RESUMO
@#Objective To explore the effect of whether or not to stop beating after conversion to cardio-pulmonary bypass (CPB) in off-pump coronary artery bypass grafting. Methods From 2016 to 2018, 177 patients with off-pump coronary artery bypass grafting in Beijing Anzhen Hospital were transferred to CPB. According to whether they stopped beating after conversion to CPB during the operation, they were divided into two groups. A non-stop beating group: there were 76 patients with 45 males, 31 females. aged 63.53±6.98 years, who were not to stop beating after conversion to CPB. A stop beating group: there were 101 patients with 66 males and 35 females, aged 63.98 ± 8.37 years, who were to stop beating and underwent the modified perfusion and application of papaverine in perfusion after conversion to CPB. The clinical effect of the two groups was compared. Results There were 14 deaths in the perioperative period. The mean graft flow (MGF) in the stop beating group was higher (P=0.033), and the pulse index (PI) was lower (P=0.001) than those in the non-stop beating group. Intra-aortic balloon counter pulsation (P=0.036), extracorporeal membrane oxygenation (P=0.038), continuous renal replacement therapy (P=0.014), ventilator-assisted time (P=0.021), ICU monitoring time (P=0.012), perioperative mortality (P=0.025) and the ejcetion fraction value (P=0.023) were significantly different between the groups. Conclusion Compared with not to stop beating, those to stop beating can get better perioperative clinical effect after conversion to CPB, which is worthy of recommendation.
RESUMO
Clinically, six minute walk test (6MWT) is the most common exercise test. It is used to estimate the level of physical fitness among patients. The aim of this research to measure the beat by beat heart rate slopes instead of depending on the covered distance to predicate and estimate the level of physical fitness during 6MWT. Seventy (70) healthy adult male students aged between 18 to 27 years were recruited randomly from the general Saudi population in Riyadh. 6 MWT using 50 meter corridor was performed according to standardized American Thoracic Society (ATS) guidelines. Mean distance walked in 6 minutes (470.5±64.6 meters) and beat by beat heart rate (HR) was calculated by heart rate monitor. In addition Body mass index (BMI), Body surface area (BSA), Borg Rating of Perceived Exertion (BRPE) and Maximum predicted heart rate percentage (MPHRP) was also calculated. A stepwise regression equation was used to predict six minute walk test distance (6MWTD), six minute walk test slope (6MWTS) and recovery slope. There was a significant correlation between 6MWTS and the recovery slope (r= -0.460, p <0.001), 6MWTS with 6MWTD (r= 0.264, p<0.05) and recovery slope with 6MWTD (r= -0.249, p <0.05). In conclusion, both 6MWTS and recovery slope can predict the 6MWD