Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2002
Randomized Controlled Trial Clinical TrialDoes normoxemic cardiopulmonary bypass prevent myocardial reoxygenation injury in cyanotic children?
To evaluate whether the deleterious effect of cardiopulmonary bypass (CPB) can be prevented by controlling PaO(2) in cyanotic children. ⋯ Conventional clinical methods of initiating CPB at a hyperoxemic PO(2) may increase the possibility of myocardial reoxygenation injury in cyanotic children. This deleterious effect of reoxygenation can be modified by initiating CPB at a lower level of oxygen concentration. Subsequent long-term studies are needed to determine the best method of decreasing the oxygen concentration of the CPB circuit.
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J. Cardiothorac. Vasc. Anesth. · Jun 2002
Neuroprotection is associated with beta-adrenergic receptor antagonists during cardiac surgery: evidence from 2,575 patients.
To determine the impact of perioperative beta-adrenergic receptor (betaAR) antagonist administration on neurologic complications. ⋯ Use of beta-adrenergic antagonists was associated with a substantial reduction in the incidence of postoperative neurologic complications. A prospective randomized trial is needed to verify this potentially important neuroprotective strategy in cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Jun 2002
Randomized Controlled Trial Clinical TrialDiltiazem infusion for renal protection in cardiac surgical patients with preexisting renal dysfunction.
To evaluate if the calcium channel blocker diltiazem protects postoperatively renal function in cardiac surgical patients with preexisting mild-to-moderate renal dysfunction. ⋯ Diltiazem can be safely used in patients who have mild-to-moderate renal dysfunction and undergo cardiac surgery using cardiopulmonary bypass. Within the limits of this study, the data suggest that addition of prophylactic diltiazem may prevent further glomerular damage resulting from cardiopulmonary bypass and may improve glomerular function 3 weeks after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Jun 2002
Randomized Controlled Trial Clinical TrialPlatelet pheresis is not a useful adjunct to blood-sparing strategies in cardiac surgery.
To examine whether specific platelet pheresis (minimal plasma harvested) would contribute toward reduced blood loss and allogenic blood requirements after cardiac surgery. ⋯ Platelet pheresis activates a proportion of the harvested platelets and impairs the function of the remainder; this may explain its failure to reduce postoperative blood loss and transfusion requirements.