Seminars in cardiothoracic and vascular anesthesia
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Semin Cardiothorac Vasc Anesth · Dec 2010
ReviewCardiac output monitoring: is there a gold standard and how do the newer technologies compare?
As a principal determinant of oxygen delivery and of blood pressure, cardiac output (CO) represents an important hemodynamic variable. Its accurate measurement, therefore, is important to the clinician caring for critically ill patients in a variety of care environments. ⋯ The last decade has seen the introduction of several such devices into the clinical arena. This article will serve to give a brief review of the history of CO measurement, to provide a discussion of the measurement of accuracy as it relates to CO measurement, and to discuss some of the newer methods and devices for CO measurement and how they have fared against a "practical" gold standard.
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Semin Cardiothorac Vasc Anesth · Dec 2010
The efficacy of post-cardiopulmonary bypass dosing of vancomycin in cardiac surgery.
Objective. Vancomycin is administered widely to patients undergoing cardiac surgery as prophylaxis against resistant Gram-positive sternal wound and venous donor site infections. The purpose of this study was to determine the efficacy of a standardized prebypass and postbypass dosing regimen of vancomycin by assessing plasma concentrations in the immediate postoperative period and postoperative surgical site infections (SSIs). ⋯ Conclusion. Vancomycin concentrations in the serum were greater than the minimum inhibitory concentration for most staphylococci ranging from 4 to 19.3 µg/mL producing acceptable therapeutic serum concentrations and low rate of infectious complications. Thus postbypass dosing is acceptable in vancomycin cardiac surgical prophylaxis.