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Ann Thorac Surg 2001;71:765
© 2001 The Society of Thoracic Surgeons

Editorial

Collaborative practice: a personal journey

William Nugent, MDa,b

a Section of Cardiothoracic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
b Department of Surgery, Dartmouth Medical School, Hanover, New Hampshire, USA

Address reprint requests to Dr Nugent, Section of Cardiothoracic Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Dr, Lebanon, NH 03756-0001
e-mail: william.c.nugent@hitchcock.org

In this issue of The Annals of Thoracic Surgery, DeFoe and colleagues from the Northern New England Cardiovascular Disease Study Group (NNE) report on the relationship between lowest hematocrit during cardiopulmonary bypass and clinical outcome after coronary artery bypass grafting (CABG) [1]. Of 6,980 consecutive patients who underwent CABG at six medical centers in Maine, New Hampshire, and Vermont and at the Beth-Israel Deaconess Hospital between July 1996 and December 1998, those whose hematocrit while on cardiopulmonary bypass was allowed to fall below 19% had higher in-hospital mortality rates, higher intraoperative use of balloon support, and more frequent return to cardiopulmonary bypass after initial attempt at separation. Women, individuals with small body surface areas, and patients who were anemic before operation were most likely to be severely anemic on bypass.

This article is important for what it tells . . . [Full Text of this Article]






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