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000056500 084__ $$2WoS$$aMaterials Science, Multidisciplinary
000056500 084__ $$2WoS$$aPhysics, Applied
000056500 1001_ $$0P:(DE-Juel1)VDB45470$$aMeszaros, G.$$b0$$uFZJ
000056500 245__ $$aElectrochemical Fabrication and Characterization of Nanocontacts and nm-sized Gaps
000056500 260__ $$aBerlin$$bSpringer$$c2007
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000056500 520__ $$aComparison of pulmonary outcomes after off-pump coronary artery bypass (OPCAB) vs on-pump coronary artery grafting with cardiopulmonary bypass (CABG/CPB). Study design: We examined preoperative and postoperative respiratory compliance, fluid balance, hemodynamics, arterial blood gases, chest radiographs, spirometry, pulmonary complications, and time to extubation in a prospective trial of 200 patients randomized to OPCAB vs CABG/CPB performed by one surgeon.One CABG/CPB patient and two OPCAB patients required mitral valve repair or replacement and were withdrawn. After three crossovers from CABG/CBP to OPCAB and one crossover from OPCAB to CABG, 97 CABG/CPB patients and 100 OPCAB patients remained. There were no significant preoperative demographic differences between groups. Postoperative compliance was reduced more after OPCAB than after CABG/CPB (- 15.4 +/- 10.7 mL/cm H(2)O vs - 11.2 +/- 10.1 mL/cm H(2)O [mean +/- SD]; p = 0.007), associated with rotation of the heart into the right chest to perform posterolateral bypasses (p < 0.001) and the concomitant increased fluid requirements necessary to maintain hemodynamic stability during rotation of the heart. In addition to higher intraoperative fluid intake (4,541 +/- 1,311 mL vs 3,585 +/- 1,033 mL, p < 0.0001), OPCAB patients had higher intraoperative fluid balance (3,903 +/- 1,315 mL vs 1,772 +/- 1,373 mL, p < 0.0001), and higher postoperative pulmonary arterial diastolic pressure (15.0 +/- 5.5 mm Hg vs 11.8 +/- 5.2 mm Hg, p < 0.0001) and central venous pressure (10.4 +/- 4.5 mm Hg vs 8.4 +/- 4.7 mm Hg, p < 0.0001). Despite lower compliance, immediate postoperative Pao(2) on fraction of inspired oxygen of 1.0 (275 +/- 97 torr vs 221 +/- 92 torr, p = 0.001) was higher after OPCAB and extubation was earlier (p = 0.001). Postoperative chest radiographs, spirometry, mortality, reintubation, or readmission for pulmonary complications were not different between groups.Compared to CABG/CPB, OPCAB was associated with a greater reduction in postoperative respiratory compliance associated with increased fluid administration and rotation of the heart into the right chest to perform posterolateral grafts. OPCAB yielded better gas exchange and earlier extubation but no difference in chest radiographs, spirometry, or rates of death, pneumonia, pleural effusion, or pulmonary edema.
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000056500 650_2 $$2MeSH$$aCardiopulmonary Bypass
000056500 650_2 $$2MeSH$$aCoronary Artery Bypass: adverse effects
000056500 650_2 $$2MeSH$$aCoronary Artery Bypass, Off-Pump: adverse effects
000056500 650_2 $$2MeSH$$aFemale
000056500 650_2 $$2MeSH$$aHumans
000056500 650_2 $$2MeSH$$aLung Compliance
000056500 650_2 $$2MeSH$$aLung Diseases: etiology
000056500 650_2 $$2MeSH$$aMale
000056500 650_2 $$2MeSH$$aMiddle Aged
000056500 650_2 $$2MeSH$$aPulmonary Gas Exchange
000056500 650_2 $$2MeSH$$aRadiography, Thoracic
000056500 650_2 $$2MeSH$$aSpirometry
000056500 650_2 $$2MeSH$$aTreatment Outcome
000056500 650_2 $$2MeSH$$aWater-Electrolyte Balance
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000056500 7001_ $$0P:(DE-Juel1)VDB34541$$aKronholz, S.$$b1$$uFZJ
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000056500 7001_ $$0P:(DE-Juel1)128707$$aMayer, D.$$b3$$uFZJ
000056500 7001_ $$0P:(DE-Juel1)VDB9859$$aWandlowski, Th.$$b4$$uFZJ
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000056500 8567_ $$uhttp://dx.doi.org/10.1007/s00339-007-3903-2
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