RESUMEN
Objective To study the effects of acute hypervolemic hemodilution (AHH) with hydroxyethly starch 130/0.4 on function of blood clotting in patients undergoing spinal operation. Methods Thirty patients scheduled for spinal operation were randomly divided into AHH group and control group with 15 cases each. Patients in AHH group were performed AHH by transfusing hydroxyethly starch 130/0.4 (15 ml/kg) with 25 ml/min before skin incision, to achieve expansion of 20% to 30%. Patients in control group were transfused routinely. Blood samples were taken from internal jugular vein before anesthesia induction (T0), at 1 h after anesthesia induction (T1) and termination of operation (T2) for determination of hemoglobin (Hb), hematocrit (Hct), platelet (Plt), prothrombin time(PT), partial thromboplastin time ( APTT), thrombin time( TT) and fibrinogen( FIB), at the same time heart rate( HR), mean arterial pressure (MAP) and central venous pressure (CVP) were observed and recorded. Results HR and MAP in both groups had no statistical difference within or between groups (P > 0.05). CVP at T1 and T2 in AHH group [(11.8 ± 1.0,(11.3 ± 1.0) cm H2O (1 cm H2O = 0.098 kPa)]were higher than that at T0 [(6.3 ±0.7) cm H2O]and that in control group ( P < 0.05). Hb and Hct at T1 and T2 in AHH group were lower than that at T0 and that in control group (P< 0.05). Plt and FIB at T1 and T2 in AHH group decreased significantly than that at T0(P<0.05), while there were no statistical difference between two groups(P> 0.05). PT, TT and APTT in both groups had no statistical difference within or between groups (P > 0.05). Conclusion AHH with hydroxyethly starch 130/0.4 has no significant effect on function of blood clotting in patients undergoing spinal operation.
RESUMEN
Objective To investigate the application of repeated myocardial perfusion on difficult cardiac resuscitation after aortic unclamping under open heart operation. Methods Fifteen cases met difficult cardiac resuscitation after release of aortic cross-clamping under open heart operation were analyzed retrospectively. They were perfused with or without repeated aortic clamping, with warm blood cardioplegic solution until electric activity of cardiac muscle stop. Results All cases got cardiac resuscitation and detached from-cardiopulmonary bypass (CPB) successfully,9 cases perfused with warm blood cardioplegic solution without repeated aortic clamping got cardiac resuscitation automatically(7 cases) or after defibrillation for one time (2 cases),5 cases experiencing repeated aortic clamping and perfused with warm blood cardioplegic solution for two times got cardiac resuscitation automatically (3 cases) or after defibrillation for one time (2 cases) and another one experiencing for four times. Conclusion Application of repeated perfusion on difficult cardiac resuscitation after aortic unclamping under open heart operation is effective.
RESUMEN
Objective To investignte the effects of ambroxol on lung injury in children undergoing cardiac surgery with cardiopulmonary bypass (CPB).Methods Thirty-six ASA Ⅱ or Ⅲ children of both sexes aged≤8 yr,weighing≤25 kg undergoing repair of ventricular septal defect (VSD) under CPB were randomly divided into 3 groups (n=12 each):I control group (C);II low dose ambroxol group (2.25 mg/kg) (A,) and III moderate dose ambroxol group (4.50 mg/kg) (A2).Ambrexol was diluted with normal saline 10 ml and infused slowly after skin incision in group A1 and A2.In group C equal volume of normal saline(10 ml) was infused instead of ambroxol.Blood samples were taken from radial artery before skin incision,at 20 rain of CPB,20 rain after aortic unclamping,2 h and 6 h after temtination of CPB and 12 h after operation for determination of plasma MDA concentration and SOD activity and blood gas analysis.Respiratory index (RI) and pulmonary compliance (CL)were calculated.Results The plasma MDA concentration and RI were significantly lower while plasma SOD activity was significantly higher in group A2 than in group C and A1·CL was significantly higher in group A2 than in group C.Conclusion Ambroxol 4.50 mg/kg can attenuate lung injury in children undergoing cardiac surgery with CPB by decreasing lipid peroxidation.