Reduced per- and postoperative mortality following the use of urea during elective cardiopulmonary bypass. A proposed treatment for the prevention of reduced red cell deformability during open heart surgery.
The vital micro-rheological function of the red cells to deform was monitored during extracorporeal circulation in 75 patients undergoing open heart surgery. Red cell deformability was assessed in vitro by estimating red cell filtration rate (RFR). Urea was given to 32 patients during surgery and the remaining 43 acted as controls. After one hour on cardiopulmonary bypass (CPB) all patients showed a significant reduction of red cell filtration rate which continually worsened. In control patients where the RFR was severely altered there appeared to be more morbidity and mortality (11.6%). Using this simple method it is possible for the perfusionist to assess blood damage rapidly and possibly anticipate a difficult postoperative recovery. Urea administered during CPB reduced the decrease in RFR by a significant extent and in these patients the postoperative course was relatively uneventful and all survived.
D001026:Coronary Artery Bypass / Q000379:methods / Q000401:mortality*; D004907:Erythrocyte Deformability / Q000187:drug effects*; D005260:Female; D006349:Heart Valve Diseases / Q000097:blood* / Q000401:mortality / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011897:Random Allocation; D013997:Time Factors; D014508:Urea / Q000627:therapeutic use*
D014508:Urea