Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2001
Randomized Controlled Trial Comparative Study Clinical TrialPain relief after esophagectomy: Thoracic epidural analgesia is better than parenteral opioids.
To compare postoperative pain relief and pulmonary function in patients after thoracoabdominal esophagectomy treated by continuing perioperative thoracic epidural anesthesia or changing to parenteral opioids. ⋯ Continuation of intraoperative thoracic epidural anesthesia for 5 postoperative days provides better pain relief at mobilization compared with a switch to patient-controlled analgesia with intravenous morphine. There was no intergroup difference in the impact on measures of pulmonary function.
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J. Cardiothorac. Vasc. Anesth. · Jun 2001
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the hemodynamic effects of milrinone with dobutamine in patients after cardiac surgery.
To compare the hemodynamic effects, efficacy, and safety of intravenous milrinone (M), 50 microg/kg during 10 minutes followed by 0.5 microg/kg/min, with intravenous dobutamine (D), 10 to 20 microg/kg/min, in patients with low cardiac output after cardiac surgery. ⋯ Milrinone and dobutamine are appropriate and comparable for the pharmacologic treatment of the low- output syndrome after cardiopulmonary bypass.
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J. Cardiothorac. Vasc. Anesth. · Jun 2001
Randomized Controlled Trial Clinical TrialTranexamic acid in aortic valve replacement.
To assess the relative efficacy of tranexamic acid compared with a control group to decrease bleeding and transfusion requirements in a uniform population undergoing aortic valve replacement. ⋯ Tranexamic acid reduces postoperative blood loss and transfusion requirements in elective aortic valve replacement.
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J. Cardiothorac. Vasc. Anesth. · Jun 2001
Randomized Controlled Trial Clinical TrialInfluence of a vital capacity maneuver on pulmonary gas exchange after cardiopulmonary bypass.
To investigate the effect of a single, vital capacity breath (vital capacity maneuver [VCM]), administered at the end of cardiopulmonary bypass (CPB), on pulmonary gas exchange in patients undergoing coronary artery bypass graft surgery. ⋯ The use of a VCM prevented an increase in Q(S)/Q(T) from occurring in the operating room. Although a VCM did not influence pulmonary gas exchange in the ICU, its application in the operating room appears to exert a beneficial effect on tracheal extubation times after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Jun 2001
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the effects of a cell saver and low-dose aprotinin on blood loss and homologous blood usage in patients undergoing valve surgery.
To compare 2 important techniques of blood conservation, use of a cell saver and low-dose aprotinin, in terms of blood loss and homologous blood usage in patients undergoing cardiac valve surgery. ⋯ Low-dose aprotinin and a cell saver are effective and comparable methods of blood conservation. Aprotinin helps by decreasing the postoperative drainage, and a cell saver helps by making the patient's own blood available for transfusion.