Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Dec 2007
Comparative StudyResults and predictors of early and late outcomes of coronary artery bypass graft surgery in octogenarians.
The aim of this study was to investigate early and late outcomes of coronary artery bypass graft (CABG) surgery in a large cohort of octogenarian patients. The results were compared with 2 other age groups including septuagenarians and patients <70 years old. ⋯ Excellent results after CABG surgery can be expected in octogenarians, with a minimal increase in postoperative mortality and acceptable postoperative morbidity. Respiratory failure is the main postoperative complication in octogenarians. Recent advances in operative techniques and perioperative management have contributed in improving surgical outcome in these patients compared with historic reports.
-
J. Cardiothorac. Vasc. Anesth. · Dec 2007
Randomized Controlled Trial Comparative StudyEffects of intrapleural analgesia on pulmonary function and postoperative pain in patients with chronic obstructive pulmonary disease undergoing coronary artery bypass graft surgery.
Pain after coronary artery bypass graft (CABG) surgery remains a significant problem and may cause serious complications because of restricted breathing and limited early mobilization. The aim of this study was to assess the effects of intrapleural analgesia on the relief of postoperative pain in patients undergoing CABG surgery. ⋯ Improvement in lung function parameters correlating with decreased postoperative pain with intrapleural bupivacaine was observed. Intrapleural analgesia provided a good level of analgesia, improved respiratory performance, and allowed rapid mobilization, which led to a reduction of postoperative respiratory complications.
-
J. Cardiothorac. Vasc. Anesth. · Dec 2007
Randomized Controlled TrialFenoldopam infusion for renal protection in high-risk cardiac surgery patients: a randomized clinical study.
The purpose of this study was to evaluate the renoprotective effects of fenoldopam in patients at high risk of postoperative acute kidney injury undergoing elective cardiac surgery requiring cardiopulmonary bypass. ⋯ A 24-hour infusion of 0.1 mug/kg/min of fenoldopam prevented acute kidney injury in a high-risk population undergoing cardiac surgery.
-
J. Cardiothorac. Vasc. Anesth. · Dec 2007
The acute physiology and chronic health evaluation III outcome prediction in patients admitted to the intensive care unit after pneumonectomy.
The Acute Physiology and Chronic Health Evaluation (APACHE) III prognostic system has not been previously validated in patients admitted to the intensive care unit (ICU) after pneumonectomy. The purpose of this study was to determine if the APACHE III predicts hospital mortality after pneumonectomy. ⋯ In patients admitted to the ICU after pneumonectomy, the APACHE III discriminates moderately well between survivors and nonsurvivors. The calibration of the model appears to be good, although the low number of deaths limits the power of the calibration analysis. The use of APACHE III data in outcomes research involving patients who have undergone pneumonectomy is acceptable.
-
J. Cardiothorac. Vasc. Anesth. · Dec 2007
Comparative StudyHigh thoracic epidural anesthesia in coronary artery bypass surgery: a propensity-matched study.
To assess if 2 different anesthesia strategies, high-thoracic epidural anesthesia (HTEA) plus inhalation anesthesia and total intravenous anesthesia (TIVA) with sufentanil/propofol had different influence on outcomes of coronary artery bypass graft (CABG) surgery patients. ⋯ HTEA and TIVA provided similar early outcomes after CABG surgery, and there were no major differences between these 2 strategies in the average risk CABG patient populations. Although HTEA did not cause neurologic problems and yielded a significant reduction in time to extubation, a consistent benefit over standard techniques could not be shown.