Improvement of PaO2 During One-Lung Ventilation With Partial Left-Heart Bypass in Pediatric Patients Is Caused by Increased Blood Flow to the Dependent Lung

Yuki, Koichi; Chilson, Kelly; DiNardo, James A.

doi:10.1053/j.jvca.2011.12.011

Cited by 2 publications

(2 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some studies have suggested the use of a CPB or an oxygenator during LHB to achieve better oxygenation in patients with impaired pulmonary function ( 41 , 42 ). The research found that LHB improved arterial oxygenation during single-lung ventilation in open TAAA repair ( 40 , 43 ). The marked improvement in oxygenation was due to improvements in ventilation/perfusion mismatch and the pulmonary shunt elicited by the inserting an inflow cannula via the left pulmonary vein ( 44 ).…”

Section: Discussionmentioning

confidence: 99%

The application of modular multifunctional left heart bypass circuit system integrated with ultrafiltration in thoracoabdominal aortic aneurysm repair

Huang

Chen

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

Open thoracoabdominal aortic aneurysm (TAAA) repair is a complex and challenging operation with a high incidence of serious complications, and high perioperative mortality and morbidity. Left heart bypass (LHB) is a circulatory support system used to perfuse the distal aorta during TAAA operation, and the advantages of LHB include guaranteeing distal perfusion, reducing the use of heparin, and diminishing the risk of bleeding and postoperative neurological deficits. In China, the circuit for TAAA repair is deficient, and far from the perfusion requirements. We designed a modular multifunctional LHB circuit for TAAA repair. The modular circuit consisted of cannulation pipelines, functional consumables connection pipelines, and accessory pipelines. The accessory pipelines make up lines for selective visceral perfusion and kidney perfusion, suckers and rapid infusion. The circuit can be assembled according to surgical requirements. The ultrafilter and heat exchanger are integrated into the circuit to fulfill the basic demands of LHB. The LHB circuit also has pipelines for selective visceral perfusion to the celiac artery and superior mesenteric artery and renal perfusion pipelines. Meanwhile, the reserved pipelines facilitate the quick switch from LHB to conventional cardiopulmonary bypass (CPB). The reserved pipelines reduce the time of reassembling the CPB circuit. Moreover, the rapid infusion was integrated into the LHB circuit, which can rapid infusion when massive hemorrhage during the open procedures such as exposure and reconstruction of the aorta. The ultrafiltration can diminish the consequent hemodilution of hemorrhage and rapid infusion. A hemoperfusion cartridge also can be added to reduce the systemic inflammatory during operation. The circuit can meet the needs of LHB and quickly switch to conventional CPB. No oxygenator was required during LHB, which reduce the use of heparin and reduce the risk of bleeding. The heat exchanger contributes to temperature regulation; ultrafiltration, arterial filter, and rapid-infusion facilitated the blood volume management and are useful to maintain hemodynamic stability. This circuit made the assembly of the LHB circuit more easily, and more efficient, which may contribute to the TAAA repair operation performed in lower volume centers easily. 26 patients who received TAAA repair under the modular multifunctional LHB from January 2018-March 2022 were analyzed, and we achieved acceptable clinical outcomes. The in-hospital mortality and 30-day postoperative mortality were 15.4%, and the postoperative incidences of paraparesis (4%), stroke (4%), and AKI need hemodialysis (12%) were not particularly high, based on the limited patients sample size in short research period duration.

show abstract

Section: Discussionmentioning

confidence: 99%

The application of modular multifunctional left heart bypass circuit system integrated with ultrafiltration in thoracoabdominal aortic aneurysm repair

Huang

Chen

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

show abstract

“…6,7 However, only 2 studies have reported that LHB improved arterial oxygenation during OLV. 8,9 Because the change in oxygenation during LHB and the mechanism of its improvement have not been elucidated fully, such questions should be evaluated in more detail to prevent unexpected hypoxia during LHB.…”

mentioning

confidence: 99%

Impact of Left Heart Bypass on Arterial Oxygenation During One-Lung Ventilation for Thoracic Aortic Surgery

Suga

Kobayashi

Ochiai

2017

Journal of Cardiothoracic and Vascular Anesthesia

View full text Add to dashboard Cite

Improvement of PaO2 During One-Lung Ventilation With Partial Left-Heart Bypass in Pediatric Patients Is Caused by Increased Blood Flow to the Dependent Lung

Cited by 2 publications

References 17 publications

The application of modular multifunctional left heart bypass circuit system integrated with ultrafiltration in thoracoabdominal aortic aneurysm repair

The application of modular multifunctional left heart bypass circuit system integrated with ultrafiltration in thoracoabdominal aortic aneurysm repair

Impact of Left Heart Bypass on Arterial Oxygenation During One-Lung Ventilation for Thoracic Aortic Surgery

Contact Info

Product

Resources

About