Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
Microvascular Alterations During Cardiac Surgery Using a Heparin or Phosphorylcholine-Coated Circuit.
Heparin biocompatible coating frequently is used to reduce inflammation and blood coagulation during cardiopulmonary bypass (CPB) in cardiac surgery. Whether heparin coating is protective or damaging to the vascular endothelium is unclear. The authors investigated whether heparin-coated (HC) circuits are associated with better preservation of microcirculatory perfusion and glycocalyx dimensions compared with nonheparin phosphorylcholine-coated (PC) circuits. ⋯ The use of an HC circuit is associated with better preservation of the endothelial glycocalyx compared with PC circuits, whereas microcirculatory perfusion was disturbed equally in both groups. Hence, CPB-induced microcirculatory perfusion disturbances seem to be coating independent.
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
Observational StudyEvaluation of Increase in Intraoperative Lactate Level as a Predictor of Outcome in Adults After Cardiac Surgery.
Early onset hyperlactatemia develops intraoperatively or within the first 6 hours of admission to the intensive care unit (ICU) and is associated with a poor prognosis. The aim of the present study was to determine the utility of an increase in the intraoperative lactate level, independent of the absolute lactate value at baseline after induction, as a dynamic parameter for morbidity (ICU length of stay, postoperative renal failure, and inotrope use) and mortality in adults post-cardiac surgery. ⋯ An increase in intraoperative lactate, independent of the level on induction, is a useful dynamic parameter to identify patients at risk of postoperative morbidity and mortality and might provide an early trigger for introducing measures to avoid poor outcomes.
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J. Cardiothorac. Vasc. Anesth. · Apr 2020
ABO Blood Group and Transfusions In the Intraoperative and Postoperative Period After LVAD Implantation.
To assess whether blood group O patients undergoing left ventricular assist device (LVAD) insertion have higher perioperative transfusion requirements, postoperative chest tube output, and postoperative changes in hematocrit. ⋯ O blood group is not a significant predictor of transfusion requirements in the combined intraoperative and postoperative period up to 90 days after LVAD implantation.