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L-Arginina

¿Qué es?

La L-arginina es un aminoácido que se encuentra naturalmente en las carnes rojas, las aves, el pescado y los lácteos. Es necesario para producir proteínas y se usa comúnmente para la circulación.

La L-arginina se convierte en el cuerpo en una sustancia química llamada óxido nítrico. El óxido nítrico hace que los vasos sanguíneos se abran más para mejorar el flujo sanguíneo. La L-arginina también estimula la liberación de hormona del crecimiento, insulina y otras sustancias en el cuerpo. Puede elaborarse en un laboratorio y utilizarse en suplementos.

Las personas usan L-arginina para el dolor de pecho y varios problemas de flujo de golpes, disfunción eréctil, presión arterial alta durante el embarazo y una enfermedad grave en bebés prematuros llamada enterocolitis necrotizante (NEC). También se usa para muchas otras afecciones, pero no existe una buena evidencia científica que respalde estos otros usos.

¿Qué tan efectivo es?

Natural Medicines Comprehensive Database (La Base Exhaustiva de Datos de Medicamentos Naturales) clasifica la eficacia, basada en evidencia científica, de acuerdo a la siguiente escala: Eficaz, Probablemente Eficaz, Posiblemente Eficaz, Posiblemente Ineficaz, Probablemente Ineficaz, Ineficaz, e Insuficiente Evidencia para Hacer una Determinación.

La clasificación de la eficacia para este producto es la siguiente:

Posiblemente eficaz para...

  • Dolor de pecho (angina). La ingesta de L-arginina parece disminuir los síntomas y mejorar la tolerancia al ejercicio y la calidad de vida en personas con angina de pecho. Pero no parece ayudar a ensanchar los vasos sanguíneos que se estrechan en la angina.
  • Disfunción eréctil (DE). La ingesta diaria de 2.5 a 5 gramos de L-arginina parece mejorar la función sexual en personas con disfunción eréctil. Tomar L-arginina con medicamentos como sildenafil y tadalafil podría funcionar mejor que tomar L-arginina o el medicamento solo.
  • Alta presión sanguínea. La ingesta de L-arginina puede reducir la presión arterial en personas sanas, personas con presión arterial alta y personas con presión arterial ligeramente alta con o sin diabetes.
  • Una enfermedad intestinal grave en bebés prematuros (enterocolitis necrotizante o ECN). Agregar L-arginina a la fórmula parece reducir el riesgo de esta afección en los bebés prematuros.
  • Estrechamiento de los vasos sanguíneos que causa un flujo sanguíneo deficiente a las extremidades (enfermedad arterial periférica). La ingesta de L-arginina por vía oral o intravenosa durante un máximo de 8 semanas aumenta el flujo sanguíneo en personas con esta afección. Pero usarlo hasta por 6 meses no ayuda a mejorar la velocidad o la distancia al caminar. Los productos intravenosos solo los puede administrar un proveedor de atención médica.
  • Una complicación del embarazo caracterizada por presión arterial alta y proteínas en la orina (preeclampsia). Tomar L-arginina por vía intravenosa puede reducir la presión arterial en personas embarazadas con preeclampsia. La L-arginina también podría reducir el riesgo de preeclampsia en personas que tienen un alto riesgo de padecer esta afección. Los productos intravenosos solo los puede administrar un proveedor de atención médica. No está claro si la ingesta de L-arginina ayuda.
  • Presión arterial alta durante el embarazo. La ingesta de L-arginina por vía intravenosa puede reducir la presión arterial durante el embarazo. No está claro si la ingesta de L-arginina reduce la presión arterial durante el embarazo, pero podría disminuir la necesidad de tomar medicamentos para bajar la presión arterial. Los productos intravenosos solo los puede administrar un proveedor de atención médica.

Posiblemente ineficaz para...

