Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2006
Clinical TrialRenal dysfunction after thoracic aortic surgery requiring deep hypothermic circulatory arrest: definition, incidence, and clinical predictors.
The purpose of this study was to evaluate renal dysfunction (RD) after thoracic aortic surgery (TAS) requiring deep hypothermic circulatory arrest (DHCA), to determine the influence of definition on RD after TAS-DHCA, to determine univariate predictors of RD after TAS-DHCA, and to determine multivariate predictors for RD TAS-DHCA. RD was defined in 3 ways: (1) >25% reduction in creatinine clearance, (2) >50% increase in serum creatinine, and (3) >50% increase in serum creatinine with an abnormal peak serum creatinine (>1.3 mg/dL for men and >1.0 mg/dL for women). ⋯ Although RD after TAS-DHCA varies substantially because of definition, it is still very common. Its multivariate predictors merit further focused research to enhance perioperative protection of the kidney.
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J. Cardiothorac. Vasc. Anesth. · Oct 2006
Teaching practices of thoracic epidural anesthesia in the United States: should lumbar epidurals be taught before thoracic epidurals?
The purpose of this study was to determine the current teaching practice of thoracic epidural procedures in the United States and to determine the effect of the teaching sequence of thoracic and lumbar epidurals on technical difficulties and complications. ⋯ Thoracic epidurals are widely taught in the United States. Most programs teach lumbar before thoracic epidurals. Thoracic epidurals are safe to teach without prior experience with lumbar epidurals.
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J. Cardiothorac. Vasc. Anesth. · Oct 2006
Hemodynamic effects of lidocaine in the thoracic paravertebral space during one-lung ventilation for thoracic surgery.
There is increasing interest in the use of the thoracic paravertebral block (TPVB) in association with general anesthesia for lung-resection surgery. The aim of the study was to evaluate the hemodynamic effects of a 5-mg/kg lidocaine bolus injected in the thoracic paravertebral space during one-lung ventilation (OLV) in noncardiac patients undergoing thoracic surgery. ⋯ In noncardiac patients, TPVB is associated with good hemodynamic stability, despite a small and transient decrease in myocardial contractility that could be related to the drug's systemic effects after its absorption.
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J. Cardiothorac. Vasc. Anesth. · Oct 2006
Randomized Controlled TrialEffects of sevoflurane on biomechanical markers of hepatic and renal dysfunction after coronary artery surgery.
The purpose of this study was to compare the effects of a total intravenous and a volatile anesthetic regimen on biochemical markers of hepatic and renal dysfunction after coronary artery surgery. ⋯ Postoperative biochemical markers of hepatic dysfunction were lower with a sevoflurane-based anesthetic regimen in patients undergoing coronary artery surgery with cardiopulmonary bypass.