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Effect of sequential assist-control ventilation on cardio-pulmonary function and systemic inflammatory state of chronic pulmonary heart disease complicated with respiratory failure patients

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Journal of Hainan Medical University 2018年第8期24卷 10-13页

作者： Jiang Wang Ya-Dong Yang Qiu-Fang She Yu Tang Huanggang Central Hospital Hubei Province

Objective:To discuss the effect of sequential assist-control ventilation on cardio-pulmonary function and systemic inflammatory state of chronic pulmonary heart disease complicated with respiratory failure ***: A total of 90 cases of chronic pulmonary heart disease complicated with respiratory failure patients, who were treated in our hospital between May, 2012 and Feb., 2016, were selected, and were divided into study group (n=45) and control group (n=45) based on random number table. Patients in control group were given auxiliary - control ventilation. (A/C) treatment during the whole course, while patients in study group were given A/C+BiPAP treatment. cardio-pulmonary function and serum inflammatory factor content difference was compared inboth groups before and after ***: Before treatment, difference ofcardiac function indicator, ABG level and inflammatory factor content in both groups had no statistical significance. After treatment, cardiac function indicator (PASP, RVd) levels in both groups were lower than before treatment, and EFRV levels were higher than before treatment, and changes in study group were more obvious than that in control group;ABG indicator (PaO2) levels in both groups were higher than before treatment, and PaCO2 levels werelower than before treatment, and changes in study group were more obvious than that in control group;serum inflammatory factor (hs-CRP, IL-6, TNF-α) content in both groups was lower than before treatment, and changes in study group were more obvious than that in control ***: sequential assist-control ventilation could optimize the cardio-pulmonary function of chronic pulmonary heart disease complicated with respiratory failure patients and reduce the systemic inflammatory response.

关键词： Chronic pulmonary heart disease Respiratory failure Sequential assist-control ventilation cardio-pulmonary function Inflammatory response

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Unexpected complication during extracorporeal membrane oxygenation support: Ventilator associated systemic air embolism

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World Journal of Clinical Cases 2018年第9期6卷 274-278页

作者： Se-Min Ryu Sung-Min Park Department of Thoracic and cardiovascular Surgery Kangwon National University Hospital School of Medicine Kangwon National Univerity

Systemic air embolism through a bronchovenous fistu-la(BVF) has been described in patients undergoing positive-pressure ventilation. However, no report has mentioned the potential risks of systemic air embolism through a BVF in patients undergoing extracorporeal membrane oxygenation(ECMO). Positive-pressure ventilation and ECMO support in patients with lung injury can increase the risk of systemic air embolism through a BVF. Increased alveolar pressure, decreased pulmonary venous pressure, and anticoagulation are thought to be the factors that contribute to this complication. Here, we present a case of systemic air embolism in a patient with ECMO and mechanical ventilator support.

关键词： Air embolism Extracorporeal membrane oxygenation Cerebral embolism Positive-pressure ventilation cardio-pulmonary resuscitation

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Time Course of Elevations in Plasma Olprinone Concentration during Pediatric Cardiac Surgery

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Open Journal of Anesthesiology 2013年第2期3卷 80-83页

作者： Satoshi Kurokawa Minoru Nomura Department of Anesthesiology Faculty of Medicine Tokyo Women’s Medical University Tokyo Japan

Purpose: Little research has been reported to date on the usefulness of olprinone in pediatric cardiac surgery, and no standard pediatric infusion protocol is currently established. Our study sought to confirm that the regimen described herein rapidly achieves the requisite plasma olprinone concentrations. Methods: For the purposes of our study, we enrolled 13 patients: 7 biventricular repair candidates and 6 Fontan-type operation candidates. We administered a continuous infusion of olprinone to our study subjects at 0.3 μg/kg/min with no loading dose starting approximately 30 minutes (min) before weaning from cardiopulmonary bypass (CPB). We performed blood sampling at 15, 30, 45, 60, 90, and 120 min after the start of infusion and at the same elapsed intervals after separation from CPB. We measured plasma olprinone concentrations using ultra-fast liquid chromatography. Results: We observed effective plasma olpri-none concentrations (>20 ng/ml) at 30 min after weaning from CPB, or at 60 min after the start of infusion. Conclusion: We conclude that continuous olprinone infusion at 0.3 μg/kg/min without a loading dose initiated immediately after the release of aortic cross-clamping or immediately after the completion of all surgical procedures quickly and reliably achieves effective plasma concentrations.

关键词： Olprinone Phosphodiesterase-3 Inhibitor Plasma Concentration Pediatric Cardiac Surgery Weaning from cardio-pulmonary Bypass

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Malposition of Stent a Rare Complication in Coarctation of Aorta Corrected with Extraanatomic Aortic Bypass

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World Journal of cardiovascular Surgery 2017年第12期7卷 164-168页

作者： Navnita Kisku Subrata Pramanik Kumar Aditya Subodh Satyarthi Department of CTVS GB Pant Hospital New Delhi India

Mal-position of stent in coarctation of aorta is very rare but a major complication. Symptoms can worsen even more. We present here one such case where stenting done in some other institute in which we did an extra-anatomical bypass from ascending aorta to supracelial aorta successfully bypassing the coarct segment. This was an early approach without assistance of Cadio-pulmonary (CP) Bypass. We conclude that this procedure should be done in centres where experienced operator and cardiac surgery back up is present. This was a good approach without assistance of CP Bypass.

关键词： Coarctation of Aorta Extra-Anatomical Bypass cardio-pulmonary Bypass

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