The development of the heart-lung apparatus

Gibbon, John H.

doi:10.1016/0002-9610(78)90119-8

Cited by 110 publications

(64 citation statements)

References 6 publications

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“…Since the beginnings of cardiopulmonary bypass (CPB) supported cardiac surgery in the 1950's, clinicians and surgeons have faced the challenge of balancing the desire to achieve optimal surgical results, while minimizing the consequences of exposure to cardiac bypass [1,2]. The inflammatory response to CPB has been implicated in many of the post-operative clinical problems that often occur in these patients including coagulopathy, respiratory failure, post-operative shock states, and multiple organ failure [3].…”

Section: Introductionmentioning

confidence: 99%

Endotoxemia related to cardiopulmonary bypass is associated with increased risk of infection after cardiac surgery: a prospective observational study

et al. 2011

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IntroductionPrevious studies have documented a high frequency of endotoxemia associated with cardiopulmonary bypass (CPB). Endotoxemia may be responsible for some of the complications associated with cardiac surgery. The purpose of the study was to examine the prevalence of endotoxemia during cardiopulmonary bypass supported aortocoronary bypass grafting surgery (ACB) using a new assay, the Endotoxin Activity Assay (EAA), and explore the association between endotoxemia and post-operative infection.MethodsThe study was a single center prospective observational study measuring EAA during the perioperative period for elective ACB. Blood samples were drawn at induction of anesthesia (T1), immediately prior to release of the aortic cross-clamp (T2), and on the first post-operative morning (T3). The primary outcome was the prevalence of endotoxemia. Secondary outcomes assessed included infection rates, intensive care unit (ICU) and hospital length of stay. An EAA of < 0.40 units was interpreted as "low", 0.41 to 0.59 units as "intermediate", and ≥0.60 units as "high".ResultsA total of 57 patients were enrolled and 54 patients were analyzable. The mean EAA at T1 was 0.38 +/- 0.14, at T2 0.39 +/- 0.18, and at T3 0.33 +/- 0.18. At T2 only 13.5% (7/52) of patients had an EAA in the high range. There was a positive correlation between EAA and duration of surgery (P = 0.02). In patients with EAA ≥0.40 at T2, 26.1% (6/23) of patients developed post-operative infections compared to 3.5% (1/29) of those that had a normal EAA (P = 0.0354). Maximum EAA over the first 24 hours was also strongly correlated with risk of post-operative infection (P = 0.0276).ConclusionsHigh levels of endotoxin occur less frequently during ACB than previously documented. However, endotoxemia is associated with a significantly increased risk of the development of post-operative infection. Measuring endotoxin levels during ACB may provide a mechanism to identify and target a high risk patient population.

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Section: Introductionmentioning

confidence: 99%

Endotoxemia related to cardiopulmonary bypass is associated with increased risk of infection after cardiac surgery: a prospective observational study

et al. 2011

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“…The findings of the present study, based on newspapers and Internet web pages, are consistent with Diem and colleagues’ findings from television medical dramas, in that medical information provided by newspapers and the Internet to the public is over-optimistic as indicated by the survival rate of the patients sustained using LST, and may mistakenly convince the public that an aggressive LST (such as CPR and ECMO) can rescue patients from all life-threatening conditions. Although the portrayal of the survival of patients receiving aggressive LST on television medical dramas remains controversial, it is apparent that such media outlets can substantially influence the public [14-17]. …”

Section: Discussionmentioning

confidence: 99%

The over-optimistic portrayal of life-supporting treatments in newspapers and on the Internet: a cross-sectional study using extra-corporeal membrane oxygenation as an example

Chen

Kao

et al. 2014

BMC Med Ethics

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BackgroundExtra-corporeal membrane oxygenation has been introduced to clinical practice for several decades. It is unclear how internet and newspapers portray the use of extra-corporeal membrane oxygenation. This study were: (1) to quantify the coverage of extra-corporeal membrane oxygenation use in newspapers and on the Internet; (2) to describe the characteristics of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those shown in extra-corporeal membrane oxygenation studies in Taiwan; and (3) to examine the survival rates of extra-corporeal membrane oxygenation users presented in newspaper articles and the Internet web pages in comparison with those in Taiwan and in the Extracorporeal Life Support Registry Report International Summary for January 2014.MethodsAll issues of Taiwan’s four major newspapers from 2006 to 2010 were reviewed. In October 2011, a search of Internet web pages was performed based on the subjects of “yeh-ko-mo” (extra-corporeal membrane oxygenation in Traditional Chinese), “ECMO”, and “extra-corporeal membrane oxygenation.” All the Internet web pages and newspaper articles recounting the use of extra-corporeal membrane oxygenation were reviewed. The information, such as patient characteristic and the status at hospital discharge, was collected.ResultsThe survival rate of extra-corporeal membrane oxygenation use shown on the Internet (83.97%) was significantly higher than all the survival rates reported in Taiwan’s literature (p < .01) and in the Extracorporeal Life Support Registry Report International Summary for January 2014 (p < .01). In addition, the survival rate of extra-corporeal membrane oxygenation use shown in newspapers (61.54%) was significantly higher than the average survival rate (43%) reported in Taiwan’s literature, the pediatric average survival rate (51%), and the adult average survival rate (47%) in the Extracorporeal Life Support Registry Report International Summary for January 2014.ConclusionsInternet and newspapers both showed over-optimistic survival to hospital discharge for patients sustained by extra-corporeal membrane oxygenation. Internet was more likely to provide optimistic information for aggressive life-supporting treatments such as extra-corporeal membrane oxygenation than newspapers as indicated by survival to hospital discharge.

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“…In 1953 when Gibbon first successfully supported a patient with a vertical screen oxygenator, 8 this encouraged the development of oxygenators. Although direct contact bubble oxygenators were used initially, hollow fibre micro-porous oxygenators with blood flow outside the fibres have become the dominant type of oxygenator in use (Figure 3).…”

Section: Oxygenatormentioning

confidence: 99%

The science and practice of cardiopulmonary bypass: From cross circulation to ECMO and SIRS

Punjabi

Taylor

2013

Global Cardiology Science and Practice

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The development of the heart-lung apparatus

Cited by 110 publications

References 6 publications

Endotoxemia related to cardiopulmonary bypass is associated with increased risk of infection after cardiac surgery: a prospective observational study

Endotoxemia related to cardiopulmonary bypass is associated with increased risk of infection after cardiac surgery: a prospective observational study

The over-optimistic portrayal of life-supporting treatments in newspapers and on the Internet: a cross-sectional study using extra-corporeal membrane oxygenation as an example

The science and practice of cardiopulmonary bypass: From cross circulation to ECMO and SIRS

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