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Inderpaul Birdi
Mohammad Bashar Izzat
Alan J. Bryan
Gianni D. Angelini
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Ann Thorac Surg 1996;61:1573-1580
© 1996 The Society of Thoracic Surgeons

Current Reviews

Normothermic Techniques During Open Heart Operations

Inderpaul Birdi, FRCS, Mohammad Bashar Izzat, FRCS, Alan J. Bryan, FRCS, Gianni D. Angelini, FRCS

Bristol Heart Institute, University of Bristol, Bristol, United Kingdom

There has been considerable interest in the use of normothermic techniques during cardiac operations, both as a means of myocardial protection and as a more physiologic environment for other organs during cardiopulmonary bypass. Although a limited number of uncontrolled studies have suggested superior clinical results compared with conventional hypothermic regimens, these claims have not been thoroughly investigated using randomized protocols. The limited available data suggest that the successful use of warm blood cardioplegia requires adequate delivery of the solution to all parts of the myocardium at optimal flow rates to maintain aerobic arrest, so those who advocate the use of normothermic arrest must pay particular attention to ensure that their myocardial protection is effective. The advantages of employing normothermic systemic perfusion in regard to factors such as improved hemodynamic performance and reduced blood loss postoperatively need to be balanced against concerns regarding the inadequacy of cerebral protection offered by this method.




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