在心肺旁路术期间心脏和心肌保护
R M Engelman1, S Levitsky, M J O'Donoghue
1Department of Surgery, The Abraham Lincoln School of Medicine, The University of Illinois at the Medical Center, Chicago, USA.
Circulation
|September 1, 1978
概括
低温症与多剂量性心脏结合,在心脏骤停和再注射期间提供足够的心肌保护. 其他方法,包括单独的低温停止或正常热量的心肌,证明不足以提供最佳的心脏保护.
科学领域:
- 心脏病学 心脏病学
- 心血管外科心血管外科
- 实验医学是一种实验医学.
背景情况:
- 在涉及缺血性心脏骤停的心脏手术期间,肌肉心脏的保存至关重要.
- 优化保存技术可以减少缺血-再输血损伤.
- 低温和心脏是常见的,但需要改进.
研究的目的:
- 评估低温和性心肌丧在心肌脏保存方面的疗效.
- 为了比较不同组合的低温症,心肌,和 perfusates.
- 确定在长期缺血期间保护心脏的最佳方案.
主要方法:
- 在体内准备的猪心,120分钟的缺血性停止和30分钟的再注血.
- 七个实验小组评估了不同的保存策略.
- 测量的主要参数:心肌收缩性,顺应性和血液流量.
主要成果:
- 没有心肌的低温性停止和正常热量的心肌性停止导致了不充分的保存.
- 作为血性透剂和单剂量心肌,表现出改善但不充分的结果.
- 只有低温与多剂量 (35mEq/L) 心脏,才能达到足够的心肌维护,收缩率为129%,并增加了遵守.
结论:
- 多剂量性心与低温相结合,对于有效的心肌保护至关重要.
- 简单的方法,如低温性停止或正常热性心是不够的.
- 这项研究确定了在手术期间保持心脏功能的最佳方案.
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