Linked Life Data

9394573

Source:http://linkedlifedata.com/resource/pubmed/id/9394573

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
10
pubmed:dateCreated
1998-1-20
pubmed:abstractText
From July 1988 through August 1996, 54 patients with chronic renal failure (CRF) on maintenance dialysis (50 hemodialysis = HD, and 4 continuous ambulatory peritoneal dialysis) have undergone some sort of surgical procedure requiring the use of extra corporeal circulation (ECC); 42 patients underwent isolated coronary artery bypass grafting (CABG), 8 valve replacement, 3 combined procedures and 1 correction of a congenital heart defect. The protocol called for maintenance dialysis on the day before surgery, large volume hemofiltration (HF) during the ECC period, postoperative K+ management with dextrose-insulin if required, and resumption of whatever preoperative maintenance dialysis 24 hours after the operative procedure. The mean diafiltrate volume of HF was 7963 +/- 2688 ml which was replaced with 6342 +/- 2748 ml. No patient required emergency HD before the resumption of the maintenance dialysis, although in 40% of the early patients HD was added on the second postoperative day. However as experience was gained, in the latter 60% of patients resumption of maintenance dialysis (HD 3 times a week) was thought to be sufficient. The incidence of calcification in patients with CRF is higher not only of involved coronary artery segments (4.5 +/- 2.3 segments; AHA coronary classification) than its counterpart without CRF, but also of the ascending aorta which mandated modifications of the technique in 6 patients (operation under ventricular fibrillation, cannulation access other than ascending aorta). The use of arterial in situ conduits for CABG was also thought to be advantageous, and the left internal thoracic artery combined to the gastro-epiploic artery was used in 11 patients (26.2%). Four patients died) (7.4%): 2 from arrhythmia, one from intestinal necrosis and one from multiple cerebral infarction. Thus we conclude that the outlined protocol is quite effective in controlling fluid and electrolyte balance in patients on maintenance dialysis allowing to undertake surgical procedures requiring the use of extra corporeal circulation relatively safely.
pubmed:language
jpn
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
0369-4739
pubmed:author
pubmed:issnType
Print
pubmed:volume
45
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1661-6
pubmed:dateRevised
2011-7-27
pubmed:meshHeading
pubmed:year
1997
pubmed:articleTitle
[Cardiac surgery in patients with chronic renal failure on maintenance dialysis].
pubmed:affiliation
Department of Cardiovascular Surgery, Kumamoto Chu-oh Hospital, Japan.
pubmed:publicationType
Journal Article, English Abstract