Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 1996
Relationship of regional wall motion abnormalities detected by biplane transesophageal echocardiography and electrocardiographic changes in patients undergoing coronary artery bypass graft surgery.
It has been demonstrated that new regional wall motion abnormalities (RWMAs) are infrequently associated with electrocardiographic (ECG) ischemic changes during coronary artery bypass graft (CABG) surgery. The evaluation of apical or basal areas by biplane transesophageal echocardiography (TEE) may clarify the relationship between RWMA and ECG changes. ⋯ Biplane TEE provides additional information about spatial distribution of new RWMAs. This study was the first to demonstrate that a clear relationship between TEE and ECG ischemia exists. When these new RWMAs exhibited a large spatial distribution, the frequency of ECG ischemic changes increased.
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Randomized Controlled Trial Comparative Study Clinical TrialContinuous infusion is superior to bolus doses with thoracic paravertebral blocks after thoracotomies.
This study was designed to determine whether a continuous thoracic paravertebral infusion of bupivacaine (continuous TPVI) offers a higher quality of analgesia than a bolus regimen after thoracotomy. ⋯ Results suggest that continuous TPVI provides better pain control than the bolus regimen after this kind of surgery.
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Randomized Controlled Trial Clinical TrialEffects of positive end-expiratory pressure ventilation on splanchnic oxygenation in humans.
To examine the influence of positive end-expiratory pressure (PEEP) ventilation on splanchnic oxygenation and lactate production in humans without pulmonary disorders. ⋯ Ventilation with PEEP causes reductions in CO and MAP, resulting in a comparable impairment of systemic and splanchnic oxygen. The absence of changes in lactate concentrations indicates that a critical reduction in systemic and splanchnic oxygenation is unlikely during ventilation with low or high PEEP levels.
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J. Cardiothorac. Vasc. Anesth. · Aug 1996
Positive end-expiratory pressure during one-lung ventilation improves oxygenation in patients with low arterial oxygen tensions.
The application of 10 cm H2O of positive end-expiratory pressure (PEEP10) to the ventilated lung during one-lung ventilation (OLV) has an unpredictable effect on PaO2. It was hypothesized that patients with a low PaO2 (< 80 mmHg) during OLV may benefit from application of PEEP. ⋯ In patients with a low PaO2 (< 80 mmHg) during OLV with F1O2 = 0.5, PaO2 is increased by the application of PEEP10. This maneuver may be useful in situations in which application of continuous positive airway pressure (CPAP) to the nonventilated lung is not possible.