Journal of clinical anesthesia
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To determine whether postoperative cardiac surgery patients who are sedated with dexmedetomidine have fewer atrial arrhythmias, and whether dexmedetomidine is associated with fewer renal and more gastrointestinal (GI) complications. ⋯ Dexmedetomidine use after cardiac surgery was associated with a lower incidence of atrial arrhythmias.
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Case Reports
Incidental discovery of a partial anomalous pulmonary venous connection in the surgical critical care unit.
Routine chest roentgenogram to confirm catheter placement in a postsurgical patient showed a left-sided internal jugular central venous catheter that did not appear to cross the midline. Arterial blood gas samples showed greater oxygenation from the central catheter as compared with the peripheral arterial sample. However, a transduced waveform showed a venous tracing and pressure. Computed tomographic scan of the thorax without intravenous contrast showed a partial anomalous pulmonary venous connection with drainage of the left upper lobe pulmonary vein into the innominate vein.
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To identify risk factors for coagulopathy in patients undergoing liver resection. ⋯ Epidural anesthesia is feasible in patients scheduled for liver resection. Caution should be observed for patients with extended resection (≥3 segments) and increased postoperative lactate. In patients with preexisting liver disease, epidural catheters should be avoided.
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The management of an infant who underwent corrective surgery for a supracardiac total anomalous pulmonary venous drainage, which was complicated by the development of pulmonary hemorrhage while separating from cardiopulmonary bypass, is presented. Initiation of high-frequency oscillatory ventilation was effective in weaning the patient off cardiopulmonary bypass.
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To study changes in BIS values and metabolic parameters during an infusion of isoproterenol in pediatric patients. ⋯ Isoproterenol increases metabolic, respiratory, and BIS values in pediatric patients during general anesthesia. We recommend the use of BIS, close monitoring of ETCO2, and careful titration of anesthetics during isoproterenol infusion, especially when lighter planes of general anesthesia are requested for pediatric electrophysiologic procedures.