Complications of Cardiopulmonary Bypass From an Anesthesia Perspective: A Clinical Review.

Description Cardiopulmonary bypass (CPB) is frequently used for open heart surgery and other procedures that utilize temporary substitution or support of heart and lung function. While it is widely accepted as the predominant method to carry out these procedures, it is not without possible complications. CPB can be seen as the ultimate "team sport" as it includes and is dependent on contributions from multiple professionals including anesthesiologists, cardiothoracic surgeons, and perfusion technicians.

Lack of effectiveness of sodium bicarbonate in preventing kidney injury in patients undergoing cardiac surgery: a randomized controlled trial.

Study Objective: Because alkalinization of the renal tubules can theoretically protect against the mechanisms of acute kidney injury, we sought to determine whether a sodium bicarbonate infusion can prevent acute kidney injury after cardiac surgery.

Design: Prospective, randomized, double-blind, controlled trial.

Setting: Cardiac surgery service in a community hospital.

Benefits and risks of aprotinin use during cardiac surgery.

Aprotinin is a serine protease inhibitor with antithrombotic, antifibrinolytic, and antiinflammatory effects. It is effective in reducing bleeding and the need for blood transfusions after cardiac surgery with cardiopulmonary bypass. Additional benefits, such as cerebral protection, are hypothesized but not yet thoroughly substantiated.

Aprotinin use in cardiac surgery patients at low risk for requiring blood transfusion.

Study Objectives: To determine if aprotinin is safe and effective in patients at low risk for requiring blood transfusion after cardiac surgery by evaluating whether there is any significant difference in blood product use or other significant clinical outcomes between patients who received aprotinin versus those who did not.

Design: Retrospective review.

Setting: Inpatient community nonteaching hospital.

Risk of worsening renal function with nesiritide following cardiac surgery.

Purpose: The relationship between the perioperative use of nesiritide and the development of postoperative renal insufficiency in open-heart surgery (OHS) patients is discussed.

Summary: Postoperative renal dysfunction occurs in about 8% of patients who undergo elective coronary bypass surgery. The worsening of renal function is associated with increased length of stay and mortality.