Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Oct 1995
Determinants of systolic pressure variation in patients ventilated after vascular surgery.
To discover the predominant determinant of systolic pressure variation during positive-pressure ventilation in mechanically ventilated patients after a vascular surgical procedure. ⋯ The decrease in systolic pressure provoked by positive-pressure inspiration reflects simultaneous decreases in stroke volume. This suggests that a decrease in left ventricular filling, associated with positive-pressure inspiration, is responsible for systolic pressure variation. This finding confirms the interest in considering systolic pressure variation to provide reliable information about the responsiveness of the heart to preload variations.
-
J. Cardiothorac. Vasc. Anesth. · Oct 1995
Randomized Controlled Trial Clinical TrialClosed mitral valvotomy and elective ventilation in the postoperative period: effect of mild hypercarbia on right ventricular function.
It is customary to extubate patients immediately after closed mitral valvotomy. These patients often have deranged respiratory function caused by chronic lung congestion. The left ventricular function may also be subnormal after valvotomy in some patients. Therefore, elective ventilation for some duration in the postoperative period can be beneficial to these patients. This work is an attempt to find whether elective ventilation should be preferred over immediate extubation in these patients. ⋯ Avoidance of even mild hypercarbia, therefore, appears advisable in the early postoperative period because of potential impedence to right ventricular ejection. Continuous monitoring of end-tidal CO2 and frequent blood gas analyses should be practiced, and elective ventilation should be considered in patients with long-standing disease and pulmonary hypertension.
-
J. Cardiothorac. Vasc. Anesth. · Oct 1995
Randomized Controlled Trial Clinical TrialLidocaine and the inhibition of postoperative pain in coronary artery bypass patients.
This study was designed to evaluate whether a continuous low-dose lidocaine infusion reduces postoperative pain and anxiety in patients undergoing coronary artery bypass grafting (CABG) and to retrospectively examine time to extubation, intensive care unit stay (ICU), and hospital length of stay. ⋯ Continuous infusion of low-dose lidocaine did not significantly decrease supplemental fentanyl, midazolam, or propranolol requirement postoperatively. Similarly, a lidocaine infusion does not result in reduced time to extubation. ICU stay, or hospital length of stay.