Single transpulmonary thermodilution and continuous monitoring of central venous oxygen saturation during off‐pump coronary surgery

Smetkin, A.; Kirov, Mikhail Y.; Kuzkov, Vsevolod V.; Lenkin, A. I.; Еремеев, А. В.; Slastilin, V.; Бородин, В. В.; Bjertnæs, Lars J.

doi:10.1111/j.1399-6576.2008.01855.x

Cited by 79 publications

(60 citation statements)

References 45 publications

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“…The MUF group showed values of drainage and consumption of oxygen very similar to those of the control group, we observed that these two variables behaved differently in both groups with decreased oxygen drainage to the end of 48 hours of postoperative and increase in oxygen consumption in the same period. This behavior has already been described by other authors in patients submitted to heart surgery [15] which only stresses the fact that MUF did not imply harmful implications in its application.…”

Section: Resultssupporting

confidence: 78%

Efeitos da ultrafiltração modificada na função pulmonar e necessidade de hemotransfusão em pacientes submetidos à revascularização do miocárdio

Torina¹,

Petrucci²,

Oliveira³

et al. 2010

Rev Bras Cir Cardiovasc

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Efeitos da ultrafiltração modificada na função pulmonar e necessidade de hemotransfusão em pacientes submetidos à revascularização do miocárdioThe effects of modified ultrafiltration on pulmonary function and transfusion requirements in patients undergoing coronary artery bypass graft surgery Abstract Objective: The inflammatory response after cardiac surgery increases vascular permeability leading to higher mortality and morbidity in the post operative time. The modified ultrafiltration (MUF) has shown benefits in respiratory and hemodynamic function in pediatric patients. This approach in adults is not well established yet. We hypothesize that modified ultrafiltration may improve respiratory, hemodynamic and coagulation function in adults after cardiac surgeries.Methods: A prospective randomized study was carried out with 37 patients who underwent coronary artery bypass graft surgery (CABG) were randomized either to MUF (n=20) at the end of bypass or to control (no MUF) (n=17). The anesthesia and ICU team were blinded for the group selection. The MUF were carried out for 15 minutes after the end of bypass. The patients' data were taken at beginning of anesthesia, ending of bypass, ending MUF, 24 hours, and 48 hours after surgery. For clinical outcome the pulmonary, hemodynamic and coagulation function were evaluated.Results: We observed lower drain loss in the MUF group compared to control group after 48 hours (598±123 vs. 848±455 ml; p=0.04) and required less red blood cell unit transfusions compared to control group (0.6 ± 0.6 vs.1.6±1.1 units/patient; P=0.03). The MUF group showed lower airway resistance (9.3±0.4 vs. 12.1±0.8 cmH2O.L-1s-1; P=0.04). There were no deaths in both groups.Conclusion: The MUF reduces post operatory bleeding and red blood cells unit transfusion, but with no differences on clinical outcome were observed. The routinely MUF employment was not associated with hemodynamic instability. Descriptors 60TORINA, AG ET AL -The effects of modified ultrafiltration on pulmonary function and transfusion requirements in patients undergoing coronary artery bypass graft surgery Bras Cir Cardiovasc 2010; 25(1): 59-65 transfusion and postoperative drain loss inelective coronary artery bypass graft surgery. Rev METHODS Patient selectionAfter approval of the Ethics in Research Committee of our institution and registration in the National Ethics in Research System the patients were included in a prospective, randomized and blind study to the anesthesia and ICU team. The included patients presented the following characteristics: male/female, coronary artery bypass graft surgery, ejection fraction higher than 40%, which was estimated by cardiac catheterism in anterior right oblique projection, elective surgery, diabetics or nondiabetics. The criteria of exclusion were: presence of any kind of neoplasia, depressed renal function that was defined as creatinine clearance lower than 45 ml/minute for males and lower than 40 ml/minute for females. Surgical procedureThe patients were submitted to inhalant and...

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Section: Resultssupporting

confidence: 78%

Efeitos da ultrafiltração modificada na função pulmonar e necessidade de hemotransfusão em pacientes submetidos à revascularização do miocárdio

Torina¹,

Petrucci²,

Oliveira³

et al. 2010

Rev Bras Cir Cardiovasc

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“…In our own study [18 ], we randomized two groups of patients with off-pump CABG to receive haemodynamic therapy guided by either conventional (MAP, HR, CVP) or advanced monitoring. In the latter group, in addition to maintaining normal values of MAP and HR, therapy was aimed at intrathoracic blood volume index 850-1000 ml/m 2 , continuous S CV O 2 higher than 60% and CI more than 2 l/min per m 2 .…”

Section: Haemodynamic Therapy In Cardiac Surgerymentioning

confidence: 99%

Perioperative haemodynamic therapy

Kirov

Kuzkov

Molnár

2010

Current Opinion in Critical Care

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“…Moreover, in another study on cardiac surgery patients, a filling pressure-guided management was compared to a management based on ITBVI, CI, MAP, HR, and ScvO 2 use. The first group showed a longer ICU and hospital stay, with respect to the second group (Smetkin et al 2009). …”

Section: Hemodynamic Variables In Gdtmentioning

confidence: 93%

“…Moreover, comparing 40 cardiac surgery patients treated with a GEDVI, ITBVI, CI, and MAP-guided algorithm, with a historic sample treated with standard approach, the GDT group presented a shorter duration of mechanical ventilation and a reduced need for intensive therapies and catecholamines (Habicher et al 2011;Goepfert et al 2007). In a similar study conducted in off-pump coronary artery bypass patients, it was shown that GDT determined an increased use of dobutamine and colloids, correlating with a reduction of the length ICU and hospital stay (Habicher et al 2011;Smetkin et al 2009). …”

Section: Clinical Impact In Cardiac Surgery Patientsmentioning

confidence: 96%