Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2006
Randomized Controlled Trial Comparative StudyComparison of hemodynamic changes after acute normovolemic hemodilution using Ringer's lactate versus 5% albumin in patients on beta-blockers undergoing coronary artery bypass surgery.
Acute normovolemic hemodilution (ANH) is used cautiously in coronary artery disease (CAD) patients because of concerns of compromised coronary blood flow. This study aimed to compare hemodynamic changes by using either Ringer's lactate or albumin for ANH in CAD patients receiving beta-blockers. ⋯ Hemodynamic stability was better maintained by 5% albumin than Ringer's lactate for ANH in chronic beta-blocked CAD patients. Despite an increase in cardiac index, systemic oxygen delivery was decreased irrespective of the hemodiluting fluid used. ANH to a hemoglobin value of 10 g/dL in chronically beta-blocked CAD patients was well tolerated.
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J. Cardiothorac. Vasc. Anesth. · Dec 2006
Randomized Controlled TrialBolus administration of landiolol, a short-acting, selective beta1-blocker, to treat tachycardia during anesthesia: a dose-dependent study.
The purpose of this study was to clarify the clinical efficacy of landiolol, a selective beta(1)-blocker, in patients developing tachycardia during anesthesia. ⋯ The results showed that bolus administration of landiolol was effective in the treatment of tachycardia during anesthesia in surgical patients. Landiolol was more efficacious in reducing heart rate than blood pressure.
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J. Cardiothorac. Vasc. Anesth. · Dec 2006
Staged anesthesia for combined carotid and coronary artery revascularization: a different approach.
Combined coronary artery bypass graft (CABG) surgery and carotid endarterectomy (CEA) are performed in an attempt to reduce the risk of postoperative stroke after CABG surgery in patients with significant or symptomatic carotid artery stenosis. The choice between regional and general anesthesia for CEA is still under debate. Regional anesthesia offers an excellent monitoring technique of the neurologic status of the awake patient during carotid clamping. In an attempt to improve monitoring of the neurologic status and avoid the use of temporary shunting in patients undergoing the combined procedure, a different approach is described combining regional anesthesia for CEA followed immediately by general anesthesia for CABG surgery. ⋯ This staged anesthetic approach for combined CABG and CEA surgery is an alternative in this complex subset of patients.
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J. Cardiothorac. Vasc. Anesth. · Dec 2006
Calcium supplementation of saline-based colloids does not produce equivalent coagulation profiles to similarly balanced salt preparations.
The primary objective of this study was to test the hypothesis that calcium alone does not account for the observed coagulation differences between saline-based and balanced electrolyte IV fluid preparations. ⋯ The different coagulation profiles between the 2 pentastarch preparations, as well as similar profiles of pentastarch in saline and hetastarch in balanced electrolyte solution, suggest that calcium is not solely responsible for previously observed effects.