Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2004
Transcranial Doppler emboli count predicts rise in creatinine after coronary artery bypass graft surgery.
To examine the correlation between transcranial Doppler ultrasonography-detected emboli during coronary artery bypass graft surgery with cardiopulmonary bypass and renal dysfunction as determined by the postoperative change in creatinine. ⋯ Increased numbers of Doppler-detected emboli during coronary artery bypass graft surgery are associated with postoperative renal dysfunction.
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J. Cardiothorac. Vasc. Anesth. · Oct 2004
Clinical TrialSimvastatin blunts the increase of circulating adhesion molecules after coronary artery bypass surgery with cardiopulmonary bypass.
Endothelial dysfunction has been shown to be a critical early component of organ injury after myocardial ischemia and reperfusion. Circulating levels of adhesion molecules have been regarded as a valid index of endothelial activation. Recent reports suggest that statins, widely used in the control of hypercholesterolemia, exert a protective effect on the endothelium reflected by a reduced level of circulating adhesion molecules. In this study, the effects of preoperative simvastatin treatment, at doses equivalent to those used orally for cholesterol control, were studied on plasma levels of VCAM-1, ICAM-1, and ELAM-1. ⋯ Pretreatment with simvastatin significantly reduces the increase of ICAM-1 and ELAM-1 after coronary artery bypass surgery, by a mechanism that seems not related to its efficacy in lowering cholesterol levels.
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J. Cardiothorac. Vasc. Anesth. · Oct 2004
Clinical TrialAccuracy and performance of a modified continuous intravascular blood gas monitoring device during thoracoscopic surgery.
The only commercially available continuous intravascular blood gas monitoring system for adults, the Paratrend (Diametrics Medical Inc, High Wycombe, UK), was modified by the manufacturer to the Paratrend 7+ (PT7+) in 1999. The aim of this study was to evaluate the modified probe over a wide range of blood gas and pH values during thoracoscopic surgery in a similar setup as done with the previous model. ⋯ In patients undergoing thoracoscopic surgery with rapidly changing blood gas parameters, the PT7+ device is a valuable trend indicator and hence may be helpful for clinical decision making. However, the underestimation of PO(2) values by 20 mmHg on average and the wide limits of agreement documented in this study must be regarded as limiting factors.
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J. Cardiothorac. Vasc. Anesth. · Oct 2004
Clinical TrialCerebral oxygen desaturation is associated with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery.
To evaluate the relationship between cerebral oxygen saturation and neuropsychological dysfunction after cardiac surgery. ⋯ Intraoperative cerebral oxygen desaturation is associated with early postoperative neuropsychological dysfunction in patients undergoing cardiac surgery with cardiopulmonary bypass. However, it remains to be determined whether interventions to maintain adequate cerebral oxygenation may improve neuropsychological outcome.
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The aim of this study was to investigate cases of difficult intubation in pediatric cardiac surgical patients and to evaluate the importance of associated congenital abnormalities. ⋯ The likelihood of difficult intubation during pediatric cardiac surgery, especially in cases with other congenital pathologies should be kept in mind, and the anesthetic approach must be planned accordingly.