[Changes in intraoperative and postoperative colloid oncotic pressure after open heart surgery especially in relation to non-blood priming or blood priming].
In order to evaluate the colloid oncotic pressure (COP) is useful index of hemodynamics and respiratory recovery after open heart surgery, cardiac index (CI), pulmonary capillary wedge pressure (PCWP), (A-a) Do2 and COP were measured in 34 patients during 48 hours after the cardiopulmonary bypass (CPB). The patients were divided into non-blood priming group: 11 patients and blood priming group (23 patients). In addition, blood priming group divided into two groups, one with dopamine (more than 15 micrograms/kg/min), epinephrine or intraaortic balloon pumping (severe blood subgroup, n = 6) and the other without these treatments after open heart surgery (slight blood subgroup n = 17). The COP levels in the non-blood priming group were significantly higher than those in the blood priming group from aortic cross-clamp to 10 minutes after aortic declamping (p < 0.01). From 1 to 48 hours after CPB, COP in the non-blood priming group and slight blood subgroups was significantly higher than severe blood subgroups (p < 0.05). CI and COP-PCWP levels were significantly higher in the non-blood priming group and slight blood subgroups than those in the severe blood group (p < 0.05). It is concluded that COP is useful index of hemodynamics and respiratory recovery after open heart surgery and our priming system without blood is effective in order to eliminate the blood transfusion.
Kanazawa
M
M
First Department of Surgery, Yamaguchi University School of Medicine, Ube, Japan.
Fujimura
Y
Y
Kawamura
T
T
Takaki
Y
Y
Okada
H
H
Nishi
K
K
Tsuboi
H
H
Esato
K
K
D000368:Aged; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003102:Colloids; D006331:Heart Diseases / Q000503:physiopathology* / Q000601:surgery; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D007423:Intra-Aortic Balloon Pumping; D007432:Intraoperative Period; D008875:Middle Aged; D009997:Osmotic Pressure; D010949:Plasma / Q000502:physiology*; D011184:Postoperative Period; D012119:Respiration
D003102:Colloids