[Practical postoperative management in open heart surgery].
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Biomedical subjects
Publications and source records attributed to S Teramoto.
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We have developed a new plate-type membrane oxygenator (MO) using a microporous polysulfone membrane. The MO is compact, handy and very easy to set up, and has easy defoaming. The MO is primed with crystalloid; through the cardiotomy reservoir, air exits across the porous membrane and is removed through ports in the membrane oxygenator. Performance and clinical use have shown that the PS oxygenator has a better gas exchange than conventional silicone oxygenators, with appropriate O2/CO2 balance and a capability for controlling oxygen and carbon dioxide separate exchange. The advantage of the MPS membrane is improved blood compatibility, and TABLE 1. BLOOD GAS ANALYSIS DURING PERFUSION Mean +/- SD Range Blood Flow (L/min) 1.56 +/- 0.29 1.04-2.12 Gas Flow (L/min) 1.89 +/- 0.73 0.5-3.0 Gas/Blood Flow Ratio 1.19 +/- 0.38 0.45-1.95 pH venous 7.340 +/- 0.083 7.220-7.443 arterial 7.390 +/- 0.080 7.272-7.507 pCO2 (mm Hg) venous 44.8 +/- 10.8 29.6-65.2 arterial 35.7 +/- 7.1 23.8-51.1 pO2 (mm Hg) venous 46.4 +/- 17.2 26.1-98.8 arterial 276.3 +/- 135.6 66.1-533.4 SO2 (%) venous 71.9 +/- 14.7 35.7-95.6 arterial 98.7 +/- 2.3 91.5-99.9 a larger number of small pores than the MPP membrane. Vapor loss, thought to be typical of microporous membranes, was found to be negligibly small. Use of the PS oxygenator for open heart surgery on 15 pediatric patients proved satisfactory, and in the future the oxygenator may prove useful for prolonged perfusions.
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Eleven urea compounds were administered individually as a single oral dose to rats either on day 12 or 14 and to mice on day 10 of pregnancy. 1-Methylurea and 1-ethylurea were not teratogenic in either of the animal species. Administration of 1-methylthiourea and 1-ethylthiourea, however, resulted in high incidences of malformations in the rat but not in the mouse fetuses. The types of malformation were similar to those produced by the known teratogen ethylenethiourea. Methylated ureas such as 1,3-dimethylurea, 1,3-dimethylthiourea, 1,1,3,3-tetramethylurea, and 1,1,3,3-tetramethylthiourea were fetotoxic and produced malformations in the tail, palate, or extremities of the surviving rat and/or mouse fetuses. These findings suggest that the teratogenic properties of N-alkylureas can be categorized into two groups, i.e., mono-alkylated thioureas and methylated ureas or thioureas.
Thirty-seven consecutive cases of mitral valve replacement have been retrospectively reviewed. The prognostic significance of preoperative clinical, hemodynamic and quantitative angiographic factors for survival has been evaluated. In the Mitral stenosis (MS) group, all of the patients who showed small Stroke volume index (SVI) (less than 45 ml/m2) with pulmonary hypertension died from the low output syndrome. The prognosis was poor in patients who had large cardiothoracic ratio (CTR) in the MS group. Aortic valve replacement must be considered when moderate aortic regurgitation is associated with mitral valve disease. In the MR factors for predicting the survival. The eccentricity ratio is also a sensitive parameter for recognizing a patient who will have a poor prognosis after mitral valve replacement. The main mode of death was found to be heart failure due to myocardial impairment.
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