Splanchnic injury during coronary surgery with and without cardiopulmonary bypass
Splanchnic injury during coronary surgery with and without cardiopulmonary bypass
In the first part of this thesis aspects of the haemodynamic performance during off-pump surgery were examined. Intraoperative haemodynamic changes were described using a continuous, real-time cardiac output monitoring technique, which is superior to the thermodilution method. The haemodynamic effects of an intraoperative pleuropericardial release manoeuvre were also investigated. A significant transient decline in cardiac output was observed during cardiac manipulation for off-pump coronary anastomosis. Significant improvement of the haemodynamic performance with a right pleuropericardial release manoeuvre was also documented.
The second part of the thesis examined the effect of surgery with and without CPB on endocrine function. This was done in a prospective randomised fashion, and the Perioperative changes in thyroid and stress hormones in patients undergoing surgery with CPB vs off-pump were measured. We observed significant transient elevations in stress hormones and thyroid hormonal changes consistent with euthyroid sick response in both groups. There were no significant differences between the groups.
In the final part of this thesis the effect of coronary surgery with and without CPB on the gastrointestinal system was examined. Significant gastric mucosal hypoxia in the early postoperative period was observed in both groups, with no significant differences between the groups. Gastric mucosal oxygenation was inversely related to global oxygen extraction fraction. There was no evidence of temporary decline in intestinal absorptive and barrier function in both groups, and off-pump patients demonstrated a quicker recovery of intestinal function. There was a transient and similar reduction in hepatic function in both groups, but no significant hepatic injury.
University of Southampton
Velissaris, Theodore
731d89bf-8c7a-4e68-ab6c-61e815d94415
2006
Velissaris, Theodore
731d89bf-8c7a-4e68-ab6c-61e815d94415
Velissaris, Theodore
(2006)
Splanchnic injury during coronary surgery with and without cardiopulmonary bypass.
University of Southampton, Doctoral Thesis.
Record type:
Thesis
(Doctoral)
Abstract
In the first part of this thesis aspects of the haemodynamic performance during off-pump surgery were examined. Intraoperative haemodynamic changes were described using a continuous, real-time cardiac output monitoring technique, which is superior to the thermodilution method. The haemodynamic effects of an intraoperative pleuropericardial release manoeuvre were also investigated. A significant transient decline in cardiac output was observed during cardiac manipulation for off-pump coronary anastomosis. Significant improvement of the haemodynamic performance with a right pleuropericardial release manoeuvre was also documented.
The second part of the thesis examined the effect of surgery with and without CPB on endocrine function. This was done in a prospective randomised fashion, and the Perioperative changes in thyroid and stress hormones in patients undergoing surgery with CPB vs off-pump were measured. We observed significant transient elevations in stress hormones and thyroid hormonal changes consistent with euthyroid sick response in both groups. There were no significant differences between the groups.
In the final part of this thesis the effect of coronary surgery with and without CPB on the gastrointestinal system was examined. Significant gastric mucosal hypoxia in the early postoperative period was observed in both groups, with no significant differences between the groups. Gastric mucosal oxygenation was inversely related to global oxygen extraction fraction. There was no evidence of temporary decline in intestinal absorptive and barrier function in both groups, and off-pump patients demonstrated a quicker recovery of intestinal function. There was a transient and similar reduction in hepatic function in both groups, but no significant hepatic injury.
Text
1043892.pdf
- Version of Record
More information
Published date: 2006
Identifiers
Local EPrints ID: 466138
URI: http://eprints.soton.ac.uk/id/eprint/466138
PURE UUID: 9a8ae52a-0fc2-46a6-a086-4e3eac20f24d
Catalogue record
Date deposited: 05 Jul 2022 04:27
Last modified: 16 Mar 2024 20:32
Export record
Contributors
Author:
Theodore Velissaris
Download statistics
Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.
View more statistics