Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2003
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialICU sedation after coronary artery bypass graft surgery: dexmedetomidine-based versus propofol-based sedation regimens.
To compare dexmedetomidine-based to propofol-based sedation after coronary artery bypass graft (CABG) surgery in the intensive care unit (ICU). ⋯ Dexmedetomidine provided safe and effective sedation for post-CABG surgical patients and significantly reduced the use of analgesics, beta-blockers, antiemetics, epinephrine, and diuretics.
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J. Cardiothorac. Vasc. Anesth. · Oct 2003
Comparative StudyVentricular cardiac-assist devices in infants and children: anesthetic considerations.
The application of a mechanical cardiac-assist device is now a common procedure in modern cardiac surgery in patients with end-stage failure, whereas in pediatric patients it is still a great challenge. In the recent literature, a broad range of survival and weaning rates have been reported, depending on the variety of mechanical devices and the choice of patients with different conditions before implantation or if the device is used in emergency surgery. In this article, the authors report their experience with pediatric cardiac-assist devices and the perioperative anesthesia management in this group of patients. ⋯ The surgical outcome depends on the patient's condition at the time of surgery. Emergency surgery, preoperative multiorgan failure, and the need for an extracorporeal circulation with aortic cross-clamping seem to predict a negative outcome in this group of patients.
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J. Cardiothorac. Vasc. Anesth. · Oct 2003
Review Multicenter Study Comparative Study Clinical TrialPrevalence of risk factors, and not gender per se, determines short- and long-term survival after coronary artery bypass surgery.
Much attention has been directed towards female gender as an independent risk factor for in-hospital mortality after coronary artery bypass grafting surgery; however, the effects of surgery are known to persist for 6 months or more. Studies that have compared postoperative survival in women and men beyond hospital discharge report disparate results with regard to the independent effect of gender per se on ultimate survival. ⋯ Disease prevalence in women, and not gender per se, affects mid- and long-term survival after cardiac surgery. Attention, therefore, should be focused on efforts to reduce or modify such disease prevalence earlier in women, which may in turn allow longer survival after surgical intervention. Differences in postoperative survival between women and men were related to the gender differences in the distribution of preoperative risk factors.
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J. Cardiothorac. Vasc. Anesth. · Oct 2003
Comparative Study Clinical TrialClinical experience with adaptive support ventilation for fast-track cardiac surgery.
To evaluate adaptive support ventilation (ASV), an automatic microprocessor-controlled mode of mechanical ventilation, for the initial ventilatory management in consecutive patients eligible for early extubation after cardiac surgery. ⋯ Adaptive support ventilation was used in a group of 155 consecutive patients after fast-track cardiac surgery. This ventilation mode was safe, easy to apply, and allowed rapid extubation in suitable patients. ASV may facilitate postoperative respiratory management.