Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2014
Randomized Controlled Trial Comparative StudyA Comparison of the EZ-Blocker with a Cohen Flex-Tip Blocker for One-Lung Ventilation.
The EZ-Blocker (IQ Medical Ventures BV, Rotterdam, Netherlands) is a newly designed device for one-lung ventilation. The aim of this study was to compare the effectiveness of the Cohen Flex-Tip bronchial blocker (Cook, Bloomington, IN) and the EZ-Blocker for one-lung ventilation during thoracic surgery. ⋯ In this study, both bronchial blockers provided similar surgical exposure during thoracic procedures. The EZ-Blocker had a shorter time to correct positioning and less frequent intraoperative malpositioning.
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J. Cardiothorac. Vasc. Anesth. · Aug 2014
Almitrine Fails to Improve Oxygenation During One-Lung Ventilation with Sevoflurane Anesthesia.
Almitrine enhances hypoxic pulmonary vasoconstriction (HPV) and can improve hypoxemia related to one-lung ventilation (OLV). Studies using almitrine have been conducted without inhaled anesthetics because they could inhibit HPV, counteracting the effect of almitrine. This hypothesis, however, has not been confirmed. This study's aim was to evaluate whether almitrine could improve oxygenation when administered during OLV with sevoflurane anesthesia. ⋯ During anesthesia with sevoflurane for open-chest OLV, almitrine failed to improve oxygenation and increased pulmonary artery pressure. The combination of sevoflurane and almitrine should, therefore, be avoided.
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J. Cardiothorac. Vasc. Anesth. · Aug 2014
Acute Kidney Injury Assessed by Cystatin C after Transcatheter Aortic Valve Implantation and Late Renal Dysfunction.
The aim of the present study was to evaluate acute kidney injury (AKI) with cystatin C following transcatheter aortic valve implantation (TAVI) and to assess the impact of postoperative AKI on outcome and late renal function. ⋯ The risk of postoperative AKI is considerable following TAVI, with an increased risk of early mortality for AKI+patients. Cystatin C may be a valuable adjunct to the established biomarker s-creatinine for preoperative risk assessment and for early postoperative diagnosis of AKI. The acute postoperative renal impairment in patients with AKI does not fully recover in the long term. There is a progressive renal impairment in both groups postoperatively, the etiology probably being multifactorial.
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J. Cardiothorac. Vasc. Anesth. · Aug 2014
Observational StudyHemodynamic recovery following postreperfusion syndrome in liver transplantation.
The authors' current understanding of the phenomenon of significant and sustained decrease in arterial pressure following liver graft reperfusion (postreperfusion syndrome [PRS]), is derived from relatively small observational reports, and no large scale analysis of PRS exists up to date. This study investigated its incidence, risk factors, temporal course of hemodynamic recovery, and its impact on functional graft outcome. ⋯ Host hemodynamic response to graft reperfusion appeared to be phasic: initial abrupt hypotension after portal vein reperfusion was followed by a period of gradual decline of blood pressure until hepatic artery reperfusion, and sustained hemodynamic recovery afterwards. The slope of hemodynamic recovery correlated negatively with the donor risk index. PRS was not associated with deterioration of post-transplant graft survival and function.
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J. Cardiothorac. Vasc. Anesth. · Aug 2014
Incidence of and risk factors for cardiovascular complications after thoracic surgery for noncancerous lesions.
The purpose of this study was to determine the incidence of and risk factors for cardiovascular complications after thoracic surgery for noncancerous lesions. ⋯ Knowledge of risk factors could help surgical teams to identify high risk patients and adjust modifiable risk factors including optimization of medical conditions, correction of intraoperative hypotension, and appropriate blood and fluid administration in order to reduce perioperative morbidity and mortality.