Annals of cardiac anaesthesia
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Randomized Controlled Trial
Impact of monitoring cerebral oxygen saturation on the outcome of patients undergoing open heart surgery.
We studied the usefulness of regional cerebral oxygen saturation (rSO 2 ) monitoring during cardiopulmonary bypass (CPB) and evaluated effects of cerebral oxygen desaturation on the postoperative neurological outcome. ⋯ Monitoring of rSO 2 during CPB can significantly decrease the incidence of postoperative neurocognitive decline.
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Letter Case Reports
Activated clotting time tube malfunction: a rare cause of heparin overdose.
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Cardiac surgery exerts a significant strain on the blood bank services and is a model example in which a multi-modal blood-conservation strategy is recommended. Significant bleeding during cardiac surgery, enough to cause re-exploration and/or blood transfusion, increases morbidity and mortality. Hyper-fibrinolysis is one of the important contributors to increased bleeding. ⋯ TA has been shown to increase seizure activity, whereas, EACA seems to have the least side effects. Apparently, these agents do not differentiate between pathological and physiological fibrinolysis and prevent all forms of fibrinolysis leading to possible thrombotic side effects. It would seem prudent to select the right agent knowing its risk-benefit profile for a given patient, under the given circumstances.
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Randomized Controlled Trial
Effect of levosimendan on hemodynamic changes in patients undergoing off-pump coronary artery bypass grafting: a randomized controlled study.
We tested the hypothesis that use of levosimendan would be associated with better perioperative hemodynamics and cardiac function during off-pump coronary artery bypass grafting (OPCAB) in patients with good left ventricular function. ⋯ Levosimendan significantly increased CI and decreased SVRI after OPCAB but it did not show any outcome benefit in terms of duration of ventilation and intensive care unit stay.
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Randomized Controlled Trial
The efficacy of caudal dexmedetomidine on stress response and postoperative pain in pediatric cardiac surgery.
We studied efficacy of caudal dexmedetomidine (DEX) on attenuation of perioperative stress response and postoperative pain in pediatric patients undergoing cardiac surgery. ⋯ Caudal DEX attenuated stress response to surgical trauma and provided better postoperative analgesia.