Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Randomized Controlled Trial Comparative StudyComparison of Effects of Thoracic Epidural and Intravenous Administration of Lidocaine on Target-Controlled Infusion of Propofol and Tracheal Intubation Response During Induction of Anesthesia.
To compare the effects of thoracic epidural anesthesia (TEA) and intravenous (IV) lidocaine on the effect-site concentration (Ce) of propofol target-controlled infusion (TCI) and the intubation-induced stress responses during general IV anesthesia induction. ⋯ Lidocaine administered via both TEA and IV decreased the induction doses of propofol and suppressed cardiovascular and stress responses to tracheal intubation. Administration of 2mg/kg of 2% lidocaine IV was better, with no side effects of lidocaine toxicity.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Review Meta AnalysisEffect of Levosimendan on Survival and Adverse Events After Cardiac Surgery: A Meta-analysis.
Left ventricular systolic dysfunction is associated with increased morbidity and mortality in patients undergoing cardiac surgery. The authors performed a meta-analysis investigating the effects of levosimendan in cardiac surgery patients with and without preoperative systolic dysfunction. ⋯ Levosimendan was associated with reduced mortality and other adverse outcomes in patients undergoing cardiac surgery, and these benefits were greatest in patients with reduced EF. These data support the need for adequately powered randomized clinical trials to confirm the benefits of levosimendan in patients with reduced EF undergoing cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Randomized Controlled TrialProstaglandin E1 Increases the Blood Flow Rate of Saphenous Vein Grafts in Patients Undergoing Off-pump Coronary Artery Bypass Grafting.
To compare the effects of prostaglandin E1 (PGEl) versus placebo on blood flow rate in coronary artery bypass grafts. ⋯ PGE1 significantly increased the flow rate in anastomosed saphenous vein grafts, and its beneficial effects on hemodynamics and oxygen metabolism were observed.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Review Meta AnalysisReducing Mortality in Acute Kidney Injury Patients: Systematic Review and International Web-Based Survey.
To identify all interventions that increase or reduce mortality in patients with acute kidney injury (AKI) and to establish the agreement between stated beliefs and actual practice in this setting. ⋯ The authors identified all interventions with at least 1 study suggesting a significant effect on mortality in patients with or at risk of AKI and found that there is discordance between participant stated beliefs and actual practice regarding these topics.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Randomized Controlled Trial Comparative StudyReversal of Decreases in Cerebral Saturation in High-risk Cardiac Surgery.
To measure the incidence of cerebral desaturation during high-risk cardiac surgery and to evaluate strategies to reverse cerebral desaturation. ⋯ Cerebral desaturation in high-risk cardiac surgery is frequent but can be reversed most of the time resulting in a smaller desaturation load. A large randomized study will be needed to measure the impact of reversing cerebral desaturation on patient's outcome.