Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2010
Review Meta AnalysisReducing mortality in cardiac surgery with levosimendan: a meta-analysis of randomized controlled trials.
The authors performed a meta-analysis to evaluate whether levosimendan is associated with improved survival in patients undergoing cardiac surgery. ⋯ Levosimendan has cardioprotective effects that could result in a reduced postoperative mortality. A large randomized controlled study is warranted in this setting.
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J. Cardiothorac. Vasc. Anesth. · Dec 2009
Meta AnalysisSpinal analgesia in cardiac surgery: a meta-analysis of randomized controlled trials.
Controversial results exist on the effects of spinal analgesia in cardiac surgery. The authors conducted a review of randomized studies to show whether there are any advantages in clinically relevant outcomes using spinal analgesia in patients undergoing cardiac surgery. ⋯ This analysis indicated that spinal analgesia does not improve clinically relevant outcomes in patients undergoing cardiac surgery, discouraging further randomized controlled trials on this topic even if changes in techniques, devices, and drugs could modify the outlook of the comparison between spinal and standard anesthesia in this setting.
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J. Cardiothorac. Vasc. Anesth. · Oct 2009
Meta Analysis Comparative StudyEsmolol reduces perioperative ischemia in cardiac surgery: a meta-analysis of randomized controlled studies.
beta-Blockers were associated with a reduction of mortality and morbidity in noncardiac surgery until recently when the POISE trial showed that beta-blockers could be harmful in the perioperative period because of hypotension and bradycardia. Esmolol is an ultra-short-acting beta-blocker mostly used in emergency and high-risk patients. The authors performed a meta-analysis to evaluate the clinical effects of esmolol in cardiac surgery. ⋯ Esmolol reduces the incidence of myocardial ischemia and arrhythmias in cardiac surgery. An increase in bradycardia was noted as well.
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J. Cardiothorac. Vasc. Anesth. · Aug 2009
Review Meta AnalysisLevosimendan reduces cardiac troponin release after cardiac surgery: a meta-analysis of randomized controlled studies.
The authors performed a meta-analysis to investigate the effects of levosimendan in cardiac surgery. Inotropic drugs have never shown beneficial effects on outcome in randomized controlled studies, with the possible exception of levosimendan. ⋯ Levosimendan has cardioprotective effects, resulting in reduced postoperative cardiac troponin release.