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对比心肺转流手术中应用的新型集成与非集成动脉滤器:一项随机、前瞻性、单盲研究。

Comparison of new technology integrated and nonintegrated arterial filters used in cardiopulmonary bypass surgery: a randomized, prospective, and single blind study.

机构信息

Department of Cardiovascular Surgery, Marmara University Medical Faculty, 34668 Istanbul, Turkey.

出版信息

Biomed Res Int. 2013;2013:529087. doi: 10.1155/2013/529087. Epub 2013 Nov 11.

Abstract

BACKGROUND

Innovative cardiopulmonary bypass (CPB) settings have been developed in order to integrate the concepts of "surface-coating," "blood-filtration," and "miniaturization."

OBJECTIVES

To compare integrated and nonintegrated arterial line filters in terms of peri- and postoperative clinical variables, inflammatory response, and transfusion needs.

MATERIAL AND METHODS

Thirty-six patients who underwent coronary bypass surgery were randomized into integrated (Group In) and nonintegrated arterial line filter (Group NIn) groups. Arterial blood samples for the assessments of complete hemogram, biochemical screening, interleukin-6, interleukin-2R, and C-reactive protein were analyzed before and after surgery. Need for postoperative dialysis, inotropic therapy and transfusion, in addition to extubation time, total amount of drainage (mL), length of intensive care unit, and hospital stay, and mortality rates was also recorded for each patient.

RESULTS

Prime volume was significantly higher and mean intraoperative hematocrit value was lower in Group NIn, but need for erythrocyte transfusion was significantly higher in Group NIn. C-reactive protein values did not differ significantly except for postoperative second day's results, which were found significantly lower in Group In than in Group NIn.

CONCLUSION

Intraoperative hematocrit levels were higher and need for postoperative erythrocyte transfusion was decreased in Group In.

摘要

背景

为了整合“表面涂层”、“血液过滤”和“微型化”的概念,开发了创新的心肺转流(CPB)设置。

目的

比较集成和非集成动脉管路过滤器在围手术期临床变量、炎症反应和输血需求方面的差异。

材料和方法

36 名接受冠状动脉旁路手术的患者随机分为集成(Group In)和非集成动脉管路过滤器(Group NIn)组。在手术前后分析了动脉血样的全血细胞计数、生化筛选、白细胞介素-6、白细胞介素-2R 和 C 反应蛋白。记录了每位患者的术后透析、正性肌力治疗和输血、拔管时间、总引流量(mL)、重症监护病房和住院时间以及死亡率等。

结果

Group NIn 的预充液体积明显较高,术中平均血细胞比容值较低,但 Group NIn 需要输注红细胞的情况明显更多。C 反应蛋白值除了术后第二天的结果外,没有显著差异,Group In 的结果明显低于 Group NIn。

结论

Group In 的术中血细胞比容水平较高,术后需要输注红细胞的情况减少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f65/3844207/c852e4b6a6fa/BMRI2013-529087.001.jpg

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