Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2001
Comparative StudyAssessment of intrathoracic blood volume as an indicator of cardiac preload: single transpulmonary thermodilution technique versus assessment of pressure preload parameters derived from a pulmonary artery catheter.
To analyze the clinical value of a new device (PiCCO) for cardiac output measurement and volume preload parameter assessment, based on transpulmonary thermodilution technique, as an alternative to the pulmonary artery thermodilution technique and assessment of pressure preload parameters derived from the pulmonary artery catheter. ⋯ These results suggest that increased cardiac preload is more reliably reflected by ITBV than by CVP or PCWP. The assessment of ITBV by the transpulmonary single indicator dilution technique is an interesting alternative to the pressure preload parameters.
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J. Cardiothorac. Vasc. Anesth. · Aug 2001
Randomized Controlled Trial Clinical TrialDoes isoflurane optimize myocardial protection during cardiopulmonary bypass?
To investigate the possible myocardial protective effect of isoflurane during aortic cross-clamp and cardioplegic cardiac arrest in patients undergoing conventional coronary artery bypass graft surgery. ⋯ The present report suggests that administration of isoflurane before aortic cross-clamping in patients undergoing coronary artery bypass graft surgery may optimize the myocardial protective effect of cardioplegia. Isoflurane may be particularly advantageous whenever prolonged periods of aortic cross-clamping or inadequate delivery of cardioplegia is expected.
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J. Cardiothorac. Vasc. Anesth. · Aug 2001
Randomized Controlled Trial Comparative Study Clinical TrialTarget-controlled infusion or manually controlled infusion of propofol in high-risk patients with severely reduced left ventricular function.
To compare hemodynamics, time to extubation, and costs of target-controlled infusion (TCI) with manually controlled infusion (MCI) of propofol in high-risk cardiac surgery patients. ⋯ In patients with severely reduced left ventricular function, TCI and MCI of propofol in combination with remifentanil showed similar hemodynamics. TCI patients needed inotropic support more often than MCI-treated patients. Although extubation time was longer in TCI patients and costs were higher, both anesthesia techniques can be recommended for early extubation after implantation of a cardioverter-defibrillator.
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J. Cardiothorac. Vasc. Anesth. · Aug 2001
Randomized Controlled Trial Clinical TrialEffect of C1-esterase-inhibitor on capillary leak and inflammatory response syndrome during arterial switch operations in neonates.
To determine if prophylactic administration of C1-esterase-inhibitor would have a beneficial effect on postoperative weight gain and the inflammatory response in neonates undergoing cardiac surgery with cardiopulmonary bypass (CPB). ⋯ Prophylactic application of C1-esterase-inhibitor in neonates undergoing arterial switch operations produces less inflammatory response compared with placebo. This difference may have contributed to improved clinical parameters, including less weight gain postoperatively.