◽  
S F Khuri
Keyword(s):  
Alkaline Phosphatase ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
General Anesthesia Group ◽  
Alp Activity ◽  
Anesthesia Group ◽  
Group 3 ◽  
Group 2 ◽  
Post Cardiac Surgery ◽  
Group 1

Abstract Significant decreases in magnesium (Mg) concentration and alkaline phosphatase (ALP, EC 3.1.3.1) activity in serum were seen in patients after cardiac surgery with cardiopulmonary bypass (Group 1), as compared with non-cardiac-surgery patients after general anesthesia (Group 2) or only spinal anesthesia (Group 3). Mean changes for Mg and ALP by the first postoperative day, compared with pre-operative baseline values, were as follows: Group 1: Mg -7.5 mg/L (-38.3%), ALP -46U/L (-48.4%); Group 2: Mg -3.3 mg/L (-17.4%), ALP -17 U/L (-16.5%); and Group 3: Mg -1.9 mg/L (-10.0%), ALP -15 U/L (-14.0%). The decreases in Mg and ALP observed in post-cardiac-surgery patients appear to be a consequence of the cardiac surgery and the cardiopulmonary bypass pump. Measurement of Mg and ALP in a subgroup of 10 cardiac-surgery patients for 10 days postoperatively showed initial decreases, with gradual recovery to near-normal values by the 10th day. That the changes in Mg and ALP seen postoperatively were not attributable to hemodilution alone was confirmed by measuring total-protein concentrations before and after operation. ALP requires Mg ion in vitro for optimal activity, but addition of Mg in the appropriate amounts to sera with low ALP activity did not restore ALP activity. The low ALP activity seen in post-cardiac surgery patients in vivo may perhaps be related to factors other than Mg that were removed by the cardiopulmonary bypass pump.

Cephradine and cefazolin plasma levels during cardiac surgery

Perfusion ◽  
1986 ◽  
Vol 1 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Sergio V Moran ◽  
Francisco Montiel ◽  
Guillermo Acuña ◽  
Jeanette Vergara ◽  
Manuel J Irarrazaval ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Plasma Levels ◽  
Early Postoperative Period ◽  
Good Choice ◽  
Double Blind Study ◽  
Double Blind ◽  
Postoperative Course ◽  
Group 2 ◽  
Group 1

A prospective, randomized, double-blind study was carried out to evaluate two prophylactic regimes in patients undergoing cardiac surgery with cardiopulmonary bypass. Antibiotic plasma levels were measured in fifty consecutive adult patients undergoing valve and coronary surgery. They were divided into two comparable groups of 25 patients, each matched in age, sex, type of operation and duration of cardiopulmonary bypass. Group 1 received 1 g of cephradine with the anaesthetic premedication, 1 g in the prime of the oxygenator and 1 g every six hours during the first 72 hours of the postoperative course. Group 2 received cefazolin following the same protocol except that they received 1 g every eight hours during the postoperative course. There were no allergic or toxic reactions and no infections up to two months follow-up in both groups. Antibiotic plasma levels were significantly higher (p < 0·001) in the cefazolin group in four out of five sampling periods. Antibiotic plasma levels for group 1 versus group 2 were as follows: initial level 11·7 ± 5.2 mcg/ml vs 31 4 ± 35·4 mcg/ml. During cardiopulmonary bypass 26·6 ± 9·5 mcg/ml vs 51·7 ± 21 ·1 mcg/ml. Final levels 13·6 ± 7·0 mcg/ml vs 32·2 ± 17·8 mcg/ml. Baseline levels 2·7 ± 2·3 mcg/ml vs 6·· ± 7·7 mcg/ml and peak level 44·0 ± 16·2 mcg/ml vs 51·2 ± 23·4 mcg/ml (NS). The results of this study demonstrate that cefazolin achieved significantly higher plasma levels during the different phases of the operation and early postoperative period. Also, cefazolin and cephradine levels are above the minimal inhibitory concentrations for the gram positive and gram negative susceptible bacteria, except for the basal levels obtained by cephradine. The favourable pharmacokinetic characteristics of cefazolin, makes it a good choice for prophylactic use during cardiac surgery.

scholarly journals Evaluation of Gingival Microleakage in Class II Composite Restorations with Different Lining Techniques: An In Vitro Study

