Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2001
Dynamic changes in blood solubility of desflurane, isoflurane, and halothane during cardiac surgery.
To determine an estimate of blood/gas partition coefficients of volatile anesthetics during cardiac surgery. ⋯ Dynamic changes in blood/gas partition coefficients of volatile anesthetics were found during cardiac surgery. They could be estimated by using multiple linear regression equations reflecting the combined effects of hypothermia and hemodilution.
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J. Cardiothorac. Vasc. Anesth. · Oct 2001
Subjective assessment of left ventricular preload using transesophageal echocardiography: corresponding pulmonary artery occlusion pressures.
To record pulmonary artery occlusion pressures (PAOPs) in patients whose left ventricular preload reserve was subjectively determined using transesophageal echocardiography (TEE). ⋯ In patients with well-preserved left ventricular function and normal wall thickness, preload reserve volumes subjectively determined by TEE corresponded to a range of filling pressures historically targeted to maximize cardiac performance (13 to 19 mmHg). In a subset of patients with increased wall thickness, however, subjective determination of preload reserve was associated with filling pressures that were higher than traditionally considered optimal (20 to 25 mmHg). Similarities in left ventricular fractional area change and end-diastolic area between these 2 groups suggest that patients with elevated filling pressures had decreased ventricular compliance and were managed correctly with higher than usual PAOPs.
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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
Endotoxin-neutralizing capacity of serum from cardiac surgical patients.
To determine if endotoxin core antibody (EndoCAb) from the serum of cardiac surgical patients neutralizes endotoxin in an ex vivo biologic assay. ⋯ Anti-EndoCAbs of both classes (IgM and IgG) were able to neutralize lipopolysaccharide from a clinically relevant bacterium in an ex vivo model. Neither Igm nor IgG appeared to be more capable of neutralization in this model. These antibodies did not completely predict neutralization capacity; other endogenous factors in human serum must be capable of lipopolysaccharide neutralization.