  • Enfermedad renal a largo plazo (enfermedad renal crónica o ERC). La ingesta de L-arginina por vía oral o intravenosa no mejora la función renal en la mayoría de las personas con ERC.
  • Colesterol alto. La ingesta de L-arginina no ayuda a reducir los niveles de colesterol.
  • Infarto de miocardio. La ingesta de L-arginina no parece ayudar a prevenir un ataque cardíaco. Tampoco parece ayudar a tratar un ataque cardíaco después de que ocurre. De hecho, existe la preocupación de que la L-arginina pueda ser dañina para las personas después de un ataque cardíaco reciente. No tome L-arginina si ha tenido un ataque cardíaco reciente.
  • Tuberculosis. La ingesta de L-arginina junto con el tratamiento estándar para la tuberculosis no parece ayudar a mejorar los síntomas ni eliminar la infección.
  • Cicatrización de la herida. La ingesta de L-arginina no parece mejorar la cicatrización de las heridas.
Existe interés en usar L-arginina para otros propósitos, pero no hay suficiente información confiable para decir si podría ser útil.

¿Es seguro?

Cuando se toma por vía oral: La L-arginina es posiblemente segura para la mayoría de las personas cuando se toma a corto plazo. Puede causar algunos efectos secundarios como dolor de estómago, hinchazón, diarrea y presión arterial baja.

Cuando se aplica a la piel: La L-arginina es posiblemente segura para la mayoría de las personas cuando se usa a corto plazo. También es posible que sea seguro cuando se usa en una pasta de dientes a corto plazo.

Cuando se inhala: La L-arginina es posiblemente segura para la mayoría de las personas cuando se usa a corto plazo.

Advertencias y precauciones especiales:

Embarazo: La L-arginina es posiblemente segura cuando se toma por vía oral durante un período breve durante el embarazo. No se sabe lo suficiente sobre el uso prolongado de L-arginina durante el embarazo. Manténgase en el lado seguro y evite el uso prolongado.

Lactancia: No hay suficiente información confiable para saber si la L-arginina es segura de usar durante la lactancia. Manténgase en el lado seguro y evite su uso.

Niños: La L-arginina es posiblemente segura en los niños cuando se toma por vía oral, cuando se usa en una pasta de dientes o cuando se inhala.

Deficiencia de guanidinoacetato metiltransferasa (GAMT): Las personas con esta afección hereditaria no pueden convertir la arginina y otras sustancias químicas similares en creatina. Para prevenir complicaciones de esta condición, evite los suplementos de L-arginina.

Ataque cardíaco reciente: La L-arginina podría aumentar el riesgo de muerte después de un ataque cardíaco, especialmente en personas mayores. Si ha tenido un ataque cardíaco recientemente, no tome L-arginina.

Enfermedad renal: La L-arginina ha causado niveles altos de potasio cuando la usan personas con enfermedad renal. En algunos casos, esto ha provocado latidos cardíacos irregulares peligrosos.

Cirugía: La L-arginina puede interferir con el control de la presión arterial durante y después de la cirugía. Deje de tomar L-arginina al menos 2 semanas antes de una cirugía programada.

¿Existen interacciones con medicamentos?

