Publicación: Hematic Antegrade Repriming Reduces Emboli on Cardiopulmonary Bypass: A Randomized Controlled Trial
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2023-03
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info:eu-repo/semantics/openAccess
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Lippincott, Williams & Wilkins
Resumen
Particulate and gaseous microemboli (GME) are side effects of cardiac surgery that interfere with postoperative recovery by causing endothelial dysfunction and vascular blockages. GME sources during surgery are multiple, and cardiopulmonary bypass (CPB) is contributory to this embolic load. Hematic antegrade repriming (HAR) is a novel procedure that combines the benefits of repriming techniques with additional measures, by following a standardized procedure to provide a reproducible hemodilution of 300 ml. To clarify the safety of HAR in terms of embolic load delivery, a prospective and controlled study was conducted, by applying Doppler probes to the extracorporeal circuit, to determine the number and volume of GME released during CPB. A sample of 115 patients (n = 115) was considered for assessment. Both groups were managed under strict normothermia, and similar clinical conditions and protocols, receiving the same open and minimized circuit. Significant differences in GME volume delivery (control group [CG] = 0.28 ml vs. HAR = 0.08 ml; p = 0.004) and high embolic volume exposure (>1 ml) were found between the groups (CG = 30.36% vs. HAR = 4.26%; p = 0.001). The application of HAR did not represent an additional embolic risk and provided a four-fold reduction in the embolic volume delivered to the patient (coefficient, 0.24; 95% CI, 0.08–0.72; p = 0.01), which appears to enhance GME clearance of the oxygenator before CPB initiation.
Descripción
La versión registrada de este artículo, publicado por primera vez en ASAIO Journal, 69(3), 324., está disponible en línea en el sitio web del editor: https://doi.org/10.1097/MAT.0000000000001776
The registered version of this article, first published in ASAIO Journal, 69(3), 324., is available online at the publisher's website: https://doi.org/10.1097/MAT.0000000000001776
Categorías UNESCO
Palabras clave
cardiac surgery, cardiopulmonary bypass, extracorporeal circuits, gaseous microemboli, hematic antegrade repriming, pulsed Doppler
Citación
Blanco-Morillo, J., Salmerón Martínez, D., Morillo-Cuadrado, D. V., Arribas-Leal, J. M., Puis, L., Verdú-Verdú, A., Martínez-Molina, M., Tormos-Ruiz, E., Sornichero-Caballero, A., Ramírez-Romero, P., Farina, P., & Cánovas-López, S. (2023). Hematic Antegrade Repriming Reduces Emboli on Cardiopulmonary Bypass: A Randomized Controlled Trial. ASAIO Journal, 69(3), 324. https://doi.org/10.1097/MAT.0000000000001776
Centro
Facultades y escuelas::Facultad de Psicología
Departamento
Metodología de las Ciencias del Comportamiento