The Annals of thoracic surgery
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Na+/H+ exchange represents an important mechanism for pH regulation in the cardiac cell that, however, may paradoxically mediate tissue damage in the reperfused myocardium. We investigated whether inhibition of the exchanger can protect the heart against damage after prolonged hypothermic storage with the use of the selective inhibitor 3-methylsulfonyl-4-piperidinobenzoyl-guanidine methanesulfonate (HOE 694). ⋯ This study shows a marked protective effect of the Na+/H+ exchange inhibitor HOE 694 in rabbit hearts subjected to 12 hours of hypothermic ischemia and strongly suggests that antiport inhibitors could play an effective role in myocardial preservation.
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Penetrating thoracic trauma in the pediatric population is increasing at an alarming rate. We sought to describe this population and to define prognostic factors that might be of benefit in the management of these patients. ⋯ Injury severity score and corrected admission pH are independent predictors of mortality and need for operation in the pediatric population with penetrating chest injuries. Penetrating thoracic wounds demand special attention by the trauma team. The use of autotransfusion may be beneficial in pediatric trauma victims.
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Comparative Study
Preoperative two- and three-dimensional transesophageal echocardiographic assessment of heart tumors.
Two-dimensional transesophageal echocardiography is the most widely used diagnostic approach in the rare entity of heart tumors. The aim of this study was to assess the diagnostic usefulness of three-dimensional echocardiography in comparison with the two-dimensional technique in a rare clinical setting. ⋯ Three-dimensional transesophageal echocardiography yields important additional clinical information and improves the operative planning. Three-dimensional echocardiography may become the best approach to study the anatomy and pathology of the heart as it provides an objective display of cardiac size and shape in heart tumors.
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Randomized Controlled Trial Comparative Study Clinical Trial
Tranexamic acid reduces postbypass blood use: a double-blinded, prospective, randomized study of 210 patients.
Pharmacologic intervention to minimize postbypass bleeding and blood product transfusions has received increasing attention for both medical and economic reasons. ⋯ Tranexamic acid is safe and effective in reducing blood loss and blood use in a wide variety of cardiac surgical patients.