TAILIEUCHUNG - Báo cáo y học: " Endothelial Endotoxemia related to cardiopulmonary bypass is associated with increased risk of infection after cardiac surgery: a prospective observational stud"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Endothelial Endotoxemia related to cardiopulmonary bypass is associated with increased risk of infection after cardiac surgery: a prospective observational study. | Klein et al. Critical Care 2011 15 R69 http content 15 1 R69 KS CRITICAL CARE RESEARCH Open Access Endotoxemia related to cardiopulmonary bypass is associated with increased risk of infection after cardiac surgery a prospective observational study David J Klein1 Francoise Briet2 Rosane Nisenbaum3 Alexander D Romaschin4 and C David Mazer5 Abstract Introduction Previous studies have documented a high frequency of endotoxemia associated with cardiopulmonary bypass CPB . Endotoxemia may be responsible for some of the complications associated with cardiac surgery. The purpose of the study was to examine the prevalence of endotoxemia during cardiopulmonary bypass supported aortocoronary bypass grafting surgery ACB using a new assay the Endotoxin Activity Assay EAA and explore the association between endotoxemia and post-operative infection. Methods The study was a single center prospective observational study measuring EAA during the perioperative period for elective ACB. Blood samples were drawn at induction of anesthesia T1 immediately prior to release of the aortic cross-clamp T2 and on the first post-operative morning T3 . The primary outcome was the prevalence of endotoxemia. Secondary outcomes assessed included infection rates intensive care unit ICU and hospital length of stay. An EAA of units was interpreted as low to units as intermediate and units as high . Results A total of 57 patients were enrolled and 54 patients were analyzable. The mean EAA at T1 was at T2 - and at T3 - . At T2 only 7 52 of patients had an EAA in the high range. There was a positive correlation between EAA and duration of surgery P . In patients with EAA at T2 6 23 of patients developed post-operative infections compared to 1 29 of those that had a normal EAA P . Maximum EAA over the first 24 hours was also strongly correlated with risk of post-operative infection P . Conclusions High levels

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