جستجوی مقالات مرتبط با کلیدواژه « cardiopulmonary » در نشریات گروه « پزشکی »

 A critical, therapeutic interference that develops the opportunity of survival is cardiopulmonary resuscitation (CPR). One of the practical factors resulting from resuscitation is the presence or absence of underlying disorders in patients.

 This experiment aims to evaluate the primary disease and success rate of resuscitation.

 This study was an observational retrospective study; the therapeutic histories of all patients who sustained CPR were collected. A total of 587 patient case histories, who were supported with in Hospital CPR within two years from January 2017 to June 2018, were enrolled in the current investigation. The association of CPR success rate with underlying disease, the first cardiac rhythm observed after monitoring, and the use of cardiac defibrillator was investigated.

 Overall, the success valuation of CPR in this investigation was 26.3%. There was no notable correlation between the success rate of CPR, and the early detection of cardiac rhythm after monitoring and using a cardiac defibrillator. Past medical histories reported a difference among the success rates of CPR in patients with hypertension, diabetes, and cardiac and renal disease.

 The current study revealed a significant difference in past medical histories and CPR outcomes.
 

Donor heart shortage limits heart transplantations programs while the number of patients waiting for cardiac transplant continues to increase. Optimizing the use of all available donor hearts is a vital key to reduce waiting list mortality. Among different extended criteria, prolong cardiopulmonary resuscitation (CPR), i.e. more than 20 min, has been considered under doubt to be a selection criterion in donor selection. The aim of this study was to compare the outcomes of heart transplantation from cardiopulmonary-resuscitated donors to those who received hearts from donors who did not require cardiopulmonary resuscitation.

This study was a retrospective analysis of adult heart transplantation program in Masih Daneshvari Hospital in Tehran, Iran from 2010 to 2019. Donors and recipients’ demographics, cause of end-stage heart disease and brain death, duration of hospitalization for both donors and recipients and also the duration of cardiopulmonary resuscitation and other factors related to it were investigated. Qualitative variables were compared using Chi-square test. Quantitative variables were compared using T-test. Patient and graft survival rates were calculated using the actuarial method and compared using Wilcoxon's test.

Among 92 recipients, 39 were transplanted with cardiac grafts from CPRsuffering donors. There were no significant differences regarding sex, age, donor and recipient hospitalization periods, early rejection and 1-year-survival rate considering CPR and non-CPR grafts. However, we detected a strong negative correlation between the duration of CPR and 3-year-survival rate (P = 0.02 and R-value = -0.62) and also its association with post-transplant arrhythmias (P = 0.04).

There is a negative possible influence of long-lasting CPRs (especially more than 20 minutes) in midterm survival and post-transplant complications.

In patients undergoing Cardiopulmonary Bypass (CPB) with extracorporeal circulation, the rapid restoration of blood flow to the ischemic tissue induces cardiac damage termed as myocardial Ischemic Reperfusion (I/R) injury.

In the current study, the researchers hypothesized that Dexmedetomidine (DEX) modulates I/R injury in Coronary Artery Bypass Graft Surgery (CABG) with Cardiopulmonary Bypass (CPB).

This randomized, double-blind, clinical trial took place in a university affiliated Hospital, Gilan, Iran. From April 2016 to March 2017, 114 eligible patients undergoing elective and isolated CABG were randomized to receive either DEX infusion 0.3 to 0.5 µg/kg/hour before induction of anesthesia till 12 hours postoperatively (group D) or normal saline as placebo (group C). The endpoints were used to assess creatinine phosphokinase-MB (CKMB) and cardiac troponin I (CTnI) levels at four measurement time points, including baseline (T0) and 6, 12, 24, and 48 hours after the operation (T0 - T4).

Overall, 114 patients’ data were analyzed; group D (n = 58) and group C (n = 56). No significant differences were found between the two groups, in view of baseline characteristics. Following CPB, a marked increase in CKMB and CTnI plasma levels was observed in both groups compared with baseline (P = 0.0001). Serum CKMB levels increased from 2.27 ± 0.59 to 7.81 ± 1.39, and 2.22 ± 0.64 to 7.46 ± 1.25 and CTnI levels from 10.22 ± 0.17 to 4.89 ± 1.1, and 0.27 ± 0.28 to 4.5 ± 1.4 in groups C and D, respectively (P = 0.0001). According to CKMB, there was a significant difference between the two groups at T2 (P = 0.002) and T3 (P = 0.0001), and based on CTnI at T2 (P = 0.004) and T3 (P = 0.0001). However, no significant difference was observed at the other measurement point times. No adverse effect was recorded due to this intervention.

Perioperative DEX in cardiac surgery appears safe, with properties to alleviate I/R injury. Obviously, future standard trials are required to find optimal intervention strategies.