Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2007
Comparative StudyCardiac output measured by a new arterial pressure waveform analysis method without calibration compared with thermodilution after cardiac surgery.
To investigate whether measuring cardiac output and its course after cardiac surgery by a new analysis technique of radial artery pressure waves, without need for calibration (FloTrac/Vigileo [FV]; Edwards Lifesciences, Irvine, CA), conforms to the standard bolus thermodilution method via a pulmonary artery catheter (PAC). ⋯ The FV arterial pressure waveform analysis method is a clinically applicable method for cardiac output assessment without calibration, after cardiac surgery. It performs well at low cardiac outputs but remains sensitive to changes in vascular tone.
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J. Cardiothorac. Vasc. Anesth. · Oct 2007
Randomized Controlled Trial Comparative StudyDesflurane versus propofol in patients undergoing mitral valve surgery.
Myocardial ischemic damage is reduced by volatile anesthetics in patients undergoing coronary artery bypass graft surgery, but it is unknown whether this benefit exists in patients undergoing valvular surgery with ischemia-reperfusion injury related to cardioplegic arrest and cardiopulmonary bypass. This study compared cardiac troponin release in patients receiving either volatile anesthetics or total intravenous anesthesia for mitral valve surgery. ⋯ Myocardial damage measured by cardiac troponin release was not reduced by volatile anesthetics in patients undergoing mitral valve surgery, whereas it was reduced in patients with concomitant coronary artery disease.
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J. Cardiothorac. Vasc. Anesth. · Oct 2007
Multicenter Study Comparative StudyThe influence of propofol versus sevoflurane anesthesia on outcome in 10,535 cardiac surgical procedures.
The purpose of this study was to evaluate the possible cardioprotective effect of sevoflurane versus propofol anesthesia in patients undergoing cardiac surgery. ⋯ Sevoflurane and propofol both possess some, although different, cardioprotective properties. Sevoflurane appears to be superior to propofol in patients with little or no ischemic heart disease, such as noncoronary artery bypass graft (CABG) surgery and CABG surgery without severe preoperative ischemia, whereas propofol seems superior in patients with severe ischemia, cardiovascular instability, or in acute/urgent surgery.
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J. Cardiothorac. Vasc. Anesth. · Oct 2007
Randomized Controlled TrialIsoflurane, 0.5 minimum alveolar concentration administered through the precardiopulmonary bypass period, reduces postoperative dobutamine requirements of cardiac surgery patients: a randomized study.
Cardioprotective properties have been shown with halogenated volatile agents. It was hypothesized that low-dose isoflurane administered before aortic cross-clamping may reduce the amount of dobutamine required to improve impaired postoperative cardiac function after various types of cardiac surgery. ⋯ This study revealed that exposure to 0.5 MAC isoflurane before CPB reduced the total amount of dobutamine required to normalize postoperative cardiac dysfunction in various types of cardiac surgical patients.
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J. Cardiothorac. Vasc. Anesth. · Oct 2007
Comparative StudyUncalibrated arterial pulse contour analysis versus continuous thermodilution technique: effects of alterations in arterial waveform.
To compare an arterial pressure-derived cardiac output (APCO) (Vigileo software version 1.07; Edwards Lifesciences, Irvine, CA) and a thermodilution cardiac output (CCO) as methods for measuring cardiac output under different pathologic and experimental conditions that induce changes in arterial waveform morphology. ⋯ Cardiac output measurement based on uncalibrated pulse contour analysis is able to reflect cardiac output measured with the continuous thermodilution method in patients undergoing uncomplicated coronary artery surgery. However, in situations in which the arterial pressure waveform is changed, agreement between techniques may be altered and data obtained with uncalibrated pulse contour analysis may become less reliable.