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Hypothermic versus normothermic cardiopulmonary bypass in patients with valvular heart disease.

Abstract：

OBJECTIVE:The aim of this study was to test the hypothesis that normothermic cardiopulmonary bypass (CPB) is as effective as hypothermic CPB in terms of cardiac protection (cTnI level) and outcome in patients with valvular heart disease. DESIGN:Prospective randomized study. SETTING:A tertiary cardiothoracic referral center. PARTICIPANTS:140 patients who had valvular heart disease, with/without coronary artery disease, surgically treated under CPB. INTERVENTIONS:The patients were allocated randomly to undergo either hypothermic (temperature [T], 31 °C-32 °C) or normothermic CPB (T>36 °C). MEASUREMENTS AND MAIN RESULTS:The primary endpoint was the dynamics of troponin I. The secondary endpoints were ventilation time, the need for inotropic support, intensive care unit (ICU) and hospital stay durations, complications, and mortality. There were no significant intergroup differences in dynamics of troponin I. Ventilation time was significantly lower in the hypothermic group (6 (5-9) and 8 (5-12); p = 0.01). CONCLUSIONS:Normothermic CPB in patients with valvular heart disease was as effective as hypothermic perfusion in terms of myocardial protection after the surgery assessed by cTnI release. The short ventilation duration in patients who underwent hypothermic CPB needs to be confirmed in a future investigation.

journal_name

J Cardiothorac Vasc Anesth

journal_title

Journal of cardiothoracic and vascular anesthesia

authors

Lomivorotov VV,Shmirev VA,Efremov SM,Ponomarev DN,Moroz GB,Shahin DG,Kornilov IA,Shilova AN,Lomivorotov VN,Karaskov AM

doi

10.1053/j.jvca.2013.03.009

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

295-300

issue

2

eissn

1053-0770

issn

1532-8422

pii

S1053-0770(13)00153-5

journal_volume

28

pub_type

杂志文章,随机对照试验

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