RESUMEN
@#Objective To explore the effect of whether or not to stop beating after conversion to cardio-pulmonary bypass (CPB) in off-pump coronary artery bypass grafting. Methods From 2016 to 2018, 177 patients with off-pump coronary artery bypass grafting in Beijing Anzhen Hospital were transferred to CPB. According to whether they stopped beating after conversion to CPB during the operation, they were divided into two groups. A non-stop beating group: there were 76 patients with 45 males, 31 females. aged 63.53±6.98 years, who were not to stop beating after conversion to CPB. A stop beating group: there were 101 patients with 66 males and 35 females, aged 63.98 ± 8.37 years, who were to stop beating and underwent the modified perfusion and application of papaverine in perfusion after conversion to CPB. The clinical effect of the two groups was compared. Results There were 14 deaths in the perioperative period. The mean graft flow (MGF) in the stop beating group was higher (P=0.033), and the pulse index (PI) was lower (P=0.001) than those in the non-stop beating group. Intra-aortic balloon counter pulsation (P=0.036), extracorporeal membrane oxygenation (P=0.038), continuous renal replacement therapy (P=0.014), ventilator-assisted time (P=0.021), ICU monitoring time (P=0.012), perioperative mortality (P=0.025) and the ejcetion fraction value (P=0.023) were significantly different between the groups. Conclusion Compared with not to stop beating, those to stop beating can get better perioperative clinical effect after conversion to CPB, which is worthy of recommendation.
RESUMEN
Exposition to head to foot accelerations (+Gz) on human carrying centrifuge are associated with increase in heart rate (HR). Sometimes, especially with extremely high HR values it is almost impossible to distinguish between fast sinus rhythm and supraventricular tachycardia which is essential for the safety of the subject and therefore the decision regarding break the centrifuge examination earlier. AIM: The aim of the work was to answer the question: what is the maximum physiological rise of the sinus heart rate, recorded beat to beat, during tests in the overload centrifuge, which should lead to the suspicion of paroxysmal supraventricular tachycardia? MATERIALS AND METHODS: The material tested was an electrocardiogram (ECG) digital records of 150 pilots, achieved during both GOR and ROR tests, carried out in the human centrifuge. The HR, increase of HR (ΔHR) and their changes accompanying the + Gz acceleration ware analysed. RESULTS: Mean values of the parameters determined from all centrifuge exposures were: HR - 105.8 beats per minutes (bpm,) ΔHR 2.5, + Gz 4.06. There was no relationship between ΔHR and + Gz increase The values of ΔHR, meeting the eligibility criteria for the possible PT, were in the range 2.41 to 11.19 bpm on average 2.5 bpm. CONCLUSIONS: Rapid/unexpected HR beat to beat acceleration (ΔHR) during a GOR or ROR centrifugal test, exceeding 11 beats/min, in relation to the HR rate immediately preceding it and persisting for at least 4 consecutive heart evolutions, requires the attention of the examining doctor, and ECG should be examined for paroxysmal tachycardia.