scholarly journals High-dose ulinastatin improves postoperative oxygenation in patients undergoing aortic valve surgery with cardiopulmonary bypass: A retrospective study

2018 ◽  
Vol 46 (3) ◽  
pp. 1238-1248 ◽  
Author(s):  
Ka-Young Rhee ◽  
Tae-Yun Sung ◽  
Ju Deok Kim ◽  
Hyun Kang ◽  
Nazri Mohamad ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiopulmonary Bypass ◽  
Aortic Valve ◽  
Valve Surgery ◽  
High Dose ◽  
Aortic Valve Surgery ◽  
Time Points ◽  
Postoperative Oxygenation ◽  
Pre Treatment

Objective To determine whether pre-treatment with high-dose ulinastatin provides enhanced postoperative oxygenation in patients who have undergone aortic valve surgery with moderate hypothermic cardiopulmonary bypass (CPB). Methods Patients who underwent aortic valve surgery with moderate hypothermic CPB were retrospectively evaluated. In total, 94 of 146 patients were included. The patients were classified into one of two groups: patients in whom ulinastatin (10,000 U/kg followed by 5,000 U/kg/h) was administered during CPB (Group U, n = 38) and patients in whom ulinastatin was not administered (Group C, n = 56). The PaO2/FiO2 ratio was calculated at the following time points: before CPB (pre-CPB), 2 h after weaning from CPB (post-CPB), and 6 h after arrival to the intensive care unit (ICU-6). The incidence of a low PaO2/FiO2 ratio was also compared among the time points. Results Group U showed a significantly higher PaO2/FiO2 ratio (F(4, 89.0) = 657.339) and a lower incidence of lung injury (PaO2/FiO2 ratio < 300) than Group C at the post-CPB and ICU-6 time points. Conclusion High-dose ulinastatin improved pulmonary oxygenation after CPB and in the early stages of the ICU stay in patients undergoing aortic valve surgery with CPB.

scholarly journals Pulsatile cardiopulmonary bypass and renal function in elderly patients undergoing aortic valve surgery†

2014 ◽  
Vol 47 (2) ◽  
pp. 291-298 ◽  
Author(s):  
Aldo Domenico Milano ◽  
Mikhail Dodonov ◽  
Willem Van Oeveren ◽  
Francesco Onorati ◽  
Y. John Gu ◽  
...  
Keyword(s):  
Renal Function ◽  
Cardiopulmonary Bypass ◽  
Aortic Valve ◽  
Elderly Patients ◽  
Valve Surgery ◽  
Aortic Valve Surgery

scholarly journals Comparison of Left Atriotomy and Superior Transseptal Approaches in Mitral Valve Surgery

2018 ◽  
Vol 21 (4) ◽  
pp. E318-E321 ◽  
Author(s):  
Saygin Turkyilmaz ◽  
Ali Aycan Kavala
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cardiopulmonary Bypass ◽  
Mitral Valve ◽  
Intensive Care Unit Stay ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Time Duration ◽  
Cardiopulmonary Bypass Time ◽  
Hospitalization Time

Purpose: To compare the operative and post-operative outcomes of mitral valve surgery (MVS) with a superior transseptal (STS) approach and a left atriotomy (LA) approach. Methods: In a tertiary academic center, the charts of patients who underwent MVS between 2012 and 2016 were analyzed retrospectively. A total of 135 patients underwent MVS. Forty patients who underwent MVS with the STS approach were enrolled in the study as the STS group. In the same period, we selected 40 patients who underwent MVS with the LA approach to serve as the control group (LA group). Two groups were operated by the same surgeon. To minimize the bias related to the lack of randomization in this observational study, LA group patients were selected using propensity score matching. Results: According to the study design, the preoperative characteristics of gender, age, mitral valve stenosis, and mitral valve insufficiency were matched (P = .368, P = .920, P = .250 and P = .057, respectively). The cardiopulmonary bypass time was 91.2 ± 12.1 minutes in the superior transseptal group and 72.8 ± 6.4 minutes in the left atriotomy group (P < .001). Additionally, duration of clamp time was significantly shorter in the left atriotomy group (P < .001). Estimated blood loss was significantly less in patients with a left atriotomy (535.8 ml versus 658.0 mL, P < .001). Duration of intensive care unit stay and hospitalization time were significantly longer in patients who underwent the superior transseptal approach compared with patients who underwent left atriotomy (P < .001 versus P < .001, respectively). Post-operative dysrhythmia rate and mortality rate were similar between the groups. Conclusion: Our study demonstrated that MVS with LA decreased cardiopulmonary bypass time, duration of clamp time, amount of hemorrhage, duration of intensive care unit stay, and hospitalization time compared with MVS with STS.

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