Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2001
Pharmacokinetics of sufentanil in patients undergoing coronary artery bypass graft surgery.
To determine the pharmacokinetics of sufentanil in patients undergoing coronary artery bypass graft surgery. ⋯ The authors have determined a pharmacokinetic model for sufentanil that can be used to maintain desired target concentrations of sufentanil before cardiopulmonary bypass, with a high degree of accuracy and acceptable variability. Concomitantly administered medications (lorazepam, morphine-scopolamine, clonidine, or propofol) do not appear to have any clinically important effects on distribution-phase sufentanil pharmacokinetics.
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J. Cardiothorac. Vasc. Anesth. · Dec 2001
Anaphylactic or anaphylactoid reactions in patients undergoing cardiac surgery.
To examine the clinical features, treatment, and outcome of anaphylactic and anaphylactoid reactions during cardiac surgery. ⋯ Of the anaphylactic and anaphylactoid reactions, 60% occurred before cardiopulmonary bypass, and these were caused by antibiotics and gelatin solution. The results from this limited database showed that cardiac surgery proceeded without complications after cardiovascular collapse caused by anaphylactic or anaphylactoid reactions. Rapid institution of cardiopulmonary bypass may be life-saving and should be considered.
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J. Cardiothorac. Vasc. Anesth. · Dec 2001
Intra-aortic balloon counterpulsation: outcome in cardiac surgical patients.
To identify the major determinants of survival and nonsurvival for patients in need of intra-aortic balloon pump (IABP) support after cardiac surgery and to define the role of ventilator-associated pneumonia. ⋯ These data suggest that for patients not weaned from the IABP, the major determinants of death are low cardiac output (33.3%) and multiorgan failure (47.6%). Patients with a left ventricular ejection fraction of <30% have a poorer outcome. In patients weaned from the IABP, ventilator-associated pneumonia (66.6%) was the major cause of death.
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J. Cardiothorac. Vasc. Anesth. · Oct 2001
Randomized Controlled Trial Comparative Study Clinical TrialNormothermic versus hypothermic cardiopulmonary bypass during repair of congenital heart disease.
To compare normothermic cardiopulmonary bypass (CPB) versus hypothermic CPB in pediatric patients undergoing repair of congenital heart disease with focus on biochemical markers for brain damage. ⋯ No difference was found in the release of brain-specific proteins between normothermic and hypothermic CPB, but blood loss was higher after normothermic CPB.
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J. Cardiothorac. Vasc. Anesth. · Oct 2001
Randomized Controlled Trial Clinical TrialThe effects of aprotinin and steroids on generation of cytokines during coronary artery surgery.
To compare the efficacy of aprotinin and methylprednisolone in reducing cardiopulmonary bypass (CPB)-induced cytokine release, to evaluate the effect of myocardial cytokine release on systemic cytokine levels, and to determine the influence of cytokine release on perioperative and postoperative hemodynamics. ⋯ This study showed that methylprednisolone suppresses TNF-alpha, IL-6, and IL-8 release; however, aprotinin attenuates IL-8 release alone. Methylprednisolone does not produce any additional positive hemodynamic and pulmonary effects. An improved postoperative AaDO2 was observed with the use of aprotinin.