Autotransfusion of shed mediastinal blood after open heart surgery / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To determine the safety and effectiveness of autotransfusion of shed mediastinal blood after open heart surgery.</p><p><b>METHODS</b>Sixty patients undergoing coronary artery bypass grafting (CABG) were selected randomly to receive either nonwashed shed mediastinal blood (Group 1, n = 30) or banked blood (Group 2, n = 30). Drainage and transfusion volume were determined after the operation. Hb, RBC, HCT and PLT were detected immediately before and after the operation, as well as 24 hours and 7 days after the operation. Data were analyzed using Fisher's exact test. A P < 0.05 was considered significant.</p><p><b>RESULTS</b>There were no significant differences in Hb, HCT, PLT or length of cardiopulmonary bypass (CPB) (P > 0.05). In the two groups, no significant difference in the mean blood loss was observed during 24 hours after the operation (660 +/- 300 ml in Group 1 and 655 +/- 280 ml in Group 2, P > 0.05). In Group 1, the mean volume autotransfused was 280 +/- 160 ml, and the patients required 360 +/- 80 ml banked blood compared with 660 +/- 120 ml in Group 2. In other words, the banked blood requirement in Group 1 was 40% lower.</p><p><b>CONCLUSIONS</b>Autotransfusion of shed mediastinal blood after an open heart operation is safe and effective.</p>

Inhalation of nitric oxide to screen patients with congenital heart disease and pulmonary hypertension for operation / 中华胸心血管外科杂志

Objective: We assessed whether inhalation of low dose of nitric oxide comparing with administering 100% oxygen during cardiac catheterization would be as a method to screen patients with congenital heart disease and pulmonary hypertension for operation. Methods: We chose 67 cases of congenital heart disease with pulmonary hypertension undergoing cardiac catheterization. While spontaneously breathing room air (FiO 2, 0 21), the pulmonary artery pressure (PAP) and pulmonary vascular resistance (PVR) were recorded as baseline. Patients continued to breathing 40 ppm nitric oxide with FiO 2 0.30 and 100% oxygen, for 30 minutes. Effects of inhalation of nitric oxide on pulmonary vasculature were studied. Results: Comparing with breathing room air, after inhalation of 100% oxygen or 40 ppm nitric oxide, PAP, PVR and PRV/SVR were decreased significantly. Conclusion: Comparing with administer 100% oxygen, inhalation of nitric oxide is more sensible and reliable predictor in selecting patients with congenital heart disease and pulmonary hypertension for operation.