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hulajnoga
Dołączył: 07 Maj 2011
Posty: 37
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Wysłany: Pią 13:19, 13 Maj 2011 Temat postu: Abercrombie Paris,Anesthetic experience of emergen |
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Experience of Anesthesia ECPB
Key words anesthetic experience in cardiopulmonary bypass pump is Applied pipeline will be the great vessels of artificial human heart-lung machine with artificial connection from the venous system leads to blood,[link widoczny dla zalogowanych], and in vitro oxygenation, blood pump oxygenated blood then transferred back to the whole process of the arterial system, also known as cardiopulmonary bypass, mainly used in heart , major vascular surgery. With cardiovascular surgical techniques, cardiopulmonary bypass (CPB) as a life-support technology has been widely used in clinical. Understanding of CPB on the pharmacokinetics and pharmacodynamics will help anesthesiologists more reasonable treatment. Our hospital from January 2005 to March 2009 admitted to the emergency cardiopulmonary bypass (ECPB) surgery in 14 cases,[link widoczny dla zalogowanych], 14 patients now experience Anesthesia report below. 1 clinical data 1.1 General Information The group of 14 patients,[link widoczny dla zalogowanych], male 12, female 2; aged 16 to 63 years old, weighing 33 ~ 80kg. Valsalva sinus rupture in which 3 cases of aortic aneurysm rupture in 3 cases (including one case of rupture of thoracic aortic dissection), heart failure after mitral valve replacement surgery three cases, Marfan's syndrome, two cases of rupture of the great vessels, coronary heart disease rupture of the left anterior descending artery balloon dilatation in 1 case,[link widoczny dla zalogowanych], rupture of right coronary sinus into the right ventricle in 1 case. 2 of them into the operating room breathing, cardiac arrest, the chest incision within the cardiac thoracic compression, systemic heparinization, the aorta and right atrium were intubation ECPB. Whole body cooling to 22 ~ 28 ℃, intraoperative aortic root or direct coronary incision aortic perfusion 4 ℃ cold potassium cardioplegia supplemented with ice shavings and heart surface to enhance myocardial protection. The total CPB time was 66 to 225 minutes, aortic cross-clamping time was 46 to 134 points. The patient into the operating room after the intravenous injection of scopolamine 0.15 ~ 0.3mg, completed before the induction of the right subclavian vein infusion, the left radial artery pressure measurement, EKG Ⅱ lead and continuous monitoring of SpO2, all groups were to fentanyl as Main anesthesia. Stability of 0.1 ~ 0.2mg/kg or intravenous midazolam 0.1mg/kg, fentanyl 10 ~ 20mg/kg, induced by pancuronium 0.1mg/kg, fentanyl is about the total 50mg/kg, combined with inhaled anesthesia was maintained. 2 Results 14 patients, 11 of cardiac auto-resuscitation cases, 3 cases of electrical shock resuscitation. 9 cases were cured, 5 patients died, 2 patients died in surgery, 1 died of aortic aneurysm Louxue stump anastomosis, 1 patient died of emergency coronary artery bypass graft failure, arrhythmia,[link widoczny dla zalogowanych], and the remaining 3 cases, 1 9 days after surgery patients died of unknown causes, 1 died of acidosis and electrolyte disturbance, 1 patient died of respiratory failure 7 days. The intraoperative inotropic drugs were used and sodium nitroprusside or nitroglycerin.
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