Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2003
Randomized Controlled Trial Comparative Study Clinical TrialWhich anesthetic agent alters the hemodynamic status during pediatric catheterization? Comparison of propofol versus ketamine.
To compare the effects of propofol and ketamine on systemic and pulmonary circulations in pediatric patients scheduled for elective cardiac catheterization. ⋯ In children with cardiac shunting, the principal hemodynamic effect of propofol is a decrease in systemic vascular resistance. In children with intracardiac shunting, this results in an increase in right-to-left shunting and a decrease in the ratio of pulmonary to systemic blood flow, which may lead to arterial desaturation. Ketamine did not produce these changes. The authors suggested that during cardiac catheterization in children, both the anesthesiologists and cardiologists need to know that anesthetic agents can significantly alter the hemodynamic status in children with complex congenital heart defects and affect the results of hemodynamic calculations that are important for decision-making and treatment of these patients.
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J. Cardiothorac. Vasc. Anesth. · Dec 2003
Randomized Controlled Trial Clinical TrialThe value of preoperative pharmacologic stress testing before vascular surgery using ACC/AHA guidelines: a prospective, randomized trial.
To evaluate the validity of preoperative cardiac stress testing using clinical predictors from the American College of Cardiology/American Heart Association Guidelines on Perioperative Evaluation before Noncardiac Surgery in patients undergoing vascular surgery. ⋯ In this small prospective, randomized study evaluating the validity of preoperative cardiac stress testing using ACC/AHA Guidelines before major vascular surgery, preoperative cardiac stress testing offered no incremental value for determining postoperative adverse cardiac outcomes. Larger randomized clinical trials are needed to confirm these findings.
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J. Cardiothorac. Vasc. Anesth. · Dec 2003
Randomized Controlled Trial Clinical TrialPyruvate-enhanced cardioprotection during surgery with cardiopulmonary bypass.
To determine whether pyruvate-fortified cardioplegia solution provides cardioprotection superior to lactate-based cardioplegia solutions in patients undergoing elective coronary revascularization, with specific attention to post-surgical recovery of left ventricular performance as well as biochemical markers of ischemic injury. ⋯ Pyruvate-fortified cardioplegia mitigated myocardial injury during coronary artery bypass surgery and facilitated postsurgical recovery of cardiac performance. Thus, pyruvate-enhanced cardioplegia may provide cardioprotection superior to lactate-based solutions during surgical cardiac arrest.
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J. Cardiothorac. Vasc. Anesth. · Dec 2003
Clinical TrialPropofol-ketamine mixture for anesthesia in pediatric patients undergoing cardiac catheterization.
To evaluate the safety of a propofol-ketamine mixture to induce and maintain anesthesia in spontaneously breathing pediatric patents during cardiac catheterization. ⋯ The propofol-ketamine mixture is a safe, practical alternative for general anesthesia in pediatric patients undergoing cardiac catheterization.