Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2009
Epidural anesthesia in elderly patients undergoing coronary artery bypass graft surgery.
The purpose of this study was to evaluate the effects of thoracic epidural anesthesia on postoperative N-terminal pro B-natriuretic peptide (NT-proBNP) release in elderly patients undergoing elective coronary artery bypass graft (CABG) surgery. ⋯ Epidural anesthesia added to general anesthesia for CABG surgery significantly attenuates NT-proBNP release in elderly patients and reduces the incidence of prolonged intensive care unit stay.
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J. Cardiothorac. Vasc. Anesth. · Dec 2009
Pneumonia in a cardiothoracic intensive care unit: incidence and risk factors.
The purpose of this study was to determine the incidence, risk factors, and pathogens causing pneumonia in a cardiothoracic intensive care unit (CTICU). ⋯ Pneumonia is a common complication in the CTICU, and the authors recommend the following: the removal of the endotracheal tube as soon as possible, the minimal use of a bronchoscope and only in cases of bronchial obstruction, and the use of NIMV.
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J. Cardiothorac. Vasc. Anesth. · Dec 2009
The utility of thromboelastography for guiding recombinant activated factor VII therapy for refractory hemorrhage after cardiac surgery.
Recombinant activated factor VII (rFVIIa) is being increasingly used in cardiac surgical patients with refractory hemorrhage. In this study, the authors assessed the ability of thromboelastography (TEG) in guiding rFVIIa therapy in this setting. ⋯ TEG may be a useful tool for predicting response to rFVIIa in the setting of refractory hemorrhage after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Dec 2009
Preoperative and intraoperative risk factors for prolonged intensive care unit stay after aortic arch surgery.
The present study was performed to evaluate preoperative and intraoperative risk factors for prolonged intensive care unit (ICU) stay after aortic arch surgery. ⋯ The authors identified 4 preoperative and intraoperative risk factors for prolonged ICU stay. This is helpful to identify patients with increased risk for prolonged ICU stay, implement specific strategies, and allocate medical resources.
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J. Cardiothorac. Vasc. Anesth. · Dec 2009
Predictors of prolonged postoperative endotracheal intubation in patients undergoing thoracotomy for lung resection.
The aim of this study was to identify predictors of delayed endotracheal extubation defined as the need for postoperative ventilatory support after open thoracotomy for lung resection. ⋯ Most predictors of delayed postoperative extubation (ie, red blood cell transfusion, higher preoperative serum creatinine, lower preoperative FEV(1), and more extensive lung resection) are difficult to modify in the perioperative period and probably represent greater severity of underlying lung disease and more advanced comorbid conditions. However, thoracic epidural anesthesia and analgesia is a modifiable factor that was associated with reduced odds for postoperative ventilatory support. Thus, the use of epidural analgesia may reduce the need for post-thoracotomy mechanical ventilation.