Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2000
Postcardiopulmonary bypass hypoxemia: a prospective study on incidence, risk factors, and clinical significance.
To evaluate the clinical significance of low arterial oxygen tension-inspired oxygen concentration (PaO2-FIO2) ratio, as a measure of hypoxemia, in the early period after cardiac surgery with cardiopulmonary bypass (CPB); and to evaluate the preoperative, intraoperative, and postoperative factors contributing to the development of hypoxemia within the first 24 hours after cardiac surgery with CPB. ⋯ This study shows that despite improvements in the technique of CPB, hypoxemia depicted by low PaO2-FIO2 ratios is common in patients after CPB. It is short lived, however, and has minimal effect on the postoperative clinical course of these patients.
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J. Cardiothorac. Vasc. Anesth. · Oct 2000
Parameters associated with perioperative baffle fenestration closure in the Fontan operation.
To identify clinical parameters indicating perioperative fenestration closure in children who underwent the fenestrated Fontan operation. ⋯ Factors that correlated with postoperative fenestration closure in the fenestrated Fontan operation in this study were a high transpulmonary pressure gradient and a high oxygen saturation 1 hour after arrival in the ICU, a low fibrinogen level, and the need for temporary atrial pacing.
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J. Cardiothorac. Vasc. Anesth. · Oct 2000
Randomized Controlled Trial Comparative Study Clinical TrialA prospective comparison of three heat preservation methods for patients undergoing hypothermic cardiopulmonary bypass.
To prospectively compare 3 methods of body heat preservation in patients undergoing surgery requiring the use of hypothermic cardiopulmonary bypass (CPB). ⋯ This study suggests that there is no statistically significant disparity in the effectiveness of these 3 intraoperative heat preservation methods. Ease of use and cost-effectiveness should guide the choice of warming method post-CPB.
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J. Cardiothorac. Vasc. Anesth. · Oct 2000
Randomized Controlled Trial Clinical TrialProtective ventilation attenuates postoperative pulmonary dysfunction in patients undergoing cardiopulmonary bypass.
To ascertain if protective ventilation can attenuate the damaging postoperative pulmonary effects of cardiopulmonary bypass (increases in airway pressure, decreases in lung compliance, and increases in shunt). ⋯ Data indicate that protective ventilation decreases pulmonary damage caused by mechanical ventilation in normal and abnormal lungs. The results of this investigation indicate that protective ventilation may also help attenuate the postoperative pulmonary dysfunction (increases in airway pressure, decreases in lung compliance, and increases in shunt) commonly seen in patients after exposure to cardiopulmonary bypass.
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J. Cardiothorac. Vasc. Anesth. · Oct 2000
Randomized Controlled Trial Clinical TrialHigh oxygen concentration exacerbates cardiopulmonary bypass-induced lung injury.
To investigate the effect of ventilation with 100% oxygen on lung injury associated with surgery involving cardiopulmonary bypass (CPB). ⋯ A significant decrease of oxygenation was observed in the early post-CPB period in both groups of patients, with delay in recovery in patients treated with 100% oxygen. A larger increase of the proinflammatory cytokines was found in patients treated with 100% oxygen. High oxygen concentrations during surgery with CPB should be used only when specifically required.