Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 1998
Epidural anesthesia in cardiac surgery: is there an increased risk?
To assess the risk of hemorrhagic complications associated with epidural anesthesia in patients undergoing coronary artery bypass grafting. ⋯ By following certain guidelines, the risk for the development of epidural hematoma is not increased in patients undergoing epidural anesthesia during cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Apr 1998
Comparative StudyFlow resistances of disposable double-lumen, single-lumen, and Univent tubes.
To compare the airflow resistances of modern double-lumen, single-lumen, and Univent (Fuji Systems Corp; Tokyo, Japan) tubes. ⋯ Flow resistances of modern disposable double-lumen tubes are lower than commonly perceived. In most clinical situations, there will be no decrease in flow resistance when a Rusch or Sheridan double-lumen tube is replaced by a single-lumen tube.
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J. Cardiothorac. Vasc. Anesth. · Apr 1998
Airway compression in children due to congenital heart disease: value of flexible fiberoptic bronchoscopic assessment.
To evaluate the frequency and severity of airway compression due to congenital heart disease in children and validate the use of the fiberoptic bronchoscope to assess them. ⋯ Endoscopy in an awake patient is the only way to evaluate the functional component of a compression due to malacia; the resulting collapse of the airway can cause trapping of air and secretions. Furthermore, fiberoptic bronchoscopy offers a complete examination of the airways and can help detect airway abnormalities that are potential causes of complications. Fiberoptic bronchoscopy is a suitable and well-tolerated examination that is easy to perform at the bedside of the child. This technique optimizes the preoperative assessment of children with congenital heart disease.
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J. Cardiothorac. Vasc. Anesth. · Apr 1998
ReviewResolved: A pulmonary artery catheter should be used in the management of the critically ill patient. Pro.
Selected studies showing both positive and negative outcomes with the use of pulmonary artery catheters (PACs) are reviewed. Indications for use of a PAC are controversial, although clearly the "red cap syndrome" is an indication for its insertion. There are sufficient data as well as personal experience to suggest that PACs do make a difference in the management of critically ill patients. ⋯ Studies are reviewed that addressed physician level of expertise related to PAC insertion, complications, data and waveform interpretation, and management. User knowledge clearly is suboptimal. Before attempting to draw conclusions from outcome studies, criteria for appropriate use need to be developed and clinician knowledge needs to be significantly improved.
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J. Cardiothorac. Vasc. Anesth. · Apr 1998
Randomized Controlled Trial Comparative Study Clinical TrialPropofol-based versus fentanyl-isoflurane-based anesthesia for cardiac surgery.
To evaluate drug costs, time of mechanical ventilation, complications, and hospital length of stay comparing propofol-based with fentanyl-isoflurane-based anesthesia. ⋯ Fentanyl-isoflurane provides an inexpensive anesthetic that permits as prompt an extubation as propofol, thus conserving resources for other patients.