延长辅助循环时间对危重心脏病患者复苏的影响

目的 探讨延长辅助循环时间对危重心脏患者复苏的影响.方法 选取30例危重患者行体外循环下冠脉搭桥手术及瓣膜置换手术,采用心脏复跳后延长辅助循环时间的处理方法.体外循环使用TERUMO SYSTER I型机.采用浅低温(33℃～35℃),中高流量(2.0～2.4L/minm2)灌注.心肌保护采用血液晶体4:1停跳液,先温...

The Influence of Extending the Auxiliary Cycle Time on the Recovery of Patients with Critical Heart Disease

Objective To discuss the influence of extending the auxiliary cycle time on the recovery of patients with critical heart disease.Methods 30 patients were treated coronary artery bypass surgery under cardiopulmonary bypass and valve replacement surgery,and weretreatment with the method of extending the auxiliary cycle time after heart resuscitation.Cardiopulmonary bypass used TERUMO SYSTER I Machine.Make a perfusion using mild hypothermia(33℃～35℃) and high flow(2.0～2.4 L/min·m2).Myocardial protection used cardioplegia with the ratio of 4∶1,and made antegrade perfusion.After the first volume of perfusing cardioplegia,no cardiac electrical activity was not regarded as second perfusion.Perfusion pressure maintains in 60～100 mmHg.Results 6 patients were treated pulsatile perfusion.And 3 patients appeared hemoglobinuria,22 patiets were taken general ultrafiltration,23 patients appeared automatic cardiac resuscitation,and 7 appeared shock resuscitation.Conclusion With the advancemet of cardiopulmonary bypass techniques and the improvement of cardiopulmonary bypass equipment,extending the auxiliary cycle time is safe.For the severe patients with coronary heart disease and valvular disease combined with other complications,cardiopulmonary bypass is an important safeguard,which is helpful to makemyocardium get enough rest and oxygen debt repayment,to create favorable conditions for successfully off-line andreduce the dependence ECMO postoperatively.