Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Oct 2012
Meta Analysis Comparative StudyIntensive intraoperative insulin therapy versus conventional insulin therapy during cardiac surgery: a meta-analysis.
The goal of this meta-analysis was to determine the benefits and risks of rigorous glycemic control during cardiac surgery. ⋯ The intraoperative use of IIT may decrease the infection rate in cardiac surgical patients compared with the CIT group. However, IIT may not decrease mortality, the incidence of hypoglycemia, or the incidence of cardiovascular events. Additional well-designed randomized trials are required to clarify the potential benefit of IIT on 30-day/in-hospital mortality and the incidence of perioperative hypoglycemia.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2012
Meta AnalysisExogenous surfactant may improve oxygenation but not mortality in adult patients with acute lung injury/acute respiratory distress syndrome: a meta-analysis of 9 clinical trials.
To evaluate whether exogenous surfactant therapy may be useful in adult patients with acute lung injury or acute respiratory distress syndrome, using a meta-analysis of published clinical trials. ⋯ An exogenous surfactant may improve oxygenation over the first 24 hours after administration. However, treatment does not improve mortality and oxygenation over ≥120 hours after administration and results in a high rate of adverse effects. Therefore, the present data suggest that an exogenous surfactant cannot be considered an effective adjunctive therapy in patients with acute lung injury/acute respiratory distress syndrome.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2012
ReviewRandomized evidence for reduction of perioperative mortality.
With more than 220 million major surgical procedures performed annually, perioperative interventions leading to even minor mortality reductions would save thousands of lives per year. This international consensus conference aimed to identify all nonsurgical interventions that increase or reduce perioperative mortality as suggested by randomized evidence. ⋯ Future research and health care funding should be directed toward studying and evaluating these interventions.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2012
Randomized Controlled Trial Comparative StudyA prospective, randomized, double-blinded comparison between multimodal thoracic paravertebral bupivacaine and levobupivacaine analgesia in patients undergoing lung surgery.
To compare the effects of paravertebral analgesia with levobupivacaine or bupivacaine on intra- and postoperative pain for thoracic surgery. ⋯ Paravertebral analgesia with levobupivacaine resulted in less intraoperative fentanyl consumption, lower static (3 days) and dynamic (2 days) pain scores, and less rescue analgesia than analgesia with bupivacaine.