Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2002
Assessment of cardiac output, intravascular volume status, and extravascular lung water by transpulmonary indicator dilution in critically ill neonates and infants.
To assess cardiac output, intrathoracic blood volume, global end-diastolic volume, and extravascular lung water in critically ill neonates and small infants using transpulmonary indicator dilution. ⋯ Transpulmonary indicator dilution enables measurement of cardiac output and intravascular volume status in critically ill neonates and infants at the bedside. The effects of volume loading on cardiac preload and effective change in stroke volume can be monitored by this technique, whereas central venous pressure was not indicative of changes in intravascular volume status.
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J. Cardiothorac. Vasc. Anesth. · Aug 2002
Comparative Study Clinical Trial Controlled Clinical TrialThe use of a bronchial blocker compared with a double-lumen tube for single-lung ventilation during minimally invasive direct coronary artery bypass surgery.
To investigate whether a bronchial blocker (BB) placed through a routinely used single-lumen tube (SLT) to achieve 1-lung ventilation is appropriate in patients undergoing a minimally invasive direct coronary artery bypass (MIDCAB) operation. ⋯ To achieve 1-lung ventilation during a MIDCAB procedure, the use of a BB combined with an SLT is an appropriate technique as an alternative to the commonly used DLT.
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J. Cardiothorac. Vasc. Anesth. · Aug 2002
Randomized Controlled Trial Comparative Study Clinical TrialCoronary revascularization: a procedure in transition from on-pump to off-pump? The role of glucose-insulin-potassium revisited in a randomized, placebo-controlled study.
To investigate an optimized glucose-insulin-potassium (GIK) solution regimen as an alternate myocardial protective strategy in off-pump coronary artery bypass graft (OP-CAB) surgery and as a supplement to conventional coronary artery bypass graft (CABG) surgery using cardiopulmonary bypass (CPB). ⋯ GIK solution therapy achieved NEFA suppression and an insignificant trend toward reduced biochemical parameters of ischemic injury in OP-CAB surgery and CPB groups, but no major clinical benefit (perioperative myocardial infarction, intensive care unit length of stay, or hospital length of stay) was shown after elective CABG surgery in low-risk patients. Compared with CPB, OP-CAB surgery significantly reduced ischemic injury and postoperative infections.
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J. Cardiothorac. Vasc. Anesth. · Aug 2002
Comparative StudyPatients' conscious recollections from cardiac anesthesia.
To estimate the current incidence of conscious recollections from the time of anesthesia, the contribution of anesthetic drugs to this incidence, and the patients' experience of cardiac anesthesia and surgery. ⋯ The incidence of awareness and recall is similar to the incidence reported during general surgery. Cardiac surgery does not carry increased risk of awareness. Benzodiazepines given during anesthesia are effective in decreasing the incidence of recalled awareness, and the experience of awareness is not often particularly traumatizing. Premedication with benzodiazepine is not effective in preventing recollection of anesthesia, however.
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J. Cardiothorac. Vasc. Anesth. · Aug 2002
Randomized Controlled Trial Comparative Study Clinical TrialA prospective, randomized comparison of thromboelastographic coagulation profile in patients receiving lactated Ringer's solution, 6% hetastarch in a balanced-saline vehicle, or 6% hetastarch in saline during major surgery.
To compare the effects of lactated Ringer's solution (LR), 6% hetastarch in a balanced-saline vehicle (HS-BS), and 6% hetastarch in normal saline (HS-NS) on coagulation using thromboelastography. ⋯ LR-treated patients exhibited a hypercoagulative profile that persisted into the postoperative period. HS-BS administration was associated with a lesser change in the coagulation profile compared with HS-NS, which was associated with a hypocoagulative state.