Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 1992
ReviewCon: whole blood transfusions are not useful in patients undergoing cardiac surgery.
Data supporting fresh whole blood transfusion or fresh component therapy are nonblinded, and although both are conceptually attractive, neither can be considered proven. Recent blinded studies reflect fresh blood ineffectiveness. ⋯ Proven methods of blood conservation as well as standardized criteria for transfusion of blood components will more effectively decrease homologous blood transfusion. Transfusion of fresh or banked whole blood, or its components, has yet to be shown to decrease the usage of homologous blood products.
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J. Cardiothorac. Vasc. Anesth. · Dec 1992
Isoflurane and hypothermic cardiopulmonary bypass: vasodilation without metabolic effects.
During cardiopulmonary bypass, isoflurane may have beneficial effects on systemic oxygen uptake and vascular resistance. For this reason, the effects of isoflurane during low-flow (1.6 L/min/m2), hypothermic (27 degrees to 29 degrees C) cardiopulmonary bypass on systemic hemodynamics and oxygen uptake were studied in 20 patients in a cross-over experiment. Mean arterial and central venous pressures were measured during two consecutive periods of 10 minutes' duration. ⋯ Isoflurane had no significant effect on systemic oxygen uptake. Significant inverse relationships between blood isoflurane concentration and both mean arterial pressure and systemic vascular resistance were found. It is concluded that isoflurane is a vasodilator under the abnormal conditions of hypothermic cardiopulmonary bypass, but has no effect on systemic oxygen uptake.