Scientifica ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Vedavathi Bore Gowda ◽  
B. V. Sreenivasa Murthy ◽  
Swaroop Hegde ◽  
Swapna Devarasanahalli Venkataramanaswamy ◽  
Veena Suresh Pai ◽  
...  
Keyword(s):  
Study Groups ◽  
Class Ii ◽  
Composite Liner ◽  
Flowable Composite ◽  
Composite Restorations ◽  
Group 4 ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Aim. To compare the microleakage in class II composite restorations without a liner/with resin modified glass ionomer and flowable composite liner.Method. Forty standardized MO cavities were prepared on human permanent mandibular molars extracted for periodontal reasons and then divided into 4 groups of ten specimens. The cavity preparations were etched, rinsed, blot dried, and light cured and Adper Single Bond 2 is applied. Group 1 is restored with Filtek P60 packable composite in 2 mm oblique increments. Group 2 is precure group where 1 mm Filtek Z350 flowable liner is applied and light cured for 20 sec. Group 3 is the same as Group 2, but the liner was cocured with packable composite. In Group 4, 1 mm RMGIC, Fuji Lining LC is applied and cured for 20 sec. All the teeth were restored as in Group 1. The specimens were coated with nail varnish leaving 1 mm around the restoration, subjected to thermocycling, basic fuchsin dye penetration, sectioned mesiodistally, and observed under a stereomicroscope.Results. The mean leakage scores of the individual study groups were Group 1 (33.40), Group 2 (7.85), Group 3 (16.40), and Group 4 (24.35). Group 1 without a liner showed maximum leakage. Flowable composite liner precured was the best.

scholarly journals Hypogammaglobulinemia as a Predictive Factor of Postoperative Complications in Pediatric Cardiac Surgery

2021 ◽  
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Complications ◽  
Heart Defects ◽  
Blood Stream ◽  
Neonatal Unit ◽  
Pediatric Cardiac Surgery ◽  
Impact On Survival ◽  
Group 2 ◽  
Attending Physician ◽  
Group 1

Hypogammaglobulinemia, developed as a result of cardiac surgery accompanied by cardiopulmonary bypass (CPB), may be caused by hemodilution, destruction of immunoglobulin, extravasation into the interstitial space related to systemic inflammation, and capillary leak syndrome. Therefore, to address this gap, we analyzed the characteristics of the infants who developed hypogammaglobulinemia after cardiac surgery and could benefit from Immunoglobulin supplementation. Methods: This is a retrospective study evaluating infants undergoing surgery for repair of congenital heart defects from October 1, 2019 to June 30th, 2020 in the neonatal unit of our institution. Due to its retrospective design, informed consent was not required. Patients were divided in two groups: Group 1 (IgG >= 340mg/dL) and Group 2 (IgG < 340mg/dL). The value cut point was defined taking into consideration p10 level of Immunoglobulin according to Fujimura. Results: From October 1, 2019 to June 30th, 2020, 62 children were born or admitted in our neonatal unit. Among them, 19 (30%) have their IgG dosed, according to attending physician decision. Among patients with hypogammaglobulinemia, Pseudomonas sp was present in 87.5% of blood stream and/or tracheal secretion cultures. Regarding survival analysis, mortality was not different between Group 1 and 2. Conclusion: Hypogammaglobulinemia has proved to be a predictor factor of postoperative complications in pediatric cardiac surgery. However, prospective trials are needed to determine the incidence of this problem, its real impact on survival, and the appropriate therapy.

scholarly journals Characterization of Enamel After the Use of Oral Hygiene Auxiliaries with Whiteners

2019 ◽  
pp. 227-236
Author(s):  
Norma Verónica Zavala-Alonso DDS, MSc, PhD ◽  
Jorge Humberto Ramírez-González DDS, MSc ◽  
Mariana Ramírez-Vergara DDS ◽  
José Gilberto Roque-Márquez DDS, MSc ◽  
Flores Daniel Silva-Herzog DDS, MSc, PhD
Keyword(s):  
Oral Hygiene ◽  
Dental Enamel ◽  
Hardness Test ◽  
Study Groups ◽  
Micro Hardness ◽  
Sem Images ◽  
Group 4 ◽  
Group 2 ◽  
Mouth Wash ◽  
Group 1

The purpose of this study was to evaluate the effect of the use of the combined auxiliaries of oral hygiene with whitening agents on the micro-hardness and micro-morphology of dental enamel. Materials and Methods. 40 human incisors were used and sectioned to obtain 4x4mm samples and divided into four study groups. Group 1: Electric brushing with Toothpaste (BTP); Group 2: Electric brushing with Toothpaste+mouthwash (BTP+MW); Group 3: Electric brushing with Toothpaste+whitening pen (BTP+WP); Group 4: Electric brushing with Toothpaste+mouth wash+whitening pen (BTP+MW+WP). Samples were submitted toVickers micro-hardness test and visualized using scanning electron microscopy (SEM). Results. All groups, with the exception of group 1, showed a decrease in micro-hardness values after applying the treatments (p<0.05). Likewise, when comparing the values after the treatments between the groups, significant statistical differences were found in all of comparisons except for those of groups 2 and 4. SEM images showed changes in the morphology in all the study groups with the exception of group 1. Conclusion. Significant changes such as decrease in micro-hardness as well as in the topography of the enamel surface such as elevations, craters, porosities and etching patterns were founded after the use of the combination of auxiliaries of oral hygiene with whitening agents.  

