Sartini Patrizio, Winfield Anna, Bizzarri Federico
Department of Medical Surgical Sciences and Biotechnologies, Cardiac Surgery Unit, Polo Pontino, Universita' degli Studi di Roma Sapienza, Latina, Italy.
J Cardiothorac Surg. 2012 Mar 9;7:20. doi: 10.1186/1749-8090-7-20.
Obese patients undergoing cardiac surgery have been shown to have a high risk of developing postoperative complications, specifically: increased length of hospital stay, readmission to intensive care unit, acute renal failure, deep sternal wound infections and new onset of atrial fibrillation.A custom-made circuit was created to allow the use of Mini Extra Corporeal Circulation (MECC) but permitting the switch to a closed siphon drainage system in the case of difficulties.To limit artificial surface contact a small oxygenating device (Admiral, Eurosets) was employed in spite of the patients size. This adapted circuit permits a feasible and safer approach to using MECC. This report suggests that smaller oxygenators could be integrated into clinical practice in an adult MECC configuration, even for more obese patients, limiting artificial surface contact.
接受心脏手术的肥胖患者已被证明有发生术后并发症的高风险,具体如下:住院时间延长、再次入住重症监护病房、急性肾衰竭、深部胸骨伤口感染以及新发房颤。设计了一种定制回路,以允许使用迷你体外循环(MECC),但在遇到困难时可切换至闭式虹吸引流系统。尽管患者体型较大,但为限制人工表面接触,仍采用了小型氧合装置(Admiral,Eurosets)。这种改良后的回路使得采用MECC有了一种可行且更安全的方法。本报告表明,即使对于更肥胖的患者,较小的氧合器也可整合到成人MECC配置的临床实践中,以限制人工表面接触。