Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2003
Randomized Controlled Trial Clinical TrialThe value of preoperative pharmacologic stress testing before vascular surgery using ACC/AHA guidelines: a prospective, randomized trial.
To evaluate the validity of preoperative cardiac stress testing using clinical predictors from the American College of Cardiology/American Heart Association Guidelines on Perioperative Evaluation before Noncardiac Surgery in patients undergoing vascular surgery. ⋯ In this small prospective, randomized study evaluating the validity of preoperative cardiac stress testing using ACC/AHA Guidelines before major vascular surgery, preoperative cardiac stress testing offered no incremental value for determining postoperative adverse cardiac outcomes. Larger randomized clinical trials are needed to confirm these findings.
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J. Cardiothorac. Vasc. Anesth. · Dec 2003
Randomized Controlled Trial Comparative Study Clinical TrialWhich anesthetic agent alters the hemodynamic status during pediatric catheterization? Comparison of propofol versus ketamine.
To compare the effects of propofol and ketamine on systemic and pulmonary circulations in pediatric patients scheduled for elective cardiac catheterization. ⋯ In children with cardiac shunting, the principal hemodynamic effect of propofol is a decrease in systemic vascular resistance. In children with intracardiac shunting, this results in an increase in right-to-left shunting and a decrease in the ratio of pulmonary to systemic blood flow, which may lead to arterial desaturation. Ketamine did not produce these changes. The authors suggested that during cardiac catheterization in children, both the anesthesiologists and cardiologists need to know that anesthetic agents can significantly alter the hemodynamic status in children with complex congenital heart defects and affect the results of hemodynamic calculations that are important for decision-making and treatment of these patients.
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J. Cardiothorac. Vasc. Anesth. · Dec 2003
Quantitative analysis of left ventricular regional wall motion with color kinesis during abdominal aortic cross-clamping.
The authors aimed to establish a technique for quantitative analysis of regional wall motion abnormality (RWMA) using color kinesis (CK) of transesophageal echocardiography (TEE) in surgical patients. This technique was used to determine whether RWMAs develop de novo after infrarenal aortic cross-clamping in patients undergoing vascular surgery with a preoperative dipyridamole thallium stress test (DTST). ⋯ A new method is available for clinical use, which is capable of visualizing RWMAs. These results suggest that new RWMAs introduced by aortic cross-clamping occur irrespective of the risk as assessed by preoperative DTST. CK with the new analysis method might be a useful tool to quantitatively evaluate RWMAs during surgery.
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J. Cardiothorac. Vasc. Anesth. · Dec 2003
Comparative StudyA comparison of CardioQ and thermodilution cardiac output during off-pump coronary artery surgery.
To compare CardioQ esophageal Doppler cardiac output and thermodilution cardiac output during off-pump coronary artery bypass surgery. ⋯ Because of the wide limits of agreement and the large interpatient differences in both bias and precision, the CardioQ esophageal Doppler cardiac output cannot currently be recommended as an alternative to thermodilution cardiac output during off-pump coronary artery bypass surgery.
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J. Cardiothorac. Vasc. Anesth. · Dec 2003
Dose-related effects of theophylline added to modified Euro-Collins solution used for hypothermic preservation of lung.
To investigate the dose-related effects of theophylline in prevention of ischemia-reperfusion injury of the lung. ⋯ The results of this study showed that 400 mg/L and 1000 mg/L of theophylline added to the modified Euro-Collins solution decreased the intermediate products of lipid peroxidation. Theophylline merits further investigation in ischemia-reperfusion studies as a potentially beneficial agent.