Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of propofol with isoflurane for maintenance of anesthesia in patients with chronic obstructive pulmonary disease: use of pulmonary mechanics, peak flow rates, and blood gases.
Patients with chronic obstructive pulmonary disease (COPD) are usually anesthetized with an inhalation agent. After Institutional Review Board approval, informed consent was obtained from 60 patients with moderate to severe COPD according to a preoperative severity scoring system, which took into account history and objective findings. By using objective criteria, such patients were randomly assigned to receive propofol (group I) or isoflurane (group II) as primary maintenance agents. ⋯ There were no differences between groups with respect to intraoperative pulmonary mechanics (p > 0.05). The only difference between groups was an increase in postoperative PaCO2 in group I and a decrease in group II (p < 0.05). Use of Pitot tube sidestream spirometry is a practical and noninvasive technique for monitoring pulmonary mechanics during anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)
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J. Cardiothorac. Vasc. Anesth. · Feb 1995
Randomized Controlled Trial Comparative Study Clinical TrialThe use of ultra-low-dose aprotinin to reduce blood loss in cardiac surgery.
One hundred patients due to undergo primary cardiac surgery were prospectively randomized to receive aprotinin or placebo. In the aprotinin group, 250,000 kallikrein inhibitory units (KIU) of aprotinin were added to the cardiopulmonary bypass prime solution. A further 250,000 KIU of aprotinin were infused intravenously over 30 minutes immediately before the start of cardiopulmonary bypass. ⋯ In the control group, 14 patients received postoperative autotransfusion of mediastinal blood of median volume of 663 mL (interquartile range 600 to 800 mL, 95% confidence interval 600 to 700 mL). Five patients in the aprotinin group and seven patients in the control group required postoperative homologous blood transfusion. Reassessment of inclusion criteria showed a 19% reduction in blood loss in patients undergoing only aortocoronary bypass receiving aprotinin compared with controls.(ABSTRACT TRUNCATED AT 250 WORDS)