Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Aug 2002
Randomized Controlled Trial Comparative Study Clinical TrialCoronary revascularization: a procedure in transition from on-pump to off-pump? The role of glucose-insulin-potassium revisited in a randomized, placebo-controlled study.
To investigate an optimized glucose-insulin-potassium (GIK) solution regimen as an alternate myocardial protective strategy in off-pump coronary artery bypass graft (OP-CAB) surgery and as a supplement to conventional coronary artery bypass graft (CABG) surgery using cardiopulmonary bypass (CPB). ⋯ GIK solution therapy achieved NEFA suppression and an insignificant trend toward reduced biochemical parameters of ischemic injury in OP-CAB surgery and CPB groups, but no major clinical benefit (perioperative myocardial infarction, intensive care unit length of stay, or hospital length of stay) was shown after elective CABG surgery in low-risk patients. Compared with CPB, OP-CAB surgery significantly reduced ischemic injury and postoperative infections.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2002
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialIntraoperative insulin therapy does not reduce the need for inotropic or antiarrhythmic therapy after cardiopulmonary bypass.
To determine whether attempted glucose control through intraoperative insulin therapy reduces the need for inotropic or antiarrhythmic therapy after cardiopulmonary bypass (CPB). ⋯ Intraoperative insulin therapy did not reduce the use of inotropic or antiarrhythmic support after cardiac surgery with CPB. The lack of benefit may be due to the inability to prevent hyperglycemia during the physiologic stress of CPB or a tribute to the effectiveness of modern myocardial preservation techniques.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2002
Comparative Study Clinical Trial Controlled Clinical TrialDifferential effects of aprotinin and tranexamic acid on endotoxin desensitization of blood cells induced by circulation through an isolated extracorporeal circuit.
To compare the effects of aprotinin and tranexamic acid on blood cytokine secretion induced by the circulation of blood through an isolated extracorporeal circuit. ⋯ These results show that aprotinin, but not tranexamic acid, modulates the inflammatory response by reducing the IL-8 secretion of blood cells activated by contact with foreign surfaces.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2002
Comparative StudyCardiac marker responses to coronary artery bypass graft surgery with cardiopulmonary bypass and aortic cross-clamping.
To study several markers of myocardial injury in relation to aortic cross-clamping and cardiopulmonary bypass (CPB) after coronary artery bypass graft (CABG) surgery. ⋯ The increase in TnT level is strongly related to aortic cross-clamping.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2002
Randomized Controlled Trial Comparative Study Clinical TrialA prospective, randomized comparison of thromboelastographic coagulation profile in patients receiving lactated Ringer's solution, 6% hetastarch in a balanced-saline vehicle, or 6% hetastarch in saline during major surgery.
To compare the effects of lactated Ringer's solution (LR), 6% hetastarch in a balanced-saline vehicle (HS-BS), and 6% hetastarch in normal saline (HS-NS) on coagulation using thromboelastography. ⋯ LR-treated patients exhibited a hypercoagulative profile that persisted into the postoperative period. HS-BS administration was associated with a lesser change in the coagulation profile compared with HS-NS, which was associated with a hypocoagulative state.