Weaning from cardiopulmonary bypass, decannulation, and closure

2021 ◽  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Surgical Care ◽  
Cardiac Procedure ◽  
Heart Lung Machine ◽  
American College Of Surgeons ◽  
History Of ◽  
First John ◽  
Clinical Advances ◽  
Lung Machine

In 1952, John Gibbon performed the first successful cardiac procedure using cardiopulmonary bypass, which turned out to be one of the most important clinical advances of that year. Cardiopulmonary bypass has also been described as “One of the most impressive evidences of the role of investigative surgery in the history of medicine in the persevering efforts of Dr. Gibbon for more than 20 years, which finally culminated in a practical heart-lung machine,” at the first John H. Gibbon, Jr, Lecture at the annual meeting of the American College of Surgeons [1]. Due to the subsequent advancement of cardiopulmonary bypass, many patients with complex heart disease requiring surgical care undergo cardiac surgery while the other organs remain adequately oxygenated and perfused.

Surgical setup for cardiopulmonary bypass through central cannulation

2021 ◽  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Surgical Care ◽  
Heart Lung Machine ◽  
American College Of Surgeons ◽  
History Of ◽  
Central Cannulation ◽  
First John ◽  
Clinical Advances

The introduction of cardiopulmonary bypass was one of the most important clinical advances of 1952. In that year, John Gibbon performed the first successful cardiac surgery using cardiopulmonary bypass. The procedure has been described as “One of the most impressive evidences of the role of investigative surgery in the history of medicine in the persevering efforts of Dr. Gibbon for more than 20 years, which finally culminated in a practical heart-lung machine”, at the first John H. Gibbon, Jr. Lecture at the annual meeting of the American College of Surgeons. Due to on-going advancements in cardiopulmonary bypass, many patients with complex heart disease requiring surgical care undergo cardiac surgery while the other organs remain adequately oxygenated and perfused. This tutorial discusses the access, surgical technique, and initiation of cardiopulmonary bypass through central cannulation and describes the safeguards and pitfalls.

An Automatically Regulated Low Prime Heart-Lung Machine for Infants: A Rabbit Model

Perfusion ◽  
1987 ◽  
Vol 2 (2) ◽  
pp. 109-113
Author(s):  
Erik Wabeke ◽  
Piet H Mook ◽  
Jan M Elstrodt ◽  
Charles RH Wildevuur
Keyword(s):  
Cardiopulmonary Bypass ◽  
Negative Pressure ◽  
Rabbit Model ◽  
Gravity Drainage ◽  
Extracorporeal Circuit ◽  
Donor Blood ◽  
Minimal Volume ◽  
Priming Volume ◽  
Heart Lung Machine ◽  
Lung Machine

A new compact heart-lung machine for paediatric use was designed. The total volume of this system of only 90ml allows for priming without the use of donor blood. The priming volume could be kept small mainly by replacing gravity drainage with drainage by a negative pressure in the venous reservoir. To avoid volume shifts between the extracorporeal circuit and the infant's circulation and to safely operate this minimal volume circuit, the heart-lung machine was automatically controlled. In this study we show that the miniaturized system functioned reliably under various conditions during cardiopulmonary bypass in rabbits.

scholarly journals Application of blood salvaging technologies in cardiosurgical patients operated under cardiopulmonary bypass

2012 ◽  
Vol 93 (2) ◽  
pp. 354-356
Author(s):  
R K Dzhordzhikiya ◽  
I M Rakhimullin ◽  
R R Khamzin
Keyword(s):  
Cardiopulmonary Bypass ◽  
Fresh Frozen Plasma ◽  
Cell Saver ◽  
Intraoperative Bleeding ◽  
Heart Lung Machine ◽  
Mass Transfusion ◽  
Fresh Frozen ◽  
Hospital Days ◽  
Lung Machine ◽  
Frozen Plasma

