Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 1997
Randomized Controlled Trial Clinical TrialModel-driven closed-loop feedback infusion of atracurium and vecuronium during hypothermic cardiopulmonary bypass.
This study was designed to investigate the performance of a computer-controlled infusion of atracurium and vecuronium during cardiac surgery requiring hypothermic cardiopulmonary bypass. ⋯ The computer-controlled infusion can be used for the administration of atracurium and vecuronium during CPB.
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J. Cardiothorac. Vasc. Anesth. · Feb 1997
Comparative StudyHeparin detection by the activated coagulation time: a comparison of the sensitivity of coagulation tests and heparin assays.
Laboratory and point-of-care coagulation tests are frequently obtained to determine the presence of heparin after surgical procedures. The objective of this study was (1) to compare the sensitivity of the activated coagulation time (ACT), activated partial thromboplastin time (aPTT), protamine titration (Hepcon; HMS Medtronic, Hemotec, Englewood, CO), and thromboelastography (TEG) with heparin anticoagulation and (2) to determine how frequently residual heparin is present in the 24-hour period after heparin neutralization in cardiopulmonary bypass (CPB) patients. ⋯ ACT was less sensitive to residual heparin anticoagulation than aPTT, TEG, and whole blood heparin assay. The whole blood heparin assay (Hepcon) provided sensitive and specific data about the presence of residual heparin. Despite the limitation of ACT in detecting heparin, the investigators found that residual heparin was not common in the period after uncomplicated CPB.
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J. Cardiothorac. Vasc. Anesth. · Feb 1997
Randomized Controlled Trial Clinical TrialMethylprednisolone and full-dose aprotinin reduce reperfusion injury after cardiopulmonary bypass.
To compare the effects of low- and full-dose aprotinin to methylprednisolone (MPS) in reducing cardiopulmonary bypass (CPB)-induced interleukin-6 (IL-6) release. ⋯ These results demonstrate that MPS, 1 g before CPB, and full-dose aprotinin, but not half-dose aprotinin, achieve significant reduction in IL-6 release after CPB. These results further suggest that MPS and full-dose aprotinin may reduce reperfusion injury after CPB.
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J. Cardiothorac. Vasc. Anesth. · Feb 1997
Comparative StudyIsovolemic hemodilution with a bovine hemoglobin-based oxygen carrier: effects on hemodynamics and oxygen transport in comparison with a nonoxygen-carrying volume substitute.
Stroma-free hemoglobin solutions have been shown to maintain oxygen transport in the absence of red blood cells. This study was designed to investigate the impact of such solutions on hemodynamics and oxygen transport during progressive isovolemic hemodilution within and even beyond a clinically relevant range of hematocrit values. ⋯ Isovolemic hemodilution with bHBOC did not improve systemic oxygen delivery in comparison with a nonoxygen-carrying diluent (HES) in a range of Hct values down to 0.10. Unchanged mixed venous lactate levels and stable oxygen consumption indicate sufficiently maintained oxygen delivery. This might become advantageous in patients who are unable to adequately increase cardiac output during hemodilution.
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J. Cardiothorac. Vasc. Anesth. · Dec 1996
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of the effects of propofol-alfentanil versus isoflurane anesthesia on arterial oxygenation during one-lung ventilation.
To determine whether intravenous propofol-alfentanil anesthesia provides superior arterial oxygenation (Pao2) during one-lung ventilation (OLV) compared with isoflurane inhalation anesthesia. ⋯ This study does not support the theory that total intravenous anesthesia will decrease the risk of hypoxemia during OLV.