Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2008
Randomized Controlled TrialAprotinin reduces cardiac troponin I release and inhibits apoptosis of polymorphonuclear cells during off-pump coronary artery bypass surgery.
In addition to blood-sparing effects, aprotinin may have cardioprotective and anti-inflammatory effects during cardiopulmonary bypass-assisted cardiac surgery. In this study, the authors examined whether aprotinin had cardioprotective and/or anti-inflammatory effects in patients undergoing off-pump coronary artery bypass grafting. ⋯ The authors conclude that aprotinin reduces perioperative cardiac troponin I release and attenuates apoptosis in polymorphonuclear cells but has no significant effects on plasma cytokine levels in patients undergoing off-pump coronary artery bypass graft surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 2008
Randomized Controlled TrialWarming of intravenous fluids prevents hypothermia during off-pump coronary artery bypass graft surgery.
Even mild perioperative hypothermia (34 degrees -36 degrees C) can cause numerous adverse outcomes, including morbid cardiac events, coagulopathy with increased blood loss, and a decreased resistance to surgical wound infection. The purpose of this study was to evaluate the effect of fluid warming on preventing hypothermia during off-pump coronary artery bypass (OPCAB) surgery. ⋯ The results show that the warming of intravenous fluids by using the Hotline system prevents decreases in systemic temperatures during OPCAB surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 2008
Randomized Controlled Trial Comparative StudyA comparison of activated coagulation time-based techniques for anticoagulation during cardiac surgery with cardiopulmonary bypass.
The inadequacy of heparinization during cardiopulmonary bypass (CPB) can lead to hemostatic activation with increases in postoperative blood loss and blood product requirements after cardiac surgery. Because activated coagulation time (ACT) measurements may not be accurate during CPB, the use of a heparin management system (HMS) has been advocated. This study compared the efficacy of a modified ACT-based system versus an HMS (Hepcon; Medtronic Inc, Minneapolis, MN) for CPB anticoagulation. ⋯ ACT-based heparinization was found to be as efficacious as the Hepcon HMS system.
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J. Cardiothorac. Vasc. Anesth. · Feb 2008
Comparative StudyCardiopulmonary bypass parameters and hemostatic response to cardiopulmonary bypass in infants versus children.
Because infants have relatively more blood loss (mL/kg) than older children during cardiac surgery involving cardiopulmonary bypass (CPB), the authors compared hemostatic activation between infants and older children undergoing cardiac surgery. ⋯ Compared with children, infants had greater blood loss (mL/kg), greater drop in platelets during CPB, lower active tPA, and higher active PAI-1. Cumulative thrombin generation after CPB, indicated by F1.2 levels, correlated with early blood loss.