Inaoka M, Kawaharada N
Department of Thoracic and Cardiovascular Surgery, Hakodate Goryoukaku Hospital, Japan.
Kyobu Geka. 1999 Jul;52(8 Suppl):702-6.
Twenty-six nonrandomized patients undergoing emergent coronary artery bypass operation were assigned to either the cold group (traditional intermittent cold blood cardioplegia and slight hypothermic cardiopulmonary bypass (n = 7) or the warm group (intermittent warm blood cardioplegia and normothermic cardiopulmonary bypass) (n = 19). Preoperative variables were similar in both groups except the number of renal dysfunction patients were greater in the cold group. The time from removal of the aortic crossclamp to discontinuation of cardiopulmonary bypass was significantly shorter in the warm group and the incidence of heartbeat spontaniously converted to normal sinus rhythm after removal of the aortic crossclamp was higher in the warm group. The warm group showed good results concerning postoperative blood loss volume, change of base excess, time required for awakening and extubation. Significant differences were found in the hospital mortality rates between the groups (cold: 57.1%, warm: 5.3%). This study suggested a beneficial influence of warm heart surgery on postoperative hemodynamics, metabolic recovery and hospital mortality in emergent coronary artery bypass grafting.
26例接受急诊冠状动脉搭桥手术的非随机患者被分为冷组（传统间歇性冷血心脏停搏液和轻度低温体外循环，n = 7）或温组（间歇性温血心脏停搏液和常温体外循环）（n = 19）。除冷组肾功能不全患者数量较多外，两组术前变量相似。温组从主动脉阻断钳移除到体外循环停止的时间明显更短，且主动脉阻断钳移除后心跳自发转为正常窦性心律的发生率在温组更高。温组在术后失血量、碱剩余变化、苏醒和拔管所需时间方面显示出良好结果。两组之间的医院死亡率存在显著差异（冷组：57.1%，温组：5.3%）。本研究表明，温心手术对急诊冠状动脉搭桥术后的血流动力学、代谢恢复和医院死亡率有有益影响。