Moderadas
Tenga cuidado con esta combinación
Isoproterenol (Isuprel)
La L-arginina parece disminuir la presión arterial. El isoproterenol es un medicamento que se usa para reducir la presión arterial. La ingesta de L-arginina junto con isoproterenol puede hacer que su presión arterial baje demasiado.
Medicamentos para la diabetes (medicamentos antidiabéticos)
La L-arginina podría reducir los niveles de azúcar en sangre. La ingesta de L-arginina junto con medicamentos para la diabetes puede hacer que el azúcar en sangre baje demasiado. Controle de cerca su azúcar en sangre.
Medicamentos para la presión arterial alta (bloqueadores de los receptores de angiotensina (ARA))
La L-arginina podría reducir la presión arterial. La ingesta de L-arginina junto con medicamentos que reducen la presión arterial puede hacer que la presión arterial baje demasiado. Controle su presión arterial de cerca.
Medicamentos para la presión arterial alta (inhibidores de la ECA)
La L-arginina podría reducir la presión arterial. La ingesta de L-arginina junto con medicamentos que reducen la presión arterial puede hacer que la presión arterial baje demasiado. Controle su presión arterial de cerca.
Medicamentos para la presión arterial alta (medicamentos antihipertensivos)
La L-arginina podría reducir la presión arterial. La ingesta de L-arginina junto con medicamentos que reducen la presión arterial puede hacer que la presión arterial baje demasiado. Controle su presión arterial de cerca.
Medicamentos que retardan la coagulación de la sangre (medicamentos anticoagulantes / antiplaquetarios)
La L-arginina podría retardar la coagulación sanguínea. La ingesta de L-arginina junto con medicamentos que también retardan la coagulación de la sangre puede aumentar el riesgo de hematomas y hemorragias.
Pastillas de agua (diuréticos ahorradores de potasio)
La L-arginina podría aumentar los niveles de potasio en el cuerpo. Algunas "pastillas de agua" también pueden aumentar el potasio en el cuerpo. La ingesta de L-arginina junto con algunas "pastillas de agua" puede provocar que el cuerpo tenga demasiado potasio.
Sildenafil (Viagra)
El sildenafil puede reducir la presión arterial. La L-arginina también puede reducir la presión arterial. Existe la posibilidad de que la ingesta conjunta de sildenafil y L-arginina pueda hacer que la presión arterial baje demasiado. Pero la mayoría de las personas parecen estar bien cuando toman estos productos juntos.
Menores
Preste atención a esta combinación
Testosterona
La L-arginina podría aumentar los niveles de testosterona. Pero no está claro si esto es una gran preocupación. Las personas que toman testosterona deben tener cuidado hasta que se sepa más sobre esta posible interacción.

¿Existen interacciones con hierbas y suplementos?

Hierbas y suplementos que pueden reducir el azúcar en sangre
La L-arginina podría reducir el azúcar en sangre. Tomarlo con otros suplementos con efectos similares podría reducir demasiado el azúcar en sangre. Ejemplos de suplementos con este efecto incluyen aloe, melón amargo, canela casia, cromo y nopal.
Hierbas y suplementos que pueden reducir la presión arterial
L-arginine might lower blood pressure. Taking it with other supplements that have the same effect might cause blood pressure to drop too much. Examples of supplements with this effect include andrographis, casein peptides, niacin, and stinging nettle.
Hierbas y suplementos que pueden retardar la coagulación sanguínea
La L-arginina podría retardar la coagulación sanguínea y aumentar el riesgo de hemorragia. Tomarlo con otros suplementos con efectos similares podría aumentar el riesgo de hemorragia en algunas personas. Ejemplos de suplementos con este efecto incluyen ajo, jengibre, ginkgo, natokinasa y Panax ginseng.

¿Existen interacciones con alimentos?

No se conoce ninguna interacción con alimentos.

¿Como se usa normalmente?

La L-arginina ha sido utilizada con mayor frecuencia por adultos en dosis que varían de 1,5 a 24 gramos por vía oral al día, hasta por 18 meses. A veces también se usa en geles y cremas. Hable con un proveedor de atención médica para averiguar qué tipo de producto o dosis podría ser mejor para una afección específica.

Otros nombres

2-Amino-5-(diaminomethylidene amino) pentanoic acid, 2-Amino-5-guanidinopentanoic Acid, (2S)-2-Amino-5-{[amino (imino) methyl]amino}pentanoic Acid, (S)-2-Amino-5- Guanidinopentanoic Acid, Acide 2-Amino-5-Guanidinopentanoïque, Arg, Arginine, Arginine Aspartate, Arginine Aspartate, Arginine Ethyl Ester, Arginine Ethyl Ester Dihydrochloride, Arginine Ethyl Ester HCl, Arginine HCl, Arginine Hydrochloride, Di-Arginine Malate, Di-Arginine Orotate, Di-L-Arginine-L-Malate, Dl-Arginine, L-Arginina, L-Arginine Ethyl Ester Dichloride, L-Arginine HCl, L-Arginine Hexanoate, L-Arginine Hydrochloride, L-Arginine Ketoisocaproic Acid, L-Arginine L-Pyroglutamate, L-Arginine Pyroglutamate, L-Arginine Taurinate, Malate de Di-Arginine, Orotate de Di-Arginine, R-Gene 10.

