Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2011
Comparative StudySeizures after open heart surgery: comparison of ε-aminocaproic acid and tranexamic acid.
Although the lysine analogs tranexamic acid (TXA) and aminocaproic acid (EACA) are used widely for antifibrinolytic therapy in cardiac surgery, relatively little research has been performed on their safety profiles, especially in the setting of cardiac surgery. Two antifibrinolytic protocols using either TXA or aminocaproic acid were compared according to postoperative outcome. ⋯ Both lysine analogs are associated with significant side effects, which must be taken into account when performing risk-benefit analyses of their use. Their use should be restricted to patients at high risk for bleeding; routine use on low-risk patients undergoing standard surgeries should face renewed critical reappraisal.
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J. Cardiothorac. Vasc. Anesth. · Feb 2011
Pulse contour analysis to assess hemodynamic response to passive leg raising.
The authors evaluated the ability of 2 pulse contour cardiac output (CO) techniques to track CO changes during passive leg raising (PLR) to assess fluid loading responsiveness. ⋯ Changes in COm, COli, SVV, and PPV track COtd changes during PLR with a high degree of accuracy in sedated, ventilated, postoperative cardiac surgery patients. Changes in pulse contour CO after PLR can be used to predict fluid loading responsiveness.
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J. Cardiothorac. Vasc. Anesth. · Feb 2011
Cerebral desaturation during single-lung ventilation is negatively correlated with preoperative respiratory functions.
To evaluate the percent change of cerebral oxygen saturation (SctO(2)) during single-lung ventilation (SLV) and its correlation with preoperative respiratory functions. ⋯ Greater decreases were found in SctO(2) during SLV in patients with better preoperative respiratory function. These findings suggest that intraoperative monitoring during SLV should include not only measurement of SpO(2) and PaO(2) but also SctO(2).
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J. Cardiothorac. Vasc. Anesth. · Feb 2011
Editorial CommentThe post-BART anti-fibrinolytic dilemma?