Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2003
Comparative StudyComparison of continuous cardiac output measurements in patients after cardiac surgery.
To investigate in a direct comparison accuracy and precision of continuous cardiac output measurements assessed by continuous pulmonary artery thermodilution technique (TDCCO), continuous pulse contour analysis (PCCO), and noninvasive partial CO(2)-rebreathing technique (NICO) in patients after coronary artery bypass grafting (CABG) during the postoperative period. ⋯ The results of this clinical investigation show agreement between TDCCO and PCCO to satisfy clinical requirements in a setting of postoperative patients after cardiac surgery. In contrast, the NICO monitor is of very limited use in these patients.
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J. Cardiothorac. Vasc. Anesth. · Apr 2003
High thoracic epidural anesthesia as the sole anesthetic for performing multiple grafts in off-pump coronary artery bypass surgery.
The feasibility of the use of high thoracic epidural anesthesia as a sole anesthetic in patients undergoing beating heart coronary revascularization avoiding general anesthesia was studied. ⋯ Experience confirms the feasibility of performing multiple coronary artery bypasses in conscious patients without endotracheal general anesthesia.
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J. Cardiothorac. Vasc. Anesth. · Apr 2003
Randomized Controlled Trial Clinical TrialManagement of heparin resistance during cardiopulmonary bypass: the effect of five different anticoagulation strategies on hemostatic activation.
Attenuation of hemostatic activation is a central goal during CPB. However, this poses a problem in patients insensitive to heparin. The present investigation was performed to assess different strategies of managing patients with heparin resistance during CPB. ⋯ Activation of hemostasis during CPB in heparin-resistant patients most likely has to be attributed to stimulation of the tissue factor pathway. Even the sole use of high concentrations of UFH does not effectively inhibit this activation. Therefore, in these patients anticoagulation during CPB with UFH should be supplemented with either AT III, a short-acting direct thrombin inhibitor, or a short-acting platelet glycoprotein IIb/IIIa antagonist.
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J. Cardiothorac. Vasc. Anesth. · Apr 2003
Comparative StudyContinuous measurement of cardiac output by inert gas throughflow: comparison with thermodilution.
The throughflow method is a new technique for continuous and minimally invasive measurement of cardiac output by the Fick principle, which uses ventilation of the 2 lungs with unequal inspired gas concentrations by means of a double-lumen endobronchial tube. It exploits steady-state gas exchange and thus permits rapid repetition of measurement. ⋯ The throughflow method showed good agreement with thermodilution. It permits continuous cardiac output measurement without the need for sampling of mixed venous blood, using techniques of lung isolation, which are readily available in clinical anesthetic practice.
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J. Cardiothorac. Vasc. Anesth. · Apr 2003
Randomized Controlled Trial Clinical TrialHeparin-coated versus uncoated extracorporeal circuit in patients undergoing coronary artery bypass graft surgery.
To assess the effect of heparin-coated circuits on bleeding, transfusion, and platelet count in patients undergoing primary coronary artery bypass grafting with full heparinization. ⋯ The use of a heparin-coated or uncoated cardiopulmonary bypass circuit and full heparinization marginally reduced only red blood cell transfusion but was not associated with platelet sparing or reduced perioperative bleeding.