Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2000
Randomized Controlled Trial Clinical TrialHigh oxygen concentration exacerbates cardiopulmonary bypass-induced lung injury.
To investigate the effect of ventilation with 100% oxygen on lung injury associated with surgery involving cardiopulmonary bypass (CPB). ⋯ A significant decrease of oxygenation was observed in the early post-CPB period in both groups of patients, with delay in recovery in patients treated with 100% oxygen. A larger increase of the proinflammatory cytokines was found in patients treated with 100% oxygen. High oxygen concentrations during surgery with CPB should be used only when specifically required.
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J. Cardiothorac. Vasc. Anesth. · Oct 2000
Parameters associated with perioperative baffle fenestration closure in the Fontan operation.
To identify clinical parameters indicating perioperative fenestration closure in children who underwent the fenestrated Fontan operation. ⋯ Factors that correlated with postoperative fenestration closure in the fenestrated Fontan operation in this study were a high transpulmonary pressure gradient and a high oxygen saturation 1 hour after arrival in the ICU, a low fibrinogen level, and the need for temporary atrial pacing.
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J. Cardiothorac. Vasc. Anesth. · Oct 2000
Randomized Controlled Trial Clinical TrialProphylactic nitroglycerin did not reduce myocardial ischemia during accelerated recovery management of coronary artery bypass graft surgery patients.
To evaluate the use of a high dose of nitroglycerin (NTG) for prophylaxis against myocardial ischemia and infarction in patients undergoing coronary artery bypass graft (CABG) surgery with accelerated recovery. ⋯ This study shows a high incidence of myocardial ischemia and infarction in patients presenting for CABG surgery with an accelerated recovery management scheme. NTG was well tolerated clinically; however, it was not found to be protective against myocardial ischemia or infarction in this setting.
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J. Cardiothorac. Vasc. Anesth. · Oct 2000
Randomized Controlled Trial Clinical TrialProtective ventilation attenuates postoperative pulmonary dysfunction in patients undergoing cardiopulmonary bypass.
To ascertain if protective ventilation can attenuate the damaging postoperative pulmonary effects of cardiopulmonary bypass (increases in airway pressure, decreases in lung compliance, and increases in shunt). ⋯ Data indicate that protective ventilation decreases pulmonary damage caused by mechanical ventilation in normal and abnormal lungs. The results of this investigation indicate that protective ventilation may also help attenuate the postoperative pulmonary dysfunction (increases in airway pressure, decreases in lung compliance, and increases in shunt) commonly seen in patients after exposure to cardiopulmonary bypass.
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J. Cardiothorac. Vasc. Anesth. · Oct 2000
Temporal synthesis and release of endothelin within the systemic and myocardial circulation during and after cardiopulmonary bypass: relation to postoperative recovery.
To determine endothelin levels in arterial, pulmonary, and myocardial vascular compartments in patients undergoing coronary artery bypass graft surgery and to examine the influence of endothelin on postoperative recovery. ⋯ Endothelin levels after CPB remained persistently increased for at least 24 hours after surgery and were associated with increased myocardial production of endothelin. These results suggest that the increased endothelin observed in the early postoperative period may contribute to a complex recovery from coronary artery bypass graft surgery.