Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2004
High thoracic epidural anesthesia for off-pump coronary artery bypass surgery.
To assess the feasibility of high thoracic epidural anesthesia combined with sevoflurane for off-pump coronary artery bypass surgery and to evaluate the postoperative pain control, side effects, and perioperative hemodynamics. ⋯ Thoracic epidural as an adjunct to general anesthesia is a feasible technique in off-pump coronary artery bypass surgery. It induces intense postoperative analgesia and does not compromise central hemodynamics.
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J. Cardiothorac. Vasc. Anesth. · Jun 2004
Central venous catheter-related blood stream infections: incidence, risk factors, outcome, and associated pathogens.
To determine the incidence, risk factors, outcome, and pathogens of central venous catheter-related bloodstream infections (CVC-BSIs). ⋯ By univariate analysis, the risk factors for CVC-BSI were use of multilumen catheters, duration of catheterization, total ventilation hours, IABC, emergency surgery, APACHE II score, coexistent infections, and steroids. On multivariate analysis, duration of catheterization, IABC, coexistent infections, and temperature were independent predictors of CVC-BSI. The mortality was increased with CVC-BSI.
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J. Cardiothorac. Vasc. Anesth. · Jun 2004
Cerebral ischemia caused by obstructed superior vena cava cannula is detected by near-infrared spectroscopy.
Bicaval venous cannulation is being used with increasing frequency in neonates and infants to avoid circulatory arrest. However, superior vena cava (SVC) cannula obstruction may result in cerebral ischemia with no change in blood pressure or mixed venous O2 saturation. The authors hypothesized that near-infrared spectroscopy (NIRS) would allow noninvasive detection of SVC cannula obstruction. ⋯ SVC cannula obstruction causes cerebral ischemia with no change in blood pressure or venous oxygen saturation. In view of the difficulties and risks of CVP monitoring in babies, it is recommended to use other monitoring modalities such as NIRS to assess adequacy of cerebral perfusion if bicaval cannulation is used in neonates and infants.