Intrathoracic fire during preparation of the left internal thoracic artery for coronary artery bypass grafting

A surgical fire is a serious complication not previously described in the literature with regard to the thoracic cavity. We report a case in which an intrathoracic fire developed following an air leak combined with high pressure oxygen ventilation in a patient with severe chronic obstructive pulmonary disease. The patient presented to our institution with diffuse coronary artery disease and angina pectoris. He was treated with coronary artery bypass graft surgery, including left internal thoracic artery harvesting. Additionally to this rare presentation of an intrathoracic fire, a brief review of surgical fires is included to this paper

За кадры. 1973. № 72 (1747)

Форум коммунистовНа выставку творчества студентов / Л. ВолодинаСедьмой патент / В. ЗыковДружба двух НИИ / Р. ГорскаяВыходят из печати / В. УстиноваЗолото студенческой науки / А. БатуринК новым рубежам. С VII отчетно-выборной партийной конференцииИдейность - наша сила / Е. ЧижевскийКачеству знаний - особое внимание / [беседа с] В. Е. Намоконова...Это трудное дело - газета / Л. ЕлохинаПочему молчало собрание? / Т. ЗусикВ гостях у спелеологов / Т. ЧащинаЗдравствуй, товарищ студент! / В. ЛебедевФОП сообщаетЗнак для ветеранов. Объявляется конкурсГоду - ударное завершение. По следам наших выступлений / В. Харитоно

Turbulence in surgical suction heads as detected by MRI

Background: Blood loss is common during surgical procedures, especially in open cardiac surgery. Allogenic blood transfusion is associated with increased morbidity and mortality. Blood conservation programs in cardiac surgery recommend re-transfusion of shed blood directly or after processing, as this decreases transfusion rates of allogenic blood. But aspiration of blood from the wound area is often associated with increased hemolysis, due to flow induced forces, mainly through development of turbulence. Methods: We evaluated magnetic resonance imaging (MRI) as a qualitative tool for detection of turbulence. MRI is sensitive to flow; this study uses velocity-compensated T1-weighted 3D MRI for turbulence detection in four geometrically different cardiotomy suction heads under comparable flow conditions (0–1250 mL/min). Results: Our standard control suction head Model A showed pronounced signs of turbulence at all flow rates measured, while turbulence was only detectable in our modified Models 1–3 at higher flow rates (Models 1 and 3) or not at all (Model 2). Conclusions: The comparison of flow performance of surgical suction heads with different geometries via acceleration-sensitized 3D MRI revealed significant differences in turbulence development between our standard control Model A and the modified alternatives (Models 1–3). As flow conditions during measurement have been comparable, the specific geometry of the respective suction heads must have been the main factor responsible. The underlying mechanisms and causative factors can only be speculated about, but as other investigations have shown, hemolytic activity is positively associated with degree of turbulence. The turbulence data measured in this study correlate with data from other investigations about hemolysis induced by surgical suction heads. The experimental MRI technique used showed added value for further elucidating the underlying physical phenomena causing blood damage due to non-physiological flow