Skip to main content

Pulmonary Artery Catheter Versus Central Venous Catheter in Patients Undergoing Beating Heart Coronary Artery Bypass Surgery: A Comparative Approach | Chapter 12 | New Frontiers in Medicine and Medical Research Vol. 7

Background: Hemodynamic monitoring during off-pump coronary artery bypass grafting surgery requires the use of a central venous and pulmonary artery catheter.

Methods: In this prospective randomised experiment, sixty patients were randomly assigned to one of two groups: central venous or pulmonary artery catheters after anaesthesia induction with a high dosage of morphine and Inj pancuronium. Patients between the ages of 35 and 65 who were undergoing elective off-pump coronary artery bypass surgery with an ejection fraction of 40-60% were included, whereas those with left ventricular dysfunction were omitted. The same surgeons operated on all of the patients. Fluid volume expansion and inotropic support were used to keep systolic blood pressure (SBP) and/or mean arterial pressure (MAP) above 90 and 60 mm Hg, respectively, throughout the perioperative period. The substance nitroglycerine was employed.

Results: A higher percentage of patients in the CVP group (66.6 percent vs 40 percent, P=0.038) were initiated on inotropes than in the PAC group. 75 percent of those in Grade A need it for fewer than 24 hours, compared to 65 percent in Grade B. Both groups required similar fluid challenge trials [40 percent vs 53.33 percent; P=0.30] and had similar ICU stays (more than 48 hours) [66.67 percent vs 53.3 percent; p=0.29, chi square test]. In the CVP group, more patients suffered complications [6.6 vs 16.6%; P=0.22]. Each group had one patient who died.

Conclusion: In patients with maintained LV function, PA catheter guided management does not provide any significant advantage over CVP guided management alone after OPCAB surgery.


Author (S) Details

Pushkar Desai
Department of Cardiac Anaesthesia, Seth GS Medical College and Kem Hospital, Mumbai, India.

Shirish Mahure
Department of Cardiac Anaesthesia, Seth GS Medical College and Kem Hospital, Mumbai, India.

Manjula Sarkar
Department of Cardiac Anaesthesia, Seth GS Medical College and Kem Hospital, Mumbai, India.

Sanjeeta Umbarkar
Department of Cardiac Anaesthesia, Seth GS Medical College and Kem Hospital, Mumbai, India.


View Book:-  https://stm.bookpi.org/NFMMR-V7/article/view/3225

Labels:

Comments

Post a Comment

Popular posts from this blog

Greening Regional Airports: A Vision for Carbon Neutral Infrastructure | Chapter 12 | Contemporary Perspective on Science, Technology and Research Vol. 3

 This study provides an overview of the energy demand of a regional airport, divided into individual time horizons. The electrification of aircraft systems raises the question of whether airports will be among the largest electricity consumers in our infrastructure in the future. Sustainability and especially emission reductions are significant challenges for airports that are currently being addressed. The Clean Sky 2 project GENESIS addresses the environmental sustainability of hybrid-electric 50-passenger aircraft systems in a life cycle perspective to support the development of a technology roadmap for the transition to sustainable and competitive electric aircraft systems. This article originates from the GENESIS research and describes various options for ground power supply at a regional airport. Potential solutions for airport infrastructure with a short (2030), medium (2040), and long (2050) time horizon are proposed. In addition to the environmental and conservation benefi...
Post a Comment
Read more

Alkali Element Modification of Glucose Molecules as a Method to Dissolve Cancer Cells | Chapter 12 | New Visions in Medicine and Medical Science Vol. 4

  The present study highlights about alkali element modification of glucose molecules as a method to dissolve cancer cells. The central regulation of the mechanisms governing cell proliferation has little effect on cancer cells. Cancer cells are entirely independent of the central command and divide and proliferate on their own, making it challenging to activate their response mechanism. Precisely, this is the reason why they are at risk to the health of humans and/or any biological entities. Instead of trying to reconnect the central command of the growth control mechanism to cancer cells that are already out of the range, we present a method of using the cancer cell’s own irresponsive and uncontrolled growth mechanism to their disadvantage and destroy the cancer cells. We found that this is achievable in an atomic/molecular level study of the glucose molecule, which is the primary food source used for growth and energy generation by all cells in the body, including the cancer cel...
Post a Comment
Read more

Diagnosis and Management of Scrapie in Post Mortem Goats by Immunohistochemistry | Chapter 6 | New Visions in Medicine and Medical Science Vol. 4

  The main objective of this study was to contribute to the annual passive surveillance for this pathology, since the goats are a species considered reservoir for the prion. A class of pathologies known as Transmissible Spongiform Illnesses (TSEs), which affect both humans and animals, includes scrapie, a neurological disease with a slow and deadly course that affects sheep, goats, and mouflons. Given that Immunohistochemistry (IHC) is the globally accepted technique for identifying classical scrapie in goats—a species thought to be a potential zoonotic disease reservoir. Chile in relation to Bovine Spongiform Encephalopathy (BSE), is classified as a disease-free country. Scrapie is actively monitored for the sheep, but passively for the caprine species, which is why this study was carried out in slaughtered goats in the central north of the country (IV Region), to provide information to the surveillance system for this disease. Fifty brains of goats older than 2 years were used, r...
Post a Comment
Read more