Off-pump coronary artery bypass surgery does not reduce gastrointestinal complications

Musleh, Ghassan

doi:10.1016/s1010-7940(02)00762-5

Cited by 51 publications

(37 citation statements)

References 18 publications

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“…An increase in the contractile response to alpha1-adrenergic agonist and an early release of pro-inflammatory substances has been observed after CPB [140][141][142] . Nevertheless, the effect of pulseless extracorporeal circulation on bowel hypoperfusion is still under debate [143,144] , and off-pump coronary artery bypass does not prevent subsequent mesenteric ischemia [134,145,146] . The physiologic changes in intestinal perfusion during cardiac surgery remain to be elucidated.…”

Section: Ami After Cpbmentioning

confidence: 99%

Acute mesenteric ischemia after cardio-pulmonary bypass surgery

Abboud¹,

Daher²,

Boujaoude³

2008

WJG

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Acute mesenteric ischemia (AMI) is a highly-lethal surgical emergency. Several pathophysiologic events (arterial obstruction, venous thrombosis and diffuse vasospasm) lead to a sudden decrease in mesenteric blood flow. Ischemia/reperfusion syndrome of the intestine is responsible for systemic abnormalities, leading to multi-organ failure and death. Early diagnosis is difficult because the clinical presentation is subtle, and the biological and radiological diagnostic tools lack sensitivity and specificity. Therapeutic options vary from conservative resuscitation, medical treatment, endovascular techniques and surgical resection and revascularization. A high index of suspicion is required for diagnosis, and prompt treatment is the only hope of reducing the mortality rate. Studies are in progress to provide more accurate diagnostic tools for early diagnosis. AMI can complicate the post-operative course of patients following cardio-pulmonary bypass (CPB). Several factors contribute to the systemic hypo-perfusion state, which is the most frequent pathophysiologic event. In this particular setting, the clinical presentation of AMI can be misleading, while the laboratory and radiological diagnostic tests often produce inconclusive results. The management strategies are controversial, but early treatment is critical for saving lives. Based on the experience of our team, we consider prompt exploratory laparotomy, irrespective of the results of the diagnostic tests, is the only way to provide objective assessment and adequate treatment, leading to dramatic reduction in the mortality rate.

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Section: Ami After Cpbmentioning

confidence: 99%

Acute mesenteric ischemia after cardio-pulmonary bypass surgery

Abboud¹,

Daher²,

Boujaoude³

2008

WJG

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“…The longer the duration of the CBP, the more severe the patient's physiological imbalance will be (1) and the complications this procedure can provoke (2)(3)(4) . Various researchers have attempted to demonstrate the advantages of cardiac surgery without CBP in comparison with conventional cardiac surgery (6)(7)(8)(9) . Patients with longer CBP presented more neurological deficits, including excessive sleepiness, cognitive and intellectual function alterations in comparison with patients who spent less time in CBP (10) .…”

Section: Introductionmentioning

confidence: 99%

Circulação extracorpórea e complicações no período pós-operatório imediato de cirurgias cardíacas

Torrati

Dantas

2012

Acta paul. enferm.

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Objectives: To compare the frequency of complications presented by patients during the immediate postoperative period (IPP) for cardiac surgery, based on the time of extracorporeal circulation (ECC). Methods: A quantitative, descriptive and correlational study with 83 adult patients, divided into two groups according to the time of ECC. Results: Of the total patients, 44 (53%) had an ECC duration of up to 85 minutes, and 39 (47%) had a time of over 85 minutes. Complications were common in both groups, with the most frequent being pain and oliguria. However, hemothorax, pneumothorax, and acute myocardial infarction occurred only in the group with the longer duration of ECC. Conclusion:The majority of IPP complications presented in similar frequency for patients, independent of ECC time. Keywords: Nursing care; Thoracic surgery; Postoperative care rEsumo Objetivos: Comparar a frequência de complicações apresentadas pelos pacientes, durante o pós-operatório imediato (POI), de cirurgias cardíacas de acordo com o tempo de circulação extra-corpórea (CEC). Métodos: Estudo de natureza quantitativa, descritivo e correlacional com 83 pacientes adultos divididos em dois grupos de acordo com o tempo de CEC. Resultados: Do total de pacientes, 44 (53%) tiveram o tempo de duração da CEC de até 85 minutos e 39 (47 %) tiveram o tempo acima de 85 minutos. As complicações foram comuns para ambos os grupos, sendo as mais frequentes dor e oligúria. No entanto, hemotórax, pneumotórax e infarto agudo do miocárdio ocorreram apenas no grupo com maior tempo de CEC. Conclusão: A maioria das complicações ocorridas no POI apresentou frequencia semelhante para os pacientes, independente do tempo de CEC. Descritores: Cuidados de enfermagem; Cirurgia torácica; Cuidados pós-operatórios rEsumEn Objetivos: Comparar la frecuencia de complicaciones presentadas por los pacientes, durante el post-operatorio inmediato (POI), de cirugías cardíacas de acuerdo con el tiempo de circulación extra-corpórea (CEC). Métodos: Estudio de naturaleza cuantitativa, descriptiva y correlacional realizado con 83 pacientes adultos divididos en dos grupos de acuerdo con el tiempo de CEC. Resultados: Del total de pacientes, 44 (53%) tuvieron el tiempo de duración de la CEC de hasta 85 minutos y 39 (47 %) tuvieron el tempo encima de 85 minutos. Las complicaciones fueron comunes para ambos grupos, siendo las más frecuentes dolor y oliguria. Entre tanto, hemotórax, pneumotórax e infarto agudo del miocardio ocurrieron en el grupo con mayor tiempo de CEC. Conclusión: La mayoría de las complicaciones ocurridas en el POI presentó frecuencia semejante para los pacientes, independiente del tiempo de CEC.

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“…Improvements in surgical techniques such as off-pump surgery do not seem to have made any significant impact on its incidence or prognosis [15]. One of the reasons may be that despite numerous retrospective reports of GI complications in general and of intestinal ischaemia in particular following cardiac surgery few have analysed the predictive factors systematically as pre-operative, intra-operative and post-operative [1][2][3][4][5][6][7][8][9][10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%