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開心手術에 있어서 低溫灌流法

Hypothermic Perfusion in Open Heart Surgery

대한외과학회지 1967년 9권 5호 p.241 ~ 249
김세환, 徐相賢, 洪弼勳,
소속 상세정보
김세환 (  ) - 延世大學校 醫科大學 外科學敎室
徐相賢 (  ) - 延世大學校 醫科大學 外科學敎室
洪弼勳 (  ) - 延世大學校 醫科大學 外科學敎室

Abstract


Perfusion data on the initial 40 cases of open heart surgery performed at Yonsei Medical Center is presented. The age of the patients ranged between 6 and 54 years and the body surface area between 0.64 and 1.69 M2. In all cases, a moderate hypothermia of about 30´C was used in conjunction with extracorporeal bypass. Except in the first three cases, the flow rate was adjusted according to the venous return during the perfusion and averaged 1.6L/Min./M2.
Hypothermia was accomplished by both an external cooling by water mattress and an internal cooling by a heat exchanger which is an integral part of the oxygenator system. The time required to bring the esophageal temperature to desired level was 6 minutes on the average and the rewarming time was 14 minutes. This discrepancy is thought to be due to the inlet temperature difference between the blood and the circulating water in the heat exchanger.
The systemic arterial resistance diminished proportionately with the increase in the mean flow rate. The chest tube drainage during the first 24 hours following operation was definitely related both to the total perfusion time and the total perfusion volume, indicating longer perfusion time is accompanied by more postoperative bleeding. Both the cooling and the rewarming rate was proportionately increaed with the increase in the mean flow rate.

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