A TRIAL OF SUBCUTANEOUS VERSUS INTRAVENOUS ADMINISTRATION OF LOW MOLECULAR WEIGHT (LMW) HEPARIN AND UNFRACTIONATED (UF) HEPARIN IN THE TREATMENT OF ESTABLISHED DEEP VENOUS THROMBOSIS (DVT)

1987 ◽  
Author(s):  
C J Parker ◽  
D E Huber ◽  
A R Hedges ◽  
V V Kakkar
Keyword(s):  
Low Molecular Weight ◽  
Heparin Group ◽  
Expert Radiologist ◽  
Intravenous Heparin ◽  
Antithrombotic Effects ◽  
Group 3 ◽  
Group 2 ◽  
Efficacy Of Treatment ◽  
Group 1

In a randomized clinical trial of 100 patients, the in vivo antithrombotic effects of a subcutaneously administered LMW heparin fraction (CY216) used in the treatment of established DVT, was compared with UF heparin administered by either intravenous or subcutaneous routes.Venograms were used to make the initial diagnosis, and efficacy of treatment was assessed by a repeat venogram done on day 6. Comparison of the venograms were done blind by an expert radiologist.Patients were randomized to one of three groups: Group 1 received subcutaneous CY216; Group 2 received subcutaneous UF heparin: Group 3 received continuous intravenous UF heparin. Random patients from each group had detailed haematological tests consisting of twicedaily KCCT and anti-Xa levels. Extension of thrombus occurred in significantly morepatients receiving intravenous heparin than subcutaneous heparin (p-0.02).There was no difference between the two subcutaneousgroups. There were no haematological complications.We conclude that subcutaneous administratiyon of heparin is the treatment of choice in the treatment of DVT.

Induction of mixed apneas by inhalation of 100% oxygen in preterm infants

1994 ◽  
Vol 77 (4) ◽  
pp. 1666-1670 ◽  
Author(s):  
R. Alvaro ◽  
J. Alvarez ◽  
K. Kwiatkowski ◽  
D. Cates ◽  
H. Rigatto
Keyword(s):  
Preterm Infants ◽  
Gestational Age ◽  
Flow Through ◽  
Group 2 ◽  
Central Apneas ◽  
Group 1

Administration of 100% O2 to preterm infants induces an apnea that is usually central. We hypothesized that this apnea may be “mixed” at times with an obstructive component appearing late during the respiratory pause. In addition, we reasoned that obstruction would depend on the duration of the apnea. Thus, we gave 100% O2 to 61 healthy preterm infants. Group 1 was > or = 1,500 g [birth wt 1.8 +/- 0.1 (SE) kg, gestational age 32 +/- 1 wk, postnatal age 19 +/- 2 days, n = 26] and group 2 was < 1,500 g [birth wt 1.2 +/- 0.1 kg, gestational age 29 +/- 1 wk, postnatal age 30 +/- 4 days, n = 35]. Ventilation was measured using a flow-through system. Respiratory efforts in the absence of flow were detected using chest and abdominal displacements or diaphragmatic electromyography. In group 1, 19% of the central apneas became obstructive at 17 +/- 3 s, whereas in group 2, 34% did so at 12 +/- 2 s. Mixed apneas were longer than those without obstruction (28 +/- 3 vs. 12 +/- 1 s; P = 0.0001). The incidence of mixed apneas was 0, 14, and 66% in group 1 and 0, 27, and 69% in group 2 in apneas of 3–10, 11–20, and > 20 s, respectively. These findings suggest that 1) a percentage of the central apneas induced by inhaling 100% O2 became obstructive, 2) the incidence of the obstructive component increased with the duration of apnea, and 3) smaller infants became obstructed sooner and had a higher incidence of obstruction than larger infants.(ABSTRACT TRUNCATED AT 250 WORDS)

EFFECT OF TREATMENT WITH STREPTOKINASE AND HEPARIN ON FIBRINOGEN, FIBRIN AND RELATED PROTEINS IN ACUIE MYOCARDIAL INFARCTION (/ME) PATIENTS

1987 ◽  
Author(s):  
V Vila ◽  
E Reganon ◽  
J Aznar ◽  
V Lacueva ◽  
M Ruano
Keyword(s):  
Degradation Products ◽  
Heparin Therapy ◽  
Heparin Group ◽  
Normal Value ◽  
Group 4 ◽  
Group 6 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

