European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Sep 2012
Comparative StudyIschaemic postconditioning: does cardioplegia influence protection?
Ischaemic postconditioning attenuates reperfusion injury and may be a useful adjunct to cardiac surgery. We examined the efficacy of postconditioning following ischaemic protection with cardioplegic arrest and the importance of index ischaemia and cardioplegia formulation. ⋯ We conclude that postconditioning does not enhance the protective effect of St Thomas' Hospital cardioplegia (under these strict experimental conditions); however, the efficacy of postconditioning correlates with the magnesium concentration of the cardioplegic solution, which may imply involvement of magnesium on mitochondria during ischaemia. There is a limited window of postconditioning protection dependent on the duration of the index ischaemia.
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Eur J Cardiothorac Surg · Aug 2012
Multicenter StudyAntegrade selective cerebral perfusion and moderate hypothermia in aortic arch surgery: clinical outcomes in elderly patients.
To evaluate the outcome in elderly patients (≥ 75 years) undergoing elective aortic arch surgery with the aid of selective antegrade cerebral perfusion (SACP) and moderate hypothermic circulatory arrest (HCA). ⋯ Summarizing, elective aortic arch surgery in elderly patients using SACP and moderate HCA provides excellent results regarding mortality and postoperative neurological outcome. Prolonged HCA time and femoral cannulation were the only predictors of serious adverse events (mortality, neurological injury).
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Eur J Cardiothorac Surg · Aug 2012
Comparative StudyInfluence of cardiopulmonary bypass on cefuroxime plasma concentration and pharmacokinetics in patients undergoing coronary surgery.
The aims of this study were to evaluate the influence of cardiopulmonary bypass (CPB) on the plasma concentrations and pharmacokinetics of cefuroxime and to assess whether the cefuroxime dose regimen (a 1.5 g dose, followed by 750 mg every 6 h for 24 h) is adequate for cardiac surgery antibiotic prophylaxis. ⋯ CPB does not influence cefuroxime plasma concentrations. The dosing regimen is adequate for the intraoperative period, but in the immediate postoperative period, it requires further review.