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首页> 外文期刊>Journal of cardiac surgery. >Bidirectional superior cavopulmonary anastomosis with or without cardiopulmonary bypass: A randomized study
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Bidirectional superior cavopulmonary anastomosis with or without cardiopulmonary bypass: A randomized study

机译：双向优质的肺肺吻合术，没有心肺旁路：随机研究

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Abstract Objectives This study aims to compare the bidirectional superior cavopulmonary anastomosis (BDG) with or without cardiopulmonary bypass (CPB). Methods 100 patients undergoing BDG were randomized into two groups: Off‐CPB or on‐CPB groups. All patients underwent near‐infrared spectrophotometry (NIRS) and bispectral index (BIS) monitoring and pre‐ and postoperative serum 100 beta protein measurements (Sβ100) and neuro‐cognitive evaluation. Postoperative intensive care unit (ICU) parameters were also studied. Results The median age of patients in the on‐CPB and off‐CPB group were 42 and 48 months, respectively (p?=?0.11). Median weights in the on‐CPB group and off‐CPB group were 13.5 (5‐50) kg and 15 (7‐36) kg, respectively (p?=?0.927). There was a significant rise in superior vena cava (SVC) pressure on SVC clamping in the off‐CPB group (23.12?±?6.84 vs 2.98?±?2.22?mmHg) on‐CPB group (p??0.001). There was a significant fall in NIRS and BIS values from baseline in the off‐CPB group during the anastomosis but there was no statistically significant change in serum Sβ100from pre‐clamp to post‐clamp in either group. Inotropic support, duration of ventilation, ICU stay, and hospital stay were significantly less in the off‐CPB group (p??0.001). Assessment of Social Adaptive Functioning revealed no adverse sequelae. There were significant cost savings if surgery was performed off‐CPB (p??0.001). Conclusion Off CPB‐BDG is an economical and safe procedure. Duration of inotropic and mechanical ventilatory support, ICU, and hospital stay is significantly less. We did not observe any early adverse neurologic sequelae in patients undergoing off‐CPB BDG.
机译：摘要目的本研究旨在将双向高级肺血管吻合术（BDG）与心肺旁路（CPB）进行比较。方法将BDG的100名患者随机分为两组：OFF-CPB或CPB组。所有患者均接近红外分光光度法（NIRS）和双光谱指数（BIS）监测和术后和术后血清100β蛋白质测量（Sβ100）和神经认知评估。还研究了术后重症监护单元（ICU）参数。结果CPB和OFF-CPB组中患者中位年龄分别为42和48个月（P？= 0.11）。 CPB组和OFF-CPB组中的中位重量分别为13.5（5-50）千克和15（7-36）千克（P？= 0.927）。在OFF-CPB组中的SVC钳位上的高级腔静脉（SVC）压力有显着的升高（23.12？±6.84 Vs 2.98？±2.22？mmHg）（p？＆ 0.001）。在吻合术期间，从截止值组中的基线中的NIR和BIS值有显着下降，但在任一组中，血清Sβ100没有统计学上显着的变化。在off-CPB组中，透气性支持，通风持续时间，ICU住宿和住院住院的持续时间明显较低（P？＆？0.001）。社会自适应功能评估显示没有不良后遗症。如果在CPB上进行手术，则节省成本显着（p？＆ 0.001）。结论OFF CPB-BDG是一种经济和安全的程序。渗透和机械通气支持，ICU和住院住院的持续时间明显较低。我们没有观察到接受CPB BDG的患者的任何早期不良神经系统后遗症。

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