Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2007
Comparative StudyBlood concentrations of enflurane before, during, and after hypothermic cardiopulmonary bypass.
The purpose of this study was to determine blood concentrations of enflurane delivered via a membrane oxygenator during hypothermic cardiopulmonary bypass (CPB) with changes in the input enflurane concentration and temperature and to characterize the pharmacokinetics of enflurane washout during and after CPB. ⋯ It is concluded that exposure to enflurane concentrations greater than 0.8% during CPB can result in high blood concentrations.
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J. Cardiothorac. Vasc. Anesth. · Apr 2007
Randomized Controlled TrialEffects of hemodilution on outcome after modified Blalock-Taussig shunt operation in children with cyanotic congenital heart disease.
Cyanotic congenital heart diseases (CCHD) with secondary polycythemia and hyperviscosity state are associated with a reduction in blood flow, stagnation of blood, and thrombosis. Sufficient hemodilution in cyanotic children results in higher blood flow and significant reductions in perioperative blood loss. The aim of this study was to investigate similar beneficial effects of hemodilution in preventing shunt thrombosis and decreasing postoperative blood loss after modified Blalock-Taussig (BT) shunt operations in children with CCHD. ⋯ Hemodilution in CCHD patients undergoing modified BT shunt surgery has beneficial effects including improved shunt patency because of higher blood flow through the graft and less postoperative blood loss, which may be attributed to the lower viscosity produced by hemodilution.
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J. Cardiothorac. Vasc. Anesth. · Apr 2007
Effects of escalating doses of sildenafil on hemodynamics and gas exchange in children with pulmonary hypertension and congenital cardiac defects.
Sildenafil (Viagra, Pfizer) is being increasingly used to treat pulmonary hypertension in children. However, there are limited data available to suggest dosage regimens. The purpose of this study was to determine the effects of escalating doses of sildenafil on hemodynamics and gas exchange in children with pulmonary hypertension because of congenital cardiac defects. ⋯ For the treatment of pulmonary hypertension in children with congenital cardiac defects, a 0.5 mg/kg dose of sildenafil every 4 hours is therapeutically as effective as a 2.0 mg/kg dose every 4 hours. However, a large dose-ranging and pharmacokinetic study of sildenafil in children with pulmonary hypertension because of congenital cardiac defects is needed to validate the safety and efficacy of the dose-range and dosing interval suggested by this study.