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Titolo:
Impact of myocardial protection during coronary bypass surgery on patient outcome
Autore:
Mehlhorn, U; Fattah, M; Kuhn-Regnier, F; Sudkamp, M; Geissler, HJ; Raji, MR; Fischer, UM; de Vivie, ER;
Indirizzi:
Univ Cologne, Clin Cardiothorac Surg, D-50924 Cologne, Germany Univ Cologne Cologne Germany D-50924 orac Surg, D-50924 Cologne, Germany
Titolo Testata:
CARDIOVASCULAR SURGERY
fascicolo: 5, volume: 9, anno: 2001,
pagine: 482 - 486
SICI:
0967-2109(200110)9:5<482:IOMPDC>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
COLD BLOOD CARDIOPLEGIA; BETA-BLOCKADE; CARDIOPULMONARY BYPASS; VENTRICULAR-FUNCTION; ARTERY SURGERY; ANTEGRADE; WARM; PERFUSION; ISCHEMIA; ARREST;
Keywords:
myocardium; cardioplegia; beta-blocker; surgery; coronary disease; hospital stay;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Mehlhorn, U Univ Cologne, Clin Cardiothorac Surg, Joseph Stelzmann Str 9, D-50924 Cologne, Germany Univ Cologne Joseph Stelzmann Str 9 Cologne Germany D-50924 y
Citazione:
U. Mehlhorn et al., "Impact of myocardial protection during coronary bypass surgery on patient outcome", CARDIOV SUR, 9(5), 2001, pp. 482-486

Abstract

We have recently shown that continuous coronary perfusion with warm blood enriched with the ultra-short acting B-blocker Esmolol (ES) improves functional and structural myocardial protection during coronary artery surgery ascompared with conventional cardioplegia (CP). The purpose of the present study was to compare both myocardial protection techniques in terms of patient outcome. We retrospectively analyzed the charts of 150 consecutive patients subjected to coronary artery surgery using the ES-technique: 150 patients matched for age, gender, preoperative left ventricular function, historyof renal failure, and history of neurological symptoms undergoing surgery with conventional CP during the same time period served as control group. There were no significant differences between both groups with respect to perioperative myocardial infarction rate, need for positive inotropic medication, need for mechanical circulatory support, duration of mechanical ventilation, duration of intensive care unit stay, time of mobilization, postoperative renal failure, cardiac arrhythmias, neurological symptoms, infectionsor in-hospital mortality. ES-patients were less frequently readmitted to the intensive care unit (ES: 3/150; 2.2% [95% confidence interval: 0-4.2%] vs CP: 13/150; 8.7% [4.2-13.2%]: P = 0.010) and total hospital stay was shorter (ES: 12.3 +/- 4.8 days [95% CI: 11.5-13.0] vs CP: 13.5 +/- 3.8 [12.9-14.1] days; P = 0.0013), thus saving 159 patient days on the normal ward. Procedural costs were less for the ES-technique (US$ 60 per patient) as compared to the cardioplegia technique (US$ 120 per patient). These data suggest that myocardial protection using the ES-technique does not improve clinicaloutcome in patients subjected to routine coronary artery surgery, but may save costs. (C) 2001 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 13:19:39