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Query: UMLS:C0220723 (PCA)
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We developed a new device for processing frozen myocardial biopsies. Frozen samples of 20 to 50 mg were dropped into a 25 ml stainless steel centrifuge tube held in a custom-made aluminium container precooled in liquid nitrogen. A stainless steel pestle attached to a stainless steel disk was driven by a modified heavy-duty staple gun to pulverise the tissue rapidly at low temperatures. The tissue powder was extracted with 0.3N PCA at 0 degree C in the centrifuge tube which was then transferred to a Sorvall super-speed centrifuge. Values for adenosine triphosphate (ATP) were 5.6 +/- 0.7 mumol . g-1 wet weight (mean +/- SD). Creatine phosphate (CP) yield was 12.2 +/- 3 mumol . g-1 wet weight. The % recovery of an added internal standard for ATP was 86 +/- 18% and for CP 90 +/- 16% with the new method.
Cardiovasc Res 1985 Jul
PMID:A new device for the efficient pulverisation and extraction of myocardial biopsies for high energy phosphate analysis. 401 21

With limited resources, cardiac surgery is frequently cancelled due to lack of ICU beds. Immediate postoperative extubation (UFT) is performed in our hospital setting. The aim of the present study is to report patients undergoing off-pump aortocoronary bypass grafting (OPCABG) with immediate extubation and no ICU stay. Eighty-five patients undergoing OPCABG were included. UFT analgesia consisted of high thoracic epidural analgesia (n=65), or PCA morphine (n=20). Discharge criteria from PACU to cardiac ward were: alert, cooperative patient, respiratory rate <25/min, PaO(2)>80 mmHg and PaCO(2)<45 mmHg, temperature >36 degrees C, hemodynamic stability, no bleeding, no ischemia, and sufficient analgesia. More males (71/14) were included. Mean age was 63.4 years, NYHA class III, ejection fraction 59.4. Three grafts were performed in 119 min. Patients were extubated 12+/-2 min after closure. After 428 min in PACU, four patients did not meet ward criteria; three bradycardia requiring pacing, one elevated CK-MB. Two patients returned to the ICU, one for hypertension, and one for hypovolemia. Cardiac complications were: atrial fibrillation (29%), MI=2, bradycardia=3. During the same period, 304 OR-extubated patients spent 21+/-6 h in the ICU. The cost from leaving the OR until the patient reached the cardiac ward was 1265$ for ICU bypass patients vs. 6405$ for ICU patients, the difference representing 5140$ per patient. ICU bypass after OPCABG is safe. By avoiding ICU, this protocol reduces costs, improves resource utilization and may reduce OR cancellation due to ICU bed shortages.
Interact Cardiovasc Thorac Surg 2008 Feb
PMID:Do patients after off-pump coronary artery bypass grafting need the intensive care unit? A prospective audit of 85 patients. 1802 92

The purpose of the study was to asses the potential use of pulse wave velocity (PWV) and digital volume pulse (DVP) as estimators of systolic (SBP) and diastolic (DPB) blood pressure. Single and multiple correlation studies were conducted, including biometric parameters and risk factors. Brachial-ankle PWV (baPWV) and DVP signals were obtained from a Pulse Trace PWV and Pulse Trace PCA (pulse contour analysis), respectively. The DVP (obtained by photoplethysmography), allowed stiffness (SI) and reflection indexes (RI) to be derived. The first study on 47 healthy volunteers showed that both SBP and DPB correlated significantly both with baPWV and SI. Multiple regression models of the baPWV and the waist-to-hip ratio (WHR) allowed SBP and DBP to be modeled with r = 0.838 and r = 0.673, respectively. SI results also employed WHR and modeled SBP and DBP with r = 0.852 and r = 0.663, respectively. RI did not correlate either with SBP or DBP. In order to avoid the use of ultrasound techniques to measure PWV, we then developed a custom-built system to measure PWV by photoplethysmography and validated it against the Pulse Trace. With the same equipment we conducted a second pilot study with ten healthy volunteers. The best SBP multiple regression model for SBP achieved r = 0.997 by considering the heart-finger PWV (hfPWV measured between R-wave and index finger), WHR and heart rate. Only WHR was significant in the DBP model. Our findings suggest that the hfPWV photoplethysmography signal could be a reliable estimator of approximate SBP and could be used, for example, to monitor cardiac patients during physical exercise sessions in cardiac rehabilitation.
Cardiovasc Eng 2009 Sep
PMID:Pulse wave velocity and digital volume pulse as indirect estimators of blood pressure: pilot study on healthy volunteers. 1965 33