Aim. To evaluate the effectiveness of blood salvaging technologies in cardiosurgical patients operated under cardiopulmonary circulation. Methods. Analysis of perfusion protocols and transfusion cards of cardiosurgical patients operated using cardiopulmonary bypass during the period 2010-2011. Two groups of patients were identified: the first group - with the application of blood salvaging technologies (906 patients), the second group - without the application of this technique (122 patients). Blood from the operative wound was collected during the operation, processed, filtered through the «Cell-saver» machine from «Fresenius» company and was then re-introduced into the patient’s bloodstream. After completion of cardiopulmonary bypass the blood remaining in the circuit of the cell-saver machine and blood that was discharged through the drainage tubes was returned to the patient after being processed. Results. In the first group at the end of the operation 314.6±28.6 ml of washed red blood cells were returned to the patient from the heart-lung machine, while during the first postoperative day, the amount of the returned autologous erythrocytes from the drainage tubes was 72.8±12.5 ml. In this group, only 45 (4.9%) patients required donor erythrocyte mass transfusion, its volume per patient amounted to 172.3±31.8 ml. In the first group 182 (20.1%) patients required transfusion of fresh frozen plasma with the aim of achieving hemostasis, its volume amounted to 425±51.3 ml. In the second group 51 (41.8%) patients received erythrocyte mass transfusion in the volume of 346.7±31.1 ml, and 86 (70.5%) - received fresh frozen plasma in the amount of 568.7±41.2 ml. Hemoglobin content and hematocrit at the end of the operation and on the first postoperative day were significantly higher in the first group compared to the second group (p 0.01). These changes were associated with both intraoperative bleeding and with the loss of blood through the drainage tubes on the first postoperative day in the second group of patients. Compensation for these losses required transfusion of blood components significantly more frequently (p 0.001) and in larger volumes (p 0.01) than in the first group. Conclusion. Blood salvaging technologies using the «Cell-saver» machine during cardiac surgery under cardiopulmonary bypass significantly reduce blood loss, reduce the number of postoperative hospital days and complications, and are less expensive.

John Stow and Tudor Rebellions, 1549–1569

1988 ◽  
Vol 27 (4) ◽  
pp. 352-374 ◽  
Author(s):  
Barrett L. Beer
Keyword(s):  
Sixteenth Century ◽  
Personal Experience ◽  
Primary Source ◽  
Law And Order ◽  
History Of ◽  
Government Propaganda ◽  
The Government ◽  
John Stow ◽  
First John

In recent years, historians have brought into sharper focus the role of rebellion in the political, social, and religious life of sixteenth-century England. Indeed, the Tudor dynasty established itself on the throne in 1485 as a result of a successful baronial rebellion, and each succeeding generation experienced a major rebellion as well as numerous lesser stirs and riots. Until the revival of interest in Tudor rebellions, the majority of historians preferred to portray the century as an era of law and order in which a strong but popular monarchy ruled over grateful and largely obedient subjects. Although contemporaries living in the sixteenth century knew of rebellion and popular disorder, often through direct personal experience, the government quite understandably opposed anything resembling impartial and disinterested study of the rebellions. Government propagandists denounced rebellion vigorously in royal proclamations and manifestos, while the clergy echoed similar themes from the pulpit. Of the two histories of rebellion published during the sixteenth century, the first, John Proctor's history of Wyatt's Rebellion, was unadulterated government propaganda, and the other, Alexander Neville's history of Kett's Rebellion, was a polemic written in Latin to guarantee a select readership. Without specialized books on rebellions, the literate public had one primary source of historical information, the general chronicles that appeared with greater frequency and variety as the century progressed.Although best known for hisSurvey of London, John Stow was the most prolific chronicler of the sixteenth century. Beginning with the brief octavoA Summary of English Chronicles, which appeared in 1565, Stow published no fewer than twenty-one editions and issues of chronicles in three different formats, the octavoSummary, a sextodecimo abridgment of theSummary, and the more substantialChroniclesandAnnales of Englandin quarto.

Continuous perfusion without hemodilution in neonates—the experience at the Marie Lannelongue Hospital

1993 ◽  
Vol 3 (4) ◽  
pp. 340-346 ◽  
Author(s):  
François Lacour-Gayet ◽  
François Nicolas ◽  
José Coil ◽  
Jean Pierre Daniel ◽  
Michel Weiss ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Heart Lung Machine ◽  
Lung Machine ◽  
Continuous Perfusion

Cardiopulmonary bypass in neonates is markedly different from the procedure used in children above 10 kg and in adults. There are two major reasons for this—first, the mismatch between the volume of the heart-lung machine circuit and that of the blood in the patient and second, the immaturity of tissues in the first three months of life.

scholarly journals Milestones in Understanding Pulmonary Circulation: From Antiquity to Heart-Lung Machine

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 381
Author(s):  
Adam Torbicki
Keyword(s):  
Pulmonary Circulation ◽  
Medical Community ◽  
Special Issue ◽  
Heart Lung Machine ◽  
The World ◽  
History Of ◽  
Lung Machine ◽  
As If

Human pulmonary circulation is as full of mysteries and surprises as is the history of attempts to uncover and understand them. The Special Issue of Diagnostics, appearing after 2020 immobilized the world, give us an opportunity, space and momentum to remind to our medical community at least the main milestones which mark the progress that was made before our times. This review’s aim is to remind about pioneers and their ideas which now are considered as if they were always with us—which is not the case…

Impact of temperature on the Narcotrend Index during hypothermic cardiopulmonary bypass in children with sevoflurane anesthesia

