British Journal of Anaesthesia, Vol 76, Issue 1 13-19, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia
PGM. Jansen, H. te Velthuis, W. R. Wildevuur, MAJM. Huybregts, E. R. Bulder, H. I. van der Spoel, A. Sturk, L. Eijsman and CRH. Wildevuur
We have assessed the efficacy of cardiopulmonary bypass (CPB) using normal
colloid oncotic pressure (COP) in a randomized, controlled study of 20
patients undergoing elective coronary artery surgery using heparin-coated
circuits. For CPB, we used either crystalloid priming 1650 ml (n = 10) or
colloid priming 1650 ml (2.4% modified fluid gelatin, n = 10). While COP
did not change during bypass in the colloid group, a decline was observed
in the crystalloid group (P = 0.005). By the end of bypass, the decrease in
COP compared with baseline (delta COP) was 8.5 (S.D. 1.1) mm Hg in the
crystalloid group compared with 1.5 (2.1) mm Hg in the colloid group (P =
0.0001). delta COP correlated positively with fluid balance during bypass
(r2 = 0.41, P = 0.002). Similar increments in complement factors C3b/c and
C4b/c, tumour necrosis factor-alpha and neutrophil elastase, but not
endotoxins, were found in both groups as indicators of a systemic
inflammatory response. A clinical performance score composed of fluid
balance, postoperative duration of intubation and the difference between
rectal temperature and skin temperature was more favourable in patients
treated with colloid priming (P = 0.03). Median postoperative hospital stay
was 7 (range 5-16) days in the crystalloid group compared with 5 (4-8) days
in the colloid group (P = 0.016). Regression analysis indicated that CPB
time, fluid balance during operation and postoperative PO2/FlO2 ratio were
independent factors that predicted postoperative hospital stay. From these
preliminary results we conclude that in the absence of endotoxaemia, use of
a normal COP during CPB with modified fluid gelatin in heparin-coated
circuits resulted in an improved postoperative course an a reduction in
hospital stay.
CLINICAL INVESTIGATIONS
Cardiopulmonary bypass with modified fluid gelatin and heparin-coated circuits
Center for Cardiopulmonary Surgery Amsterdam, Department of Cardiac Surgery, Free University Hospital, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Department of Anesthesiology, Free University Hospital, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Department of Surgical Intensive Care, Free University Hospital, PO Box 7057, 1007 MB Amsterdam, the Netherlands; Department of Clinical Chemistry, University Hospital, PO Box 9600, 2300 RC Leiden, the Netherlands
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  O. Mangoush, S. Purkayastha, S. Haj-Yahia, J. Kinross, M. Hayward, F. Bartolozzi, A. Darzi, and T. Athanasiou Heparin-bonded circuits versus nonheparin-bonded circuits: an evaluation of their effect on clinical outcomes Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 1058 - 1069. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R de Vroege, F te Meerman, L Eijsman, W R Wildevuur, C. R. Wildevuur, and W van Oeveren Induction and detection of disturbed homeostasis in cardiopulmonary bypass Perfusion, September 1, 2004; 19(5): 267 - 276. [Abstract] [PDF]
|
|
|
|
|
|
M. A Ali and M. Saleh Selection of optimal quantity of hydroxyethyl starch in the cardiopulmonary bypass prime Perfusion, January 1, 2004; 19(1): 41 - 45. [Abstract] [PDF]
|
|
|
|
|
|
G.P. Eising, M. Niemeyer, Th. Gunther, P. Tassani, M. Pfauder, H. Schad, and R. Lange Does a hyperoncotic cardiopulmonary bypass prime affect extravascular lung water and cardiopulmonary function in patients undergoing coronary artery bypass surgery? Eur. J. Cardiothorac. Surg., August 1, 2001; 20(2): 282 - 289. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Struber, J. T. Cremer, B. Gohrbandt, C. Hagl, M. Jankowski, B. Volker, H. Ruckoldt, M. Martin, and A. Haverich Human cytokine responses to coronary artery bypass grafting with and without cardiopulmonary bypass Ann. Thorac. Surg., October 1, 1999; 68(4): 1330 - 1335. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Tigchelaar, R. C. G. Huet, P. W Boonstra, and W. van Oeveren Comparison of three plasma expanders used as priming fluids in cardiopulmonary bypass patients Perfusion, September 1, 1998; 13(5): 297 - 303. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Bruins, H. t. Velthuis, A. P. Yazdanbakhsh, P. G. M. Jansen, F. W. J. van Hardevelt, E. M. F. H. de Beaumont, C. R. H. Wildevuur, L. Eijsman, A. Trouwborst, and C. E. Hack Activation of the Complement System During and After Cardiopulmonary Bypass Surgery : Postsurgery Activation Involves C-Reactive Protein and Is Associated With Postoperative Arrhythmia Circulation, November 18, 1997; 96(10): 3542 - 3548. [Abstract] [Full Text]
|
|