Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2011
Review Meta AnalysisEndovascular stenting or carotid endarterectomy for treatment of carotid stenosis: a meta-analysis.
To compare carotid artery stenting with open carotid surgery for the treatment of symptomatic or asymptomatic carotid artery stenosis in terms of stroke, myocardial infarction, and death at 30 days. ⋯ Compared with stenting, carotid endarterectomy decreases the risk of stroke at 30 days, increases the risk of myocardial infarction, and does not affect the risk of death.
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J. Cardiothorac. Vasc. Anesth. · Dec 2011
Review Meta Analysis Comparative StudyLevosimendan versus an intra-aortic balloon pump in adult cardiac surgery patients with low cardiac output.
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J. Cardiothorac. Vasc. Anesth. · Dec 2011
ReviewAdvances in anticoagulation: focus on dabigatran, an oral direct thrombin inhibitor.
Dabigatran is an oral direct thrombin inhibitor with a rapid onset. Patients on dabigatran do not require coagulation monitoring. Recent prospective randomized trials have shown the efficacy of dabigatran for the prevention of venous thromboembolism after knee or hip arthroplasty and for the prevention of stroke and systemic embolism in nonvalvular atrial fibrillation. ⋯ There currently is no reversal agent for dabigatran although hemodialysis can facilitate its rapid removal in life-threatening circumstances. The management of severe bleeding associated with dabigatran also may include the administration of a procoagulant, such as recombinant activated factor VII. Based on recent guidelines, regional anesthesia should be used cautiously in patients taking this novel oral thrombin inhibitor.
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J. Cardiothorac. Vasc. Anesth. · Dec 2011
Randomized Controlled TrialManagement of tight intraoperative glycemic control during off-pump coronary artery bypass surgery in diabetic and nondiabetic patients.
To optimize intra- and postoperative insulin management in cardiac surgical patients. ⋯ In diabetics and nondiabetics undergoing off-pump coronary artery bypass surgery, tight perioperative glycemic control is feasible and efficient, with minimal risks for hypo- and hyperglycemia. In nondiabetics, starting insulin therapy from induction onwards results in more measurements within target, without affecting the mean BG. In diabetics, decreasing the sampling interval from 60 to 30 minutes results in more measurements within target and in a mean blood glucose within target at ICU arrival.