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
Perioperative coagulation management and blood conservation in cardiac surgery: a Canadian Survey.
To determine which strategies are currently used for (anti)coagulation management and blood conservation during cardiac surgery in Canada. ⋯ The majority of Canadian institutions do not use point-of-care tests other than ACT. Most institutions do not have algorithms for management of bleeding following cardiac surgery and at least 30% do not monitor their transfusion practice perioperatively. Cardiac surgery patients in Canada may benefit from a standardized approach to blood conservation in the perioperative period.
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J. Cardiothorac. Vasc. Anesth. · Oct 2008
Can ROTEM thromboelastometry predict postoperative bleeding after cardiac surgery?
To evaluate the predictive ability of ROTEM thromboelastometry (Pentapharm, Basel, Switzerland) to identify patients bleeding more than 200 mL/h in the early postoperative period after cardiac surgery. ⋯ ROTEM thromboelastometry has poor predictive utility to identify patients who bleed more than 200 mL/h in the early postoperative period after cardiac surgery. However, its negative predictive value was good.
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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.