Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2009
Review Meta AnalysisThe role of natriuretic peptide administration in cardiovascular surgery-associated renal dysfunction: a systematic review and meta-analysis of randomized controlled trials.
Randomized controlled trials involving natriuretic peptide administration in the perioperative cardiovascular setting have shown inconsistent effects for renal and other clinical endpoints. The authors aimed to systematically review these trials to ascertain the role of natriuretic peptide administration in the management of cardiovascular surgery-associated renal dysfunction. ⋯ Current literature analyzing studies evaluating the administration of natriuretic peptides in cardiovascular surgery may be associated with significant improvements in clinical outcomes. Given the limitations of meta-analysis, these observations need to be confirmed in a larger, adequately powered, prospective multicenter study.
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J. Cardiothorac. Vasc. Anesth. · Feb 2009
Meta Analysis Comparative StudyRecombinant activated factor VII in cardiac surgery: a meta-analysis.
Perioperative microvascular bleeding is associated with increased morbidity and mortality and could be reduced by hemostatic drugs such as recombinant activated factor VII (rFVIIa). Few trials have investigated rFVIIa and each individually lacked power to detect a beneficial effect on transfusion of blood products or thromboembolic side effects. ⋯ This analysis suggests that the hemostatic properties of rFVIIa could reduce the rate of surgical reexploration after cardiac surgery even if an increase of hazardous side effects (eg, perioperative stroke) could not be excluded. Because meta-analyses are hypothesis generating, this issue should be investigated further in large randomized controlled trials.
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J. Cardiothorac. Vasc. Anesth. · Feb 2008
Review Meta AnalysisFenoldopam reduces the need for renal replacement therapy and in-hospital death in cardiovascular surgery: a meta-analysis.
Acute renal failure is a common and threatening complication in patients undergoing cardiovascular surgery. To determine the efficacy of fenoldopam in the prevention of acute renal failure, the authors performed a systematic review of randomized, controlled trials and propensity-matched studies in patients undergoing cardiovascular surgery. ⋯ This meta-analysis provides evidence that fenoldopam may confer significant benefits in preventing renal replacement therapy and reducing mortality in patients undergoing cardiovascular surgery.
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J. Cardiothorac. Vasc. Anesth. · Aug 2007
Review Meta AnalysisDesflurane and sevoflurane in cardiac surgery: a meta-analysis of randomized clinical trials.
The authors performed a meta-analysis to investigate whether the cardioprotective effects of volatile anesthetics translate into decreased morbidity and mortality in patients undergoing cardiac surgery. ⋯ Desflurane and sevoflurane have cardioprotective effects that result in decreased morbidity and mortality. The present data show for the first time that the choice of an anesthetic regimen based on administration of halogenated anesthetics is associated with a better outcome after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 2007
Meta Analysis Comparative StudyRegional or general anesthesia for carotid endarterectomy? Evidence from published prospective and retrospective studies.
The aim of this study was to compare outcomes of patients undergoing carotid endarterectomy under regional or general anesthesia for any new neurologic impairment, stroke, stroke and/or death, death, and myocardial infarction. ⋯ The number of patients included in randomized controlled trials or even in prospective studies is too low to allow any conclusions on the differences in outcome between the 2 anesthetic techniques. Better outcomes are suggested when results from retrospective studies are added.