Naslov
Cardiopulmonary Bypass in Infective Endocarditis Patients

Autori
Mrkonjić, Ružica ; Sentić, Marko ; Marušić, Natalija ; Solarić, Mladen ; Lukačević, Nenad

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, stručni

Izvornik
The Journal of Cardiovascular Surgery. Abstract book. / Castellani, L - Saluzzo : Minerva Medica, 2012, 161-161

Skup
The 61st International Congress of the European Society of Cardiovascular and Endovascular Surgery

Mjesto i datum
Dubrovnik, Hrvatska, 25.04.2012. - 28.04.2012

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
infective endocarditis, cardiopulmonary bypass

Sažetak
Aim: Infective endocarditis is a disease of the heart, but it is also a multisystem disorder where inflammatory response further worsens as the result of the interaction between white blood cells, platelets, endothelial cells, various cytokines and the bacterium. Due to this reason, infective endocarditis remains a challenging disease to manage during cardiopulmonary bypass (CPB). The aim of this study is to summarize the management experience of CPB during valve replacement for infective endocarditis. Methods:Between January 2000 and January 2012 in our hospital valve replacement was performed in 74 cases of infective endocarditis, 61(82%) male and 13(18%) female patients. The mean age was 50.1 years. CPB was performed using moderate to normal temperature ( 29-37°C ) and moderate to high flow rates (1.9-3.0 l/min/m2). Myocardial protection was identical for all patients and consisted of an anterograde and retrograde cold blood crystalloid cardioplegia (4:1) with topical ice slush. Pathophysiologal events and its clinical presentations during CPB, complications and mortality were recorded and analysed. Results: The most common causes of infections were Staphylococcus aureus, Staphylococus epidermidis, MRSA/MRSE and Enterococcus faecalis. Mean duration of CPB: 126 minutes Ao clamp: 80 minutes Administration of infusions during CPB: n= 46 (62%) patients, average volume 1086ml Hemofiltration: 29 ( 39%) patients Average volume of hemofiltration : 1645ml Htc before CPB: 28% Transfusion requirement during CPB: n= 56(76 %) patients Mean total RBC transfusion during CPB (keep HCT > 20%): 604ml ACT before CPB after initial heparin: 469 sec Extra Heparin during CPB (keep ACT>480) : n= 68 (92%) patients Average dose of extra Heparin: 325 mg/kg CPB vasopressor requirement :n=47 (64%) patients The average dose of vasoconstrictors: 0, 0526mg/kg Conclusions The main challenges for perfusion during valve replacement in infective endocarditis patients were handeling systemic pressure due to vasoplegic syndrome and adequate anticoagulation.

Izvorni jezik
Engleski

Znanstvena područja
Biotehnologija u biomedicini (prirodno područje, biomedicina i zdravstvo, biotehničko područje)

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