Metodología

Para saber más sobre cómo este artículo fue escrito, refiérase a la metodología de la Base exhaustiva de datos de medicamentos naturales.

Referencias

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  294. Parnell, M. M., Holst, D. P., and Kaye, D. M. Augmentation of endothelial function following exercise training is associated with increased L-arginine transport in human heart failure. Clin.Sci.(Lond) 2005;109:523-530. View abstract.
  295. Jezova, D., Makatsori, A., Smriga, M., Morinaga, Y., and Duncko, R. Subchronic treatment with amino acid mixture of L-lysine and L-arginine modifies neuroendocrine activation during psychosocial stress in subjects with high trait anxiety. Nutr.Neurosci. 2005;8:155-160. View abstract.
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  298. Gosselink, M. P., Darby, M., Zimmerman, D. D., Gruss, H. J., and Schouten, W. R. Treatment of chronic anal fissure by application of L-arginine gel: a phase II study in 15 patients. Dis Colon Rectum 2005;48:832-837. View abstract.
  299. Baecker, N., Boese, A., Schoenau, E., Gerzer, R., and Heer, M. L-arginine, the natural precursor of NO, is not effective for preventing bone loss in postmenopausal women. J Bone Miner.Res 2005;20:471-479. View abstract.
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  305. Xiao, X. M. and Li, L. P. L-Arginine treatment for asymmetric fetal growth restriction. Int.J Gynaecol.Obstet. 2005;88:15-18. View abstract.
  306. Kernohan, A. F., McIntyre, M., Hughes, D. M., Tam, S. W., Worcel, M., and Reid, J. L. An oral yohimbine/L-arginine combination (NMI 861) for the treatment of male erectile dysfunction: a pharmacokinetic, pharmacodynamic and interaction study with intravenous nitroglycerine in healthy male subjects. Br J Clin.Pharmacol. 2005;59:85-93. View abstract.
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  308. Schlaich, M. P., Ahlers, B. A., Parnell, M. M., and Kaye, D. M. beta-Adrenoceptor-mediated, nitric-oxide-dependent vasodilatation is abnormal in early hypertension: restoration by L-arginine. J Hypertens. 2004;22:1917-1925. View abstract.
  309. Kiziltepe, U., Tunctan, B., Eyileten, Z. B., Sirlak, M., Arikbuku, M., Tasoz, R., Uysalel, A., and Ozyurda, U. Efficiency of L-arginine enriched cardioplegia and non-cardioplegic reperfusion in ischemic hearts. Int.J Cardiol 2004;97:93-100. View abstract.
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  313. George, J., Shmuel, S. B., Roth, A., Herz, I., Izraelov, S., Deutsch, V., Keren, G., and Miller, H. L-arginine attenuates lymphocyte activation and anti-oxidized LDL antibody levels in patients undergoing angioplasty. Atherosclerosis 2004;174:323-327. View abstract.
  314. Dudek, D., Legutko, J., Heba, G., Bartus, S., Partyka, L., Huk, I., Dembinska-Kiec, A., Kaluza, G. L., and Dubiel, J. S. L-arginine supplementation does not inhibit neointimal formation after coronary stenting in human beings: an intravascular ultrasound study. Am Heart J 2004;147:E12. View abstract.
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  316. Bode-Boger, S. M., Muke, J., Surdacki, A., Brabant, G., Boger, R. H., and Frolich, J. C. Oral L-arginine improves endothelial function in healthy individuals older than 70 years. Vasc.Med. 2003;8:77-81. View abstract.
  317. Park, K. G., Heys, S. D., Blessing, K., Kelly, P., McNurlan, M. A., Eremin, O., and Garlick, P. J. Stimulation of human breast cancers by dietary L-arginine. Clin.Sci.(Lond) 1992;82:413-417. View abstract.
  318. Stokes, G. S., Barin, E. S., Gilfillan, K. L., and Kaesemeyer, W. H. Interactions of L-arginine, isosorbide mononitrate, and angiotensin II inhibitors on arterial pulse wave. Am J Hypertens. 2003;16(9 Pt 1):719-724. View abstract.
