Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jan 2015
Improved Performance of the Fourth-Generation FloTrac/Vigileo System for Tracking Cardiac Output Changes.
The aims of this study were to compare cardiac output (CO) measured by the new fourth-generation FloTrac™/Vigileo™ system (Version 4.00) (COFVS) with that measured by a pulmonary artery catheter (COREF), and to investigate the ability of COFVS to track CO changes induced by increased peripheral resistance. ⋯ The trending ability of the new fourth-generation FloTrac™/Vigileo™ system after increased vasomotor tone was greatly improved compared with previous versions; however, the discrepancy of the new system in CO measurement was not clinically acceptable, as in previous versions. For clinical application in critically ill patients, this vasomotor tone-dependent disagreement must be decreased.
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J. Cardiothorac. Vasc. Anesth. · Jan 2015
Reversal of Heparin After Cardiac Surgery: Protamine Titration Using a Statistical Model.
To establish a statistical model for determination of protamine dose in conjunction with cardiopulmonary bypass. ⋯ Protamine dosing based on statistical modeling represents an alternative to point-of-care tests.
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J. Cardiothorac. Vasc. Anesth. · Jan 2015
In-hospital mortality in cardiac surgery patients after readmission to the intensive care unit: a single-center experience with 10,992 patients.
Determine if readmission to the intensive care unit (ICU) after cardiac surgery procedures is associated with increased mortality. ⋯ Patient readmission to the ICU following cardiac surgery was associated with a 5-fold increase in hospital mortality rate compared to non-readmitted patients. The highest mortality rate was observed among readmitted patients who underwent CABG. Older age, previous myocardial infarction, and initial long length of stay in the post-operative ward were independent risk factors for death after readmission to the ICU.
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J. Cardiothorac. Vasc. Anesth. · Jan 2015
Patient Understanding of the Importance of Statin Use in the Perioperative Period.
Perioperative hydroxy-3-methyl glutaryl coenzyme A reductase inhibitors (statins) have been shown to decrease morbidity and mortality after noncardiac surgery. The objective of this study was to assess patient understanding of the potential benefits of perioperative statins in a select population already on chronic therapy. A secondary aim was to determine the frequency with which patients recalled having a discussion with their provider regarding perioperative statins. ⋯ This study suggested low patient understanding of the potential importance and reasons for perioperative statins. In addition, this study also suggested that the information regarding the importance of perioperative statins is not being relayed to the patient at the level of the surgeon or primary care physician. All physicians involved in perioperative care can offer improved patient education to promote compliance with statin therapy in hopes of a favorable impact on perioperative outcomes.