Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2008
Randomized Controlled TrialLevosimendan in aortic valve surgery: cardiac performance and recovery.
The aim of the present study was to test the hypothesis that levosimendan has beneficial effects on cardiac performance and that the need for other vasoactive medications during and after cardiac surgery would be reduced by levosimendan in patients with severe aortic stenosis (AS) and left ventricular (LV) hypertrophy. ⋯ Low output is a result of myocardial stunning and is common after cardiopulmonary bypass. According to the present results, levosimendan may be useful in patients with severe AS and LV hypertrophy because it may prevent LV function from dropping to a critically low level postoperatively. Levosimendan causes vasodilation and thereby decreases mean arterial pressure, but this can be controlled with the use of norepinephrine.
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J. Cardiothorac. Vasc. Anesth. · Oct 2008
Randomized Controlled TrialA randomized trial evaluating different modalities of levosimendan administration in cardiac surgery patients with myocardial dysfunction.
To evaluate the effects of 2 different administration modalities of levosimendan (start before cardiopulmonary bypass [CPB] and at the end of CPB) compared with a standard treatment with milrinone started at the end of CPB in cardiac surgery patients with a preoperative ejection fraction <30%. ⋯ In the conditions of the present study, starting the levosimendan treatment before CPB was associated with a higher initial postoperative stroke volume and a lower incidence of postoperative atrial fibrillation, but had no effect on the extent of postoperative troponin I release.
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J. Cardiothorac. Vasc. Anesth. · Oct 2008
The effects of vasodilation on cardiac output measured by PiCCO.
The purpose of this study was to investigate the effects of vasodilation on cardiac output (CO) measured by pulse contour method using PiCCO (Pulsion Medical Systems AG, Munich, Germany) in comparison with CO by the thermodilution method. ⋯ PiCCO may not be an alternative to thermodilution measurement without recalibration when SVR decreases by infusion of PGE1 > or = 0.02 microg/kg/min.
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J. Cardiothorac. Vasc. Anesth. · Oct 2008
Arterial pulse cardiac output agreement with thermodilution in patients in hyperdynamic conditions.
This study aimed to compare continuous cardiac output (CCO) obtained using the arterial pulse wave (APCO) measurement with a simultaneous measurement of the intermittent cardiac output (ICO) and CCO obtained with a pulmonary artery catheter (PAC) in liver transplant patients. ⋯ APCO enables the assessment of CO with clinically acceptable bias and precision. At higher CO levels, APCO underestimates PAC measurements and it is not as reliable as thermodilution in hyperdynamic liver transplant patients.