Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2015
Randomized Controlled TrialVasopressin Does Not Raise Cardiac Enzymes Following Cardiac Surgery: A Randomized Double-Blind Clinical Trial.
The aim of this study was to investigate the relationship between intraoperative vasopressin infusion and postoperative cardiac enzymes. ⋯ Vasopressin infusion has been used to treat catecholamine-unresponsive shock. In this study, intraoperative vasopressin was used safely as a possible first-line drug for treating hypotension; however, it did not increase the levels of cardiac enzymes after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 2015
Randomized Controlled TrialPercutaneous Superior Vena Cava Drainage during Minimally Invasive Mitral Valve Surgery: A Randomized, Crossover Study.
Minimally invasive techniques commonly are applied to mitral valve surgery; however, there has been little research investigating the optimal methods of cardiopulmonary bypass for the right minithoracotomy approach. Controversy exists as to whether a percutaneous superior vena cava drainage cannula (PSVC) is necessary during these operations. The authors, therefore, sought to determine the effect of using a percutaneous superior vena cava catheter on brain near-infrared spectroscopy, blood lactate levels, hemodynamics and surgical parameters. ⋯ The use of a percutaneous superior vena cava drainage improved surgical visualization and lowered CVP, but had no effect on brain near infrared spectroscopy during minimally invasive mitral valve surgery. (ClinicalTrials.gov Identifier: NCT01166841).
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J. Cardiothorac. Vasc. Anesth. · Feb 2015
Observational StudyEvaluation of Cerebral Oxygenation and Perfusion With Conversion From an Arterial-to-Systemic Shunt Circulation to the Bidirectional Glenn Circulation in Patients With Univentricular Cardiac Abnormalities.
Superior vena cava pressure after the bidirectional Glenn operation usually is higher than that associated with the preceding shunt-dependent circulation. The aim of the present study was to determine whether the acute elevation in central venous pressure was associated with changes in cerebral oxygenation and perfusion. ⋯ The bidirectional Glenn operation in infants with a shunt-dependent circulation is associated with an improvement in cerebral oxygenation, and the lower cerebral blood flow velocity is likely a response of intact cerebral autoregulation.
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J. Cardiothorac. Vasc. Anesth. · Feb 2015
Randomized Controlled Trial Comparative StudyCoadministration of Intravenous Remifentanil and Morphine for Post-thoracotomy Pain: Comparison with Intravenous Morphine Alone.
In this double-blind, randomized study, the authors compared the effects of a patient-controlled remifentanil and morphine combination with morphine alone on post-thoracotomy pain, analgesic consumption, and side effects. ⋯ Coadministration of PCA remifentanil with morphine for the treatment of post-thoracotomy pain did not reduce morphine consumption but provided superior analgesia, less use of rescue analgesics, and fewer side effects compared to morphine alone.
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J. Cardiothorac. Vasc. Anesth. · Feb 2015
Preliminary Experience with Combined Inhaled Milrinone and Prostacyclin in Cardiac Surgical Patients with Pulmonary Hypertension.
To retrospectively evaluate the effects of combined inhaled prostacyclin and milrinone to reduce the severity of pulmonary hypertension when administered prior to cardiopulmonary bypass. ⋯ Preemptive treatment of pulmonary hypertension with a combination of inhaled prostacyclin and milrinone before CPB was associated with a reduction in the severity of pulmonary hypertension. In addition, a significant reduction in vasoactive support in the intensive care unit during the first 24 hours after cardiac surgery was observed. The impact of this strategy on postoperative survival needs to be determined.