Circulation
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Randomized Controlled Trial Comparative Study Clinical Trial
Tight glycemic control in diabetic coronary artery bypass graft patients improves perioperative outcomes and decreases recurrent ischemic events.
This study sought to determine whether tight glycemic control with a modified glucose-insulin-potassium (GIK) solution in diabetic coronary artery bypass graft (CABG) patients would improve perioperative outcomes. ⋯ Tight glycemic control with GIK in diabetic CABG patients improves perioperative outcomes, enhances survival, and decreases the incidence of ischemic events and wound complications.
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Randomized Controlled Trial Clinical Trial
Effect of CO2 insufflation on the number and behavior of air microemboli in open-heart surgery: a randomized clinical trial.
The risks that the presence of air microemboli implies in open-heart surgery have recently been emphasized by reports that their number is correlated with the degree of postoperative neuropsychological disorder. Therefore, we studied the effect of CO2 insufflation into the cardiothoracic wound on the incidence and behavior of microemboli in the heart and ascending aorta. ⋯ Insufflation of CO2 into the thoracic wound markedly decreases the incidence of microemboli.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Safety and efficacy of enoxaparin compared with unfractionated heparin and oral anticoagulants for prevention of thromboembolic complications in cardioversion of nonvalvular atrial fibrillation: the Anticoagulation in Cardioversion using Enoxaparin (ACE) trial.
Anticoagulation in cardioversion of atrial fibrillation is currently performed with unfractionated heparin (UFH) and oral anticoagulants, with or without guidance by transesophageal echocardiography (TEE). Low-molecular-weight heparins may reduce the risk of bleeding, may obviate the need for intravenous access, and do not require frequent anticoagulation monitoring. ⋯ Enoxaparin is noninferior to UFH+phenprocoumon for prevention of ischemic and embolic events, bleeding complications, and death in TEE-guided cardioversion of atrial fibrillation. Its easier application and more stable anticoagulation may make it the preferred drug for initiation of anticoagulation in this setting.