Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 1999
Randomized Controlled Trial Clinical TrialThoracic epidural anesthesia as an adjunct to general anesthesia for cardiac surgery: effects on ventilation-perfusion relationships.
To determine the effects of thoracic epidural anesthesia (TEA) on ventilation-perfusion (VA/Q) relationships, atelectasis, and oxygenation before and after coronary artery bypass graft surgery (CABG). ⋯ TEA can reduce respirator time and the need for morphine analgesics after CABG without negative effects on VA/Q matching, oxygenation, or atelectasis formation.
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J. Cardiothorac. Vasc. Anesth. · Jun 1999
Reliability of continuous jugular venous bulb hemoglobin oxygen saturation during cardiac surgery.
To evaluate the accuracy and reliability of continuous measurement of jugular venous bulb hemoglobin oxygen saturation (SjvO2) with a fiberoptic catheter (SjvO(2OX)) during cardiac surgery versus simultaneous paired measurements of hemoglobin oxygen saturation by the Hemoximeter (SjVO(2HEM); Radiometer, Copenhagen, Denmark) and indirect estimations of hemoglobin oxygen saturation from measurements of partial pressure of oxygen in blood gases (SjVO(2BG)). ⋯ SjvO2 values obtained continuously from a jugular venous bulb fiberoptic catheter may give relatively accurate readings provided they are duly interpreted and errors caused by wall artifact or blood sampling are avoided.
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J. Cardiothorac. Vasc. Anesth. · Jun 1999
Efficacy of epsilon-aminocaproic acid in children undergoing cardiac surgery.
To compare coagulation test results, blood loss, and blood product transfusions between patients receiving prophylactic epsilon-aminocaproic acid (EACA) and a control group matched for age, resternotomy, and surgery in children undergoing cardiac surgery. ⋯ EACA reduced intraoperative blood loss but did not significantly decrease blood product transfusions. Lack of efficacy may be related to relative underdosing and should be further studied.
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J. Cardiothorac. Vasc. Anesth. · Jun 1999
Selective preoperative cardiac screening improves five-year survival in patients undergoing major vascular surgery: a cost-effectiveness analysis.
To evaluate the long-term outcomes (5-year survival) and cost-effectiveness of selective coronary revascularization before major vascular surgery. ⋯ Selective screening before vascular surgery may improve 5-year survival and be cost-effective. Neither routine noninvasive testing nor routine angiography appears to be cost-effective compared with currently accepted medical therapies.