Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2013
Randomized Controlled TrialLow target sufentanil effect-site concentrations allow early extubation after valve surgery.
To test the ability of low sufentanil effect-site concentrations (Ce) to shorten the time to tracheal extubation after valve surgery. ⋯ Compared with sufentanil Ce of 0.4 ng/mL, lower concentrations (0.2 and 0.3 ng/mL) promoted faster recovery and shorter times to extubation after valve surgery performed under target-controlled propofol infusion.
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J. Cardiothorac. Vasc. Anesth. · Feb 2013
Meta AnalysisThe effect of isoflurane on survival and myocardial infarction: a meta-analysis of randomized controlled studies.
The aim of this meta-analysis was to investigate the cardioprotective properties of isoflurane versus any comparator in terms of the rate of myocardial infarction and all-cause mortality. ⋯ Isoflurane reduced mortality in high-quality studies and showed a trend toward a reduction in mortality when it was compared with propofol. No differences in the rates of overall mortality and myocardial infarction were noted.
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J. Cardiothorac. Vasc. Anesth. · Feb 2013
Effect of cardiopulmonary bypass on thrombin generation and protein C pathway.
The purpose of this study was to evaluate the mechanisms of cardiopulmonary bypass (CPB)-induced dysregulation between thrombin and its regulatory anticoagulant activated protein C (APC). ⋯ Exposure to CPB is associated with a distinct thrombin surge that continues postoperatively for 4 hours. The impaired ability to generate APC reflects a complex process that is not associated with increased levels of sEPCR and thrombomodulin during CPB. Further studies are required to evaluate the regulation of the host APC response in cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 2013
Sevoflurane requirement to maintain bispectral index-guided steady-state level of anesthesia during the rewarming phase of cardiopulmonary bypass with moderate hypothermia.
The authors aimed to quantify any increase and the extent of the increase in sevoflurane requirements for maintaining hypnosis during hypothermic cardiopulmonary bypass (CPB) with the bispectral index (BIS) maintained between 40 and 50. ⋯ The sevoflurane requirement increases during the rewarming phase of hypothermic CPB. The percent increase in the requirement for sevoflurane is uniform and follows a particular pattern, which may be predicted.