[Personal observations with application of auto-oxygenation techniques in the surgical management of coronary...

There were presented operative technique and clinical results of extracorporeal circulation (ECG) with patients lungs utilization, instead of routinely applied artificial blood oxygenators. Auto-oxygenation method was applied in 12 patients with coronary artery disease treated by coronary artery bypass grafting (CABG). Operative procedure differs from the traditional one in two additional cannulations of pulmonary artery and left atrium. Two peristaltic pumps and incorporated in circulation blood reservoirs. Polystan 892910 allows for temporary substitution of cardiac function without lung disconnection. Lungs functioning during surgery do not render it difficult. Hypothermia enables to decrease respiration rate and tidal volume with no effect on physiological blood oxygenation and CO2 exhalation. Method assessment was based on results comparison with those obtained in patients treated by traditional method using bubble oxygenators-Venotherm 5,000. PO2, PCO2, platelets number and hemolysis extent were assessed before, in 10, 30, 60 min of ECG and just after it. Platelets activity and influence of the method on hemostatic disorders were evaluated based on clotting time by Ivy. Additionally hemostatic disorders were assessed by thoracic blood drainage volume calculated from the moment of protamine administration to drainage tubes withdrawal in average 18 hours after surgery. Laboratory parameters characteristically changing during ECG were also estimated. It was proved, that auto-oxygenation diminished negative effects of ECG. Increased platelets number, faster normalization of clotting time and decreased postoperative drainage were stated in the auto-oxygenation group. Postoperative drainage in this group was 260 +/- 60 ml in comparison with 800 +/- 100 ml of the control group. Authors consider that pulmonary function remaining during ECG positively affects on postoperative hemostasis. This method can be helpful in surgical management of coronary artery disease, especially in patients with primary coagulation disorders.