دورية أكاديمية

Effects of off-pump coronary artery bypass grafting on patient outcome.

التفاصيل البيبلوغرافية
العنوان: Effects of off-pump coronary artery bypass grafting on patient outcome.
المؤلفون: Sohrabi, Farrokh, Mispireta, Luis A., Fiocco, Michael, Dibos, Luis A., Buescher, Philip C., Sloane, Peter J.
المصدر: Journal of Investigative Medicine (Sage Publications Inc.); Feb2003, Vol. 51 Issue 1, p27-31, 5p
مصطلحات موضوعية: CARDIOPULMONARY bypass, COMPARATIVE studies, CORONARY artery bypass, RESEARCH methodology, MEDICAL cooperation, NEUROLOGICAL disorders, RESEARCH, SURGICAL complications, EVALUATION research, TREATMENT effectiveness
مصطلحات جغرافية: MARYLAND
مستخلص: Background: Cardiopulmonary bypass (CPB) is associated with postoperative myocardial stunning, hypothermia, formation of microemboli, and systemic inflammatory response syndrome, all of which may prolong recovery from coronary artery bypass grafting (CABG) surgery. This study sought to compare outcomes in patients undergoing CABG off pump versus on pump.Methods: Outcomes, including mortality and several morbidities, were reviewed in 1,623 on-pump patients and 683 off-pump patients. Morbidities assessed included postoperative bleeding, incidence of multiorgan dysfunction, and neurologic complications. Chi-square and t-test analysis were used to determine statistical significance.Results: Mortality was 42% lower in the off-pump group than the on-pump group. Both critical care and total hospital length of stay were significantly shorter in the off-pump group. The incidence of postoperative bleeding requiring transfusion or a return to the operating room was reduced by 29% in the off-pump group and the incidence of multiorgan dysfunction was reduced by 31%. The off-pump patients also presented a significantly lower incidence of cerebral vascular accidents and seizures than on-pump patients.Conclusions: We conclude that there is an association between improved patient outcome and off-pump CABG surgery. The outcomes of this study show a statistically significant decrease in mortality, critical care length of stay, total hospital stay, incidence of bleeding requiring transfusion or return to the operating room, amount of blood transfused, incidence of multiorgan dysfunction, cerebral vascular accidents, and seizures in off-pump patients when compared with on-pump patients. Such results support the use of myocardial revascularization off pump as an alternative to CABG surgery on pump. CABG surgery off pump may allow a better postoperative clinical course in patients who are candidates for the procedure. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:10815589
DOI:10.2310/6650.2003.33529