Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2013
Lack of evidence for a remote effect of renal ischemia/reperfusion acute kidney injury on outcome from temporary focal cerebral ischemia in the rat.
Acute kidney injury (AKI) and ischemic stroke may occur in the same cardiac surgical patient. It is not known if an interaction exists between these organ injuries. Isolated renal ischemia/reperfusion is associated with dysfunction in remote, otherwise normal organs, including the brain. In a rat model of simultaneous bilateral renal artery occlusion (BRAO) and middle cerebral artery occlusion (MCAO), the authors tested the hypothesis that AKI would worsen experimental stroke outcome. ⋯ In contrast to the effects reported for AKI on normal remote organs, AKI had no influence on infarct size or neurologic function after experimental ischemic cerebral stroke.
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J. Cardiothorac. Vasc. Anesth. · Feb 2013
A retrospective analysis of blood loss with combined topical and intravenous tranexamic acid after coronary artery bypass graft surgery.
Intravenous antifibrinolytics are the gold standard for blood conservation during cardiac surgery. Recent evidence suggests that topical tranexamic acid administration also is effective, although the efficacy of combined topical and intravenous administration has never been reported. Combined administration may offer superior hemostasis while decreasing side effects. The current study explores the use of combined topical and intravenous tranexamic acid as a blood conservation strategy in cardiac surgery. ⋯ This study suggested that combined tranexamic acid administration may be superior for blood conservation, but fully powered randomized controlled trials will be required to confirm these findings and determine the safety advantage and clinical relevance of adding topical tranexamic acid to existing blood conservation strategies.
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J. Cardiothorac. Vasc. Anesth. · Feb 2013
Changes in transfusion practice over time in adult patients undergoing liver transplantation.
The aim of this study was to investigate changes in transfusion practice over time in liver transplantation surgery and to evaluate potential causes for changes in practice and report associated perioperative morbidity and mortality. ⋯ When compared with patients in the early group, recent cohort patients received significantly fewer blood transfusions. The authors attribute this observation to changes in surgical technique rather than a significant alteration in transfusion triggers over the studied time period.