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  320. Houwing, R. H., Rozendaal, M., Wouters-Wesseling, W., Beulens, J. W., Buskens, E., and Haalboom, J. R. A randomised, double-blind assessment of the effect of nutritional supplementation on the prevention of pressure ulcers in hip-fracture patients. Clin.Nutr. 2003;22:401-405. View abstract.
  321. McGovern, M. M., Wasserstein, M. P., Aron, A., and Perrine, S. P. Biochemical effect of intravenous arginine butyrate in X-linked adrenoleukodystrophy. J Pediatr 2003;142:709-713. View abstract.
  322. Dallinger, S., Sieder, A., Strametz, J., Bayerle-Eder, M., Wolzt, M., and Schmetterer, L. Vasodilator effects of L-arginine are stereospecific and augmented by insulin in humans. Am J Physiol Endocrinol.Metab 2003;284:E1106-E1111. View abstract.
  323. Schon, T., Elias, D., Moges, F., Melese, E., Tessema, T., Stendahl, O., Britton, S., and Sundqvist, T. Arginine as an adjuvant to chemotherapy improves clinical outcome in active tuberculosis. Eur.Respir.J 2003;21:483-488. View abstract.
  324. Abdelhamed, A. I., Reis, S. E., Sane, D. C., Brosnihan, K. B., Preli, R. B., and Herrington, D. M. No effect of an L-arginine-enriched medical food (HeartBars) on endothelial function and platelet aggregation in subjects with hypercholesterolemia. Am Heart J 2003;145:E15. View abstract.
  325. Sydow, K., Schwedhelm, E., Arakawa, N., Bode-Boger, S. M., Tsikas, D., Hornig, B., Frolich, J. C., and Boger, R. H. ADMA and oxidative stress are responsible for endothelial dysfunction in hyperhomocyst(e)inemia: effects of L-arginine and B vitamins. Cardiovasc.Res 2003;57:244-252. View abstract.
  326. Miller, H. I., Dascalu, A., Rassin, T. A., Wollman, Y., Chernichowsky, T., and Iaina, A. Effects of an acute dose of L-arginine during coronary angiography in patients with chronic renal failure: a randomized, parallel, double-blind clinical trial. Am J Nephrol. 2003;23:91-95. View abstract.
  327. Braga, M., Gianotti, L., Vignali, A., and Carlo, V. D. Preoperative oral arginine and n-3 fatty acid supplementation improves the immunometabolic host response and outcome after colorectal resection for cancer. Surgery 2002;132:805-814. View abstract.
  328. Carey, P. E., Halliday, J., Snaar, J. E., Morris, P. G., and Taylor, R. Direct assessment of muscle glycogen storage after mixed meals in normal and type 2 diabetic subjects. Am J Physiol Endocrinol.Metab 2003;284:E688-E694. View abstract.
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  330. Lekakis, J. P., Papathanassiou, S., Papaioannou, T. G., Papamichael, C. M., Zakopoulos, N., Kotsis, V., Dagre, A. G., Stamatelopoulos, K., Protogerou, A., and Stamatelopoulos, S. F. Oral L-arginine improves endothelial dysfunction in patients with essential hypertension. Int.J Cardiol 2002;86(2-3):317-323. View abstract.
  331. Song, J. X., Qing, S. H., Huang, X. C., and Qi, D. L. Effect of parenteral nutrition with L-arginine supplementation on postoperative immune function in patients with colorectal cancer. Di Yi.Jun.Yi.Da.Xue.Xue.Bao. 2002;22:545-547. View abstract.
  332. Bennett-Richards, K. J., Kattenhorn, M., Donald, A. E., Oakley, G. R., Varghese, Z., Bruckdorfer, K. R., Deanfield, J. E., and Rees, L. Oral L-arginine does not improve endothelial dysfunction in children with chronic renal failure. Kidney Int. 2002;62:1372-1378. View abstract.
  333. Schaefer, A., Piquard, F., Geny, B., Doutreleau, S., Lampert, E., Mettauer, B., and Lonsdorfer, J. L-arginine reduces exercise-induced increase in plasma lactate and ammonia. Int.J Sports Med. 2002;23:403-407. View abstract.
