Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 1998
Comparative StudyThe clinical relevance of hemoglobin, platelet, and serotonin changes in sequestered and circulating blood during cardiopulmonary bypass.
To determine how hemoglobin (Hb), platelet, and serotonin concentrations change during cardiopulmonary bypass (CPB) in sequestered blood from the pulmonary artery compared with circulating systemic blood; and to determine the correlation between platelet and serotonin variability at the two sites and clinical outcome measurements related to hemodynamics and blood loss. ⋯ During CPB, there were significant differences in Hb, platelet, and serotonin concentrations in sequestered pulmonary artery blood compared with circulating systemic blood. The initial differences and subsequent changes were most likely attributable to decreased hemodilution and a different pattern of platelet activation in the pulmonary artery blood compared with the systemic blood. Despite the hematologic differences, serotonin concentration and platelet counts in the pulmonary artery blood had significant correlation to indices of cardiac function and postoperative chest tube drainage, respectively. Platelet and serotonin changes in sequestered pulmonary artery blood were also associated with some of the adverse consequences of CPB.
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J. Cardiothorac. Vasc. Anesth. · Aug 1998
Comparative StudyThe relationship between extracorporeal circuit prime, albumin, and postoperative weight gain in children.
This study evaluated postoperative weight gain in children who received albumin versus crystalloid prime for cardiopulmonary bypass (CPB). ⋯ Data suggest that adding albumin to the EC circuit prime and minimizing the prime volume will result in less postoperative weight gain. Further prospective study with a larger sample is warranted to determine whether albumin prime offers other clinical benefits.
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J. Cardiothorac. Vasc. Anesth. · Aug 1998
Comparative StudyMinimally invasive direct coronary artery bypass: anesthetic, monitoring, and pain control considerations.
Minimally invasive direct coronary artery bypass (MIDCAB) provides many anesthetic challenges including monitoring, managing myocardial ischemia, and pain control. The objective was to evaluate the monitoring requirements and the potential benefits of preischemic conditioning and intrathecal morphine sulfate in MIDCAB patients. ⋯ MIDCAB may reduce hospital LOS for patients with single vessel coronary artery lesions when compared with median sternotomy with a LIMA-LAD graft performed on cardiopulmonary bypass. Pharmacologic heart rate control during the LIMA-LAD anastomosis is not critical with the use of a surgical retractor which diminishes ventricular motion. A single 5-minute test LAD occlusion did not protect against subsequent regional ischemic dysfunction in our subset of patients with normal baseline function.