The amylase-creatinine clearance ratio following cardiopulmonary bypass

Murray, William R.; Mittra, Susheela; D, Mittra; Roberts, Lesley; Taylor, Kenneth M.

doi:10.1016/s0022-5223(19)39362-6

Cited by 28 publications

(2 citation statements)

References 26 publications

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“…Two relatively large human studies published in the late 1970s were contradictory 42,43. In the late 1970s to early 1980s, Taylor and associates in a series of small clinical investigations revealed PF to be safe44 and associated with decreased cortisol levels,45 improved pituitary function,46 decreased angiotensin II levels,47 decreased SVR,47 and improved pancreatic blood flow 48…”

Section: S: Contradictory Resultsmentioning

confidence: 99%

Pulsatile versus nonpulsatile blood flow during cardiopulmonary bypass

Chaney

2022

International Anesthesiology Clinics

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Section: S: Contradictory Resultsmentioning

confidence: 99%

Pulsatile versus nonpulsatile blood flow during cardiopulmonary bypass

Chaney

2022

International Anesthesiology Clinics

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“… 19 Similar findings have emerged from studies of the splanchnic circulation, with reduced frequency of elevated amylase levels observed in patients receiving CPB with IABP. 20 IABP during CPB preserves the liver, decreasing aspartate aminotransferase leakage. 21 More recently, the benefit of IABP during CPB has been investigated in an elderly population by Onorati and colleagues.…”

Section: Discussionmentioning

confidence: 97%

How much of the intraaortic balloon volume is displaced toward the coronary circulation?

Kolyva

Pantalos

Pepper

et al. 2010

The Journal of Thoracic and Cardiovascular Surgery

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ObjectiveDuring intraaortic balloon inflation, blood volume is displaced toward the heart (Vtip), traveling retrograde in the descending aorta, passing by the arch vessels, reaching the aortic root (Vroot), and eventually perfusing the coronary circulation (Vcor). Vcor leads to coronary flow augmentation, one of the main benefits of the intraaortic balloon pump. The aim of this study was to assess Vroot and Vcor in vivo and in vitro, respectively.MethodsDuring intraaortic balloon inflation, Vroot was obtained by integrating over time the aortic root flow signals measured in 10 patients with intraaortic balloon assistance frequencies of 1:1 and 1:2. In a mock circulation system, flow measurements were recorded simultaneously upstream of the intraaortic balloon tip and at each of the arch and coronary branches of a silicone aorta during 1:1 and 1:2 intraaortic balloon support. Integration over time of the flow signals during inflation yielded Vcor and the distribution of Vtip.ResultsIn patients, Vroot was 6.4% ± 4.8% of the intraaortic balloon volume during 1:1 assistance and 10.0% ± 5.0% during 1:2 assistance. In vitro and with an artificial heart simulating the native heart, Vcor was smaller, 3.7% and 3.8%, respectively. The distribution of Vtip in vitro varied, with less volume displaced toward the arch and coronary branches and more volume stored in the compliant aortic wall when the artificial heart was not operating.ConclusionThe blood volume displaced toward the coronary circulation as the result of intraaortic balloon inflation is a small percentage of the nominal intraaortic balloon volume. Although small, this percentage is still a significant fraction of baseline coronary flow.

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Pancreatic Complications Following Cardiopulmonary Bypass

Lefor

Vuocolo²,

Parker³

et al. 1992

Arch Surg

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Pancreatic complications following cardiopulmonary bypass are infrequent but are associated with high mortality. All cases of pancreatic complications following cardiopulmonary bypass from 1972 to 1987 at a single institution were retrospectively reviewed. Of 5621 patients who underwent cardiopulmonary bypass, 25 (0.44%) sustained pancreatic complications. There were 15 cases of acute pancreatitis and 10 cases of pancreatic necrosis, with 11 deaths in the group reviewed, a mortality rate of 44%. Factors that were correlated with mortality associated with pancreatic complications in this study include preoperative hypotension, preoperative use of inotropic agents, and renal failure (preoperative and postoperative). Factors that have been previously associated with mortality from pancreatic complications in other studies, such as fluid sequestration, respiratory failure, sepsis, tachycardia, hypocalcemia, age greater than 55 years, and abnormal laboratory findings, were not found to be significantly associated with mortality in this study. Of the five patients for whom complete data were available, not one patient received greater than 800 mg of calcium per square meter of body surface area in the perioperative period. While the exact mechanism of pancreatic injury remains unclear, based on experimental studies and clinical correlation, it is likely that pancreatic ischemia remains a significant contributing factor. We conclude that no factor specifically associated with cardiopulmonary bypass was correlated significantly with mortality.

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The amylase-creatinine clearance ratio following cardiopulmonary bypass

Cited by 28 publications

References 26 publications

Pulsatile versus nonpulsatile blood flow during cardiopulmonary bypass

Pulsatile versus nonpulsatile blood flow during cardiopulmonary bypass

How much of the intraaortic balloon volume is displaced toward the coronary circulation?

Pancreatic Complications Following Cardiopulmonary Bypass

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