  334. Cassone, Faldetta M., Laurenti, O., Desideri, G., Bravi, M. C., De, Luca O., Marinucci, M. C., De, Mattia G., and Ferri, C. L-arginine infusion decreases plasma total homocysteine concentrations through increased nitric oxide production and decreased oxidative status in Type II diabetic patients. Diabetologia 2002;45:1120-1127. View abstract.
  335. van den Meiracker, A. H., van der Linde, N. A., Broere, A., Derkx, F. H., and Boomsma, F. Effects of L-arginine and L-NAME on the renal function in hypertensive and normotensive subjects. Nephron 2002;91:444-451. View abstract.
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  337. Gianotti, L., Braga, M., Nespoli, L., Radaelli, G., Beneduce, A., and Di, Carlo, V. A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer. Gastroenterology 2002;122:1763-1770. View abstract.
  338. Kimber, J., Watson, L., and Mathias, C. J. Cardiovascular and neurohormonal responses to i. v. l-arginine in two groups with primary autonomic failure. J Neurol. 2001;248:1036-1041. View abstract.
  339. Schramm, L., La, M., Heidbreder, E., Hecker, M., Beckman, J. S., Lopau, K., Zimmermann, J., Rendl, J., Reiners, C., Winderl, S., Wanner, C., and Schmidt, H. H. L-arginine deficiency and supplementation in experimental acute renal failure and in human kidney transplantation. Kidney Int. 2002;61:1423-1432. View abstract.
  340. Carrier, M., Pellerin, M., Perrault, L. P., Bouchard, D., Page, P., Searle, N., and Lavoie, J. Cardioplegic arrest with L-arginine improves myocardial protection: results of a prospective randomized clinical trial. Ann.Thorac.Surg. 2002;73:837-841. View abstract.
  341. Kawano, H., Motoyama, T., Hirai, N., Kugiyama, K., Yasue, H., and Ogawa, H. Endothelial dysfunction in hypercholesterolemia is improved by L-arginine administration: possible role of oxidative stress. Atherosclerosis 2002;161:375-380. View abstract.
  342. Suzuki, T., Hayase, M., Hibi, K., Hosokawa, H., Yokoya, K., Fitzgerald, P. J., Yock, P. G., Cooke, J. P., Suzuki, T., and Yeung, A. C. Effect of local delivery of L-arginine on in-stent restenosis in humans. Am J Cardiol 2-15-2002;89:363-367. View abstract.
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  344. Bello, E., Caramelo, C., Martell, N., Alcazar, J. M., Gonzalez, J., Lopez, M. D., Ruilope, L. M., Gonzalez, F. R., Rovira, A. M., Gazapo, R., Soldevilla, M. J., and Casado, S. Impairment of renal vasodilation with l-arginine is related to more severe disease in untreated hypertensive patients. Hypertension 2001;38:907-912. View abstract.
  345. Mantovani, F., Patelli, E., Colombo, F., Pozzoni, F., Confalonieri, S., and Pisani, E. [Erectile dysfunction after non-nerve sparing radical pelvic surgery. Therapeutical experience with sildenafil and L-arginine evaluated by Buckling test]. Minerva Med. 2001;92:285-287. View abstract.
  346. Zhang, X. Z., Ardissino, G., Ghio, L., Tirelli, A. S., Dacco, V., Colombo, D., Pace, E., Testa, S., and Claris-Appiani, A. L-arginine supplementation in young renal allograft recipients with chronic transplant dysfunction. Clin.Nephrol. 2001;55:453-459. View abstract.
  347. Piatti, P. M., Monti, L. D., Valsecchi, G., Magni, F., Setola, E., Marchesi, F., Galli-Kienle, M., Pozza, G., and Alberti, K. G. Long-term oral L-arginine administration improves peripheral and hepatic insulin sensitivity in type 2 diabetic patients. Diabetes Care 2001;24:875-880. View abstract.
  348. Angdin, M., Settergren, G., Liska, J., and Astudillo, R. No effect of L-arginine supplementation on pulmonary endothelial dysfunction after cardiopulmonary bypass. Acta Anaesthesiol.Scand. 2001;45:441-448. View abstract.
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