Perfusion ◽  
2017 ◽  
Vol 33 (4) ◽  
pp. 303-309 ◽  
Author(s):  
Nils Dennhardt ◽  
Christiane Beck ◽  
Dietmar Boethig ◽  
Sebastian Heiderich ◽  
Alexander Horke ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Minimum Alveolar Concentration ◽  
Anesthesia Machine ◽  
Eeg Monitoring ◽  
Physiological Conditions ◽  
Heart Lung Machine ◽  
Processed Eeg ◽  
Independent Association ◽  
Narcotrend Index ◽  
Lung Machine

Background: During cardiopulmonary bypass (CPB) in children, anesthesia maintained by sevoflurane administered via the oxygenator is increasingly common. Anesthetic uptake and requirement may be influenced by the non-physiological conditions during hypothermic CPB. Narcotrend-processed EEG monitoring may, therefore, be useful to guide the administration of sevoflurane during this phase. Objective: The objective of this prospective, clinical, observational study was to assess the correlation between body temperature, Narcotrend Index (NI) and administered sevoflurane in children during CPB. Methods: Forty-four children aged 0 to 10 years undergoing hypothermic cardiac surgery were studied. On bypass, anesthesia was maintained with sevoflurane administered via the oxygenator of the heart-lung machine. Nasopharyngeal temperature, NI and minimum alveolar concentration (MAC) of sevoflurane were recorded in intervals of 10 minutes. Expiratory gas was sampled from the oxygenator’s sole expiratory port via a separate connecting line and the MAC was measured by the agent analyzer of the anesthesia machine. Results: Raw (r = 0.74) and corrected (r = 0.73) r-values show that narcosis depth (as indicated by NI) can primarily be explained by the interaction of MAC and temperature. The analysis of variance (without the interaction term) confirms the significant and independent association of both factors, MAC (p<0.004, 95%CI: 0.19 to 0.46) and temperature (p<0.0001, 95%CI: 0.68 to 0.78), with the NI. During hypothermia, sevoflurane had been reduced significantly (r = 0.41, p<0.0001, 95%CI: 0.33 to 0.48). Conclusion: Perfusionists and anesthetists should be aware of the results of processed electroencephalograph (EEG) monitoring during CPB. Sevoflurane requirements differ inter-individually; they may decrease during cooling and increase during rewarming. Therefore, it seems reasonable to include the results of processed EEG monitoring when administering sevoflurane during CPB in children, but further studies are necessary to confirm this thesis.

scholarly journals THE EFFECTIVENESS OF IMPLEMENTING "HEART-LUNG MACHINE SORIN C5" SOFTWARE PRODUCT IN THE EDUCATIONAL PROCESS OF MEDICAL UNIVERSITY

2020 ◽  
Vol 76 (2) ◽  
pp. 250-263
Author(s):  
Людмила Павлівна Суховірська ◽  
Ольга Миколаївна Лунгол ◽  
Оксана Володимирівна Задорожна ◽  
Поліна Григорівна Коваленко
Keyword(s):  
Educational Process ◽  
Virtual Laboratory ◽  
Laboratory Work ◽  
Software Product ◽  
Heart Lung Machine ◽  
Biological Physics ◽  
The Difference ◽  
Medical University ◽  
Lung Machine

The article is devoted to the research of the effectiveness of formation of students’ experimental competencies in hydrodynamics and hemodynamics at a medical university using the software "Heart-lung machine SORIN C5" [1]. On the basis of analysis of psychological and pedagogical literature, the professional experimental competencies of medical students are singled out and the role of virtual laboratory works in the development of students’ professional experimental competencies in higher medical education institutions is determined. The authors consider the use of information resources in the educational process on the example of the software product "Laboratory work "Study of the hemodynamics fundamentals using the apparatus "Heart-lung machine SORIN C5", which is an integral part of the discipline "Medical and Biological Physics". The paper describes the main structural elements and implementation of respective scenarios in the virtual laboratory work on hydrodynamics and hemodynamics. The article presents statistical check of the effectiveness of formation of students’ experimental competencies in hydrodynamics and hemodynamics based on the use of Student's t-test. The authors analyze the results of the conducted experiment and show that visualization, the use of web resources in physics and virtual laboratory work contribute to the formation of the logical and epistemological structure of the teaching material and the strengthening of the role of fundamental generalizations of concepts and theories. It is proved that the difference in the knowledge acquisition coefficients in the experimental and control groups is significant and depends not on random samples, but on the difference in the formation of the material structure and teaching methods in medical and biological physics. It has been established that the system of virtual laboratory works contributes to students’ training in general scientific methods of action, forms the proper professional, technological and experimental competence.

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