The properties of fibrinogen and fibrin, the levels of fibrincpeptide A (FPA) and fibrin(ogen) degradation products (FDP) were studied in 34 patients with AMI who were undergoing thrombolytic and heparin therapy. They were classified into 6 groups accordingto their stage of treatment: group 1, before intravenous administration of 800.000 U streptokinase over 30 min; group 2, after a<Mnistraticn of SK but before adninistraticn of heparin; group 3, during 24 h ofthe 5 ng/h heparin continuous infusion; group 4, during 48-72 h of the 16.6 ng/h heparin continuous infhsion; group 5, after 1 week of administration of SK and with a bolus inyection of 50 rg heparin every 4 h; group 6, patients who were undergoing only heparin treatment. The Fg 1/ Fg II ratio varies during treatment with SK and heparin. In group 1 a sligjnt increase (2.5) is observed. Group 2 shows a significantdecrease (0.6) as a result of fibrinolysis. In group3 the ratio reaches normal value (1.8) while in the fourth group it is twice the normal value (4). The value for group 5 is nearly normal (2.1), and in group 6 it reaches values similar to those obtained in group 4, which implies that the rise in the Fgl/Fgll ratio is not a result of fibrinolytic treatment. TheFPA level shows and increase in patients with AMI (group 1,126 ng/ml). When SK treatment is applied (group 2), FPA decreases to 52 ng/ml. Later treatment with heparin (group-3, 82; group-4, 44 and group-5, 81ng/ml) does not neutralize thrcmbinic activity. Patients treated only with heparin (group 6) show an FPAvalue of 19 ng/ml, which is lower than in the other groups. All of this indicates that thrombin is activated after fibrinolytic treatment. FDP values show asignificant increase in the six groups (1, 53; 2, 430; 3, 128; 4, 270; 5, 139 and 6, 141 ug/ml), which indicates that during treatment with heparin the fibrinolytic activity persists. he formation of highly cross-linked fibrin is altered in groups 1,2,3 and 4,as a consequence of circulating FDP effect and fibrincgeno- lysis.The permeability of the fibrin clotdecreases in groups 1 (0.42), 2 (1.3), 4 (1.1) and 5(0.5 ml/s/ng) and increases in group 2 (23.2 ml/s/nig) with respect to the normal plasma value (3.2 ml/s/nrg). The decrease in permeability must be related to the existence of hypercoagulability resistant to heparinization. FPA values, tine Fgl/Fgll ratio, andfibrin permeability can be used to evaluate the degree of thrcmbin activity during thrombolytic treatmentinAMI.

A numerical analysis of major groupings in Medicago employing traditionally used characters

1981 ◽  
Vol 59 (9) ◽  
pp. 1553-1577 ◽  
Author(s):  
Ernest Small
Keyword(s):  
Numerical Analysis ◽  
Study Groups ◽  
Species Group ◽  
Annual Species ◽  
Agglomerative Clustering ◽  
Medicago Arborea ◽  
Group 3 ◽  
Group 2 ◽  
Numerical Examination ◽  
Group 1

Numerical taxonomic analyses (particularly agglomerative clustering and ordination) were conducted on 55 species of Medicago, using 75 mostly vegetative and fruiting characters. The material studied represents all conservatively accepted species of the genus, as well as 14 "problematical" species of which many are often considered to belong to the genus Trigonella, rather than to Medicago. Although the characters employed are substantially the same as those used by recent monographers who evaluated the genus by traditional subjective procedures, the present numerical examination suggests many relationships not previously appreciated.As a result of the analyses, it was judged appropriate to recognize 12 groupings. These are group 1: M. sativa (alfalfa) and 11 allied species; group 2: M. lupulina and M. secundiflora; group 3: eight problematical species which have troubled taxonomists with respect to whether they should be placed in Medicago or Trigonella; groups 4–8: each made up of a single divergent species, respectively: M. carstiensis, M. radiata, M. orbicularis, M. heyniana, and M. arborea; groups 9–12 four subgroupings of a larger group of 28 annual species. In the main, the composition of the seven polytypic groups is similar to those of taxa accepted by recent monographers, although some realignments of particular species are suggested by the present study. Groups 1 and 2 are much more similar to each other than indicated in recent treatments. Medicago arborea was discovered to be much more dissimilar to all other species examined than thought previously. Medicago hybrida of group 1 was found to be a "master link" between species traditionally placed in Medicago, and many placed in Trigonella (group 3).The 12 groupings in turn fall into three assemblages that could be recognized as subgenera, or even as genera. These are A: groups 1, 2, 9, 10, 11, and 12; B: groups 3–7, inclusive; and C: M. arborea. Further research is suggested before formal categorization is undertaken.

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