Scandinavian cardiovascular journal : SCJ
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Atrial fibrillation is the most common arrhythmia occurring after heart surgery. Its prevalence after coronary artery bypass surgery is 17-33%. ⋯ Beta-blockers have been shown to effectively prevent atrial fibrillation, and beta-blockers should be a part of the medication of every patient undergoing cardiac surgery, if there are no contraindications. Amiodarone therapy can also be considered for especially high-risk patients.
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Scand. Cardiovasc. J. · Apr 2007
Randomized Controlled TrialInsulin resistance after cardiopulmonary bypass in the elderly patient.
Preoperative carbohydrate administration attenuates insulin resistance. We studied effects of preoperative oral carbohydrate loading in elderly patients undergoing coronary artery bypass grafting. ⋯ The study group was insulin resistant on postoperative day one and two. The effects were explainable by the traumatic stress response. No adverse effect was noted from the carbohydrate drink. If glucose is administered intravenously during surgery, there is no obvious advantage of preoperative carbohydrate loading on insulin resistance or stress hormone response.
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Scand. Cardiovasc. J. · Dec 2006
Randomized Controlled TrialDoes preemptive stellate ganglion blockage increase the patency of radiocephalic arteriovenous fistula?
Radio-cephalic arteriovenous fistulas (AVFs) have high early failure ratio. Increased sympathetic activity and spasm of radial artery during the surgery may responsible for early occlusion rate. ⋯ AVF occlusion rate is much more common in early postoperative period. Diminished sympathetic tonus by preemptive SGB not only increases early patency rate but also increases fistula maturation rate.
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For subsequent studies on the molecular mechanisms of postconditioning, we aimed to identify a robust postconditioning protocol in rat and mouse heart. ⋯ Rat hearts are less suitable for studies of mechanisms of postconditioning. The results suggest that the signaling pathways differ between pre- and postconditioning. Mouse hearts were strongly protected by postconditioning, and genetically engineered mice may be useful for postconditioning research.
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Blood lactate levels during cardiopulmonary bypass are often used to verify adequacy of perfusion. The present investigation aimed to propose a threshold for hyperlactatemia. Blood lactate levels in 5 121 cardiac surgical patients were retrospectively analysed by a review of database records. ⋯ Complications were more frequent, especially: renal dysfunction, infections, respiratory and circulatory disorders. Hospital mortality was 13.3% compared to an overall level at 2.2%. The threshold for hyperlactatemia during cardiopulmonary bypass attained 2 mmol/l and predicted increased morbidity and mortality.