Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2019
Clinical Impact of Protamine Titration-Based Heparin Neutralization in Patients Undergoing Coronary Bypass Grafting Surgery.
A hemostasis management system (HMS) is a point-of-care method for heparin and protamine titration. The authors hypothesized that protamine dosing over the HMS estimate would be associated with elevated activated clotting time (ACT), increased bleeding, and transfusion owing to protamine's anticoagulant activity. ⋯ Most patients received the protamine dose sufficiently close to the HMS estimate, but protamine dosing above the HMS estimate occurred in both obese and nonobese patients, which was associated independently with prolonged ACT after adjusting for sex, BMI, and CPB time.
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J. Cardiothorac. Vasc. Anesth. · Aug 2019
ReviewReview of the 2017 European Society of Cardiology's Guidelines for the Management of Acute Myocardial Infarction in Patients Presenting with ST-Segment Elevation and Focused Update on Dual Antiplatelet Therapy in Coronary Artery Disease Developed in Collaboration with the European Association for Cardio-Thoracic Surgery.
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J. Cardiothorac. Vasc. Anesth. · Aug 2019
Clinical TrialInfluence of Sternotomy on Delta Pulse Pressure and Delta Down During Open Chest Cardiac Surgery: A Preliminary Study.
Delta pulse pressure and delta down are used as dynamic preload indicators of fluid responsiveness during closed chest surgery. There are few data regarding their accuracy in open chest surgery. The present study aimed to evaluate the influence of sternotomy on the accuracy of both delta pulse pressure and delta down. ⋯ Within the study population, sternotomy significantly influenced delta pulse pressure but not delta down. In this preliminary study, delta down appeared to be more accurate to evaluate fluid responsiveness during open chest surgery than did delta pulse pressure. Before promoting delta down in current practice, confirmation is needed on a larger scale.
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J. Cardiothorac. Vasc. Anesth. · Aug 2019
Propofol-Induced Vasodilation in Human Internal Mammary Artery: Role of Potassium Channels.
The aim of this study was to investigate the vascular effects and mechanisms of propofol in the human internal mammary artery (IMA). ⋯ This study clearly reveals that propofol relaxes the IMA, and propofol-induced vasodilation may be related to large conductance calcium ion-activated potassium ion channel activation. Propofol use in coronary artery bypass surgery can be valuable via its favorable vasodilator effect to overcome perioperative vasospasm of IMA.