Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2000
ReviewMyocardial injury in cardiac surgery: the role of transfusion.
The approach to minimizing transfusion therapy in the cardiac surgical patient entails an understanding of the unique physiology of CPB. A comprehensive blood conservation program will promote autologous reinfusion techniques and pharmacologic agents that preserve hemostasis. ⋯ The use of technologies and drugs that attenuate inflammation will reduce consumption and the activation of leukocytes and platelets. This approach should be a multifaceted one that will ultimately lead to better preservation of end-organ function after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Jun 2000
Femoral artery pressures are more reliable than radial artery pressures on initiation of cardiopulmonary bypass.
To compare radial and femoral artery perfusion pressure during initiation and various stages of cardiopulmonary bypass (CPB). ⋯ Although radial artery pressures are more commonly monitored during cardiac surgery, femoral artery perfusion pressures are more reliable during the initial part of CPB, and routine monitoring of femoral artery pressures may prevent vasoconstrictor use on initiation of CPB.
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J. Cardiothorac. Vasc. Anesth. · Jun 2000
The use of the 5-HT3-receptor antagonist ondansetron for the treatment of postcardiotomy delirium.
To evaluate the effect of the 5-HT3-receptor antagonist ondansetron in patients with postcardiotomy delirium. ⋯ The use of ondansetron was effective and safe and without important side effects. This positive effect of the 5-HT3-receptor antagonist ondansetron led to speculation that impaired serotonin metabolism may play a role in postcardiotomy delirium.
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J. Cardiothorac. Vasc. Anesth. · Jun 2000
ReviewAnesthesia for left ventricular assist device placement.
Appropriate anesthesia for LVAD placement needs to incorporate an understanding of the surgical procedure and LVAD physiology, the altered physiology and pharmacology of the cardiac failure patient, and a knowledge of the interaction of anesthesia with the potent cardiac drugs used in end-stage heart failure therapy. The anesthesiologist is faced with a critically ill decompensated patient, often with altered renal and hepatic function, but must ensure adequate anesthesia to avoid intraoperative awareness. Intelligent use of TEE can assist the surgeon to pinpoint potential pitfalls of LVAD placement and can have a significant effect on improving outcome in these challenging patients.