الفهرس | Only 14 pages are availabe for public view |
Abstract PB produces wide spread alterations in endocrine, humoral, and metabolic nctions, some of which may be reduced by the use of pulsatile CPB or deeper lanes of general anaesthesia. The magnitude and direction of these changes may be influenced by the duration of bypass and the techniques employed such as the degree of hypothermia, cardiac venting, and contents of the priming solution) An awareness of the potential complications related to endocrine alterations may represent the difference between success and failure. Moreover, the importance of these changes may increase as longer durations of CPS, extracorporeal circulatory support, and total artificial heart replacements am considered 1he effects of various anaesthetic techniques on the endocrine and metabolic response to surgery raise the possibility of preventing postoperative catabolism and thereby reducing morbidity and mortality. Allhough such aims may seem remote at present, they offer exciting possibilities for the future anaesthetic management of critically ill patients. Operative stress may affect haemostatic mechanisms through hormonal systems. As the endocrine slress response to surgery may be modulated by anaesthesia, stress hormone concentrations have been altered by using either opioid or inhalation based anaesthesia to study haemostatic mechanisms in cardiac surgical patients. |