Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2004
Comparative StudyPredictors of inotrope use during separation from cardiopulmonary bypass.
To identify the demographic, clinical, and echocardiographic features that predict the use of inotropic support at separation from cardiopulmonary bypass (CPB). ⋯ Incorporating data from a comprehensive intraoperative TEE examination, the authors identified 6 reproducible factors that independently predict the use of inotropic support at separation from CPB.
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J. Cardiothorac. Vasc. Anesth. · Aug 2004
The incidence and risk of acute renal failure after cardiac surgery.
To evaluate outcome and risk factors of acute renal failure in a surgical population with or without preoperative renal dysfunction. ⋯ This study confirms that acute renal failure is one of the major complications of cardiac surgery, identifies the risk factors, and suggests that optimizing cardiac output and reducing CPB time could improve the outcome of patients at high risk of acute renal failure.
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J. Cardiothorac. Vasc. Anesth. · Aug 2004
Intrathecal morphine for off-pump coronary artery bypass grafting.
To determine if preinduction intrathecal morphine is associated with successful intraoperative extubation in patients undergoing off-pump coronary artery bypass grafting. ⋯ It is concluded that intrathecal morphine is associated with a high intraoperative extubation rate in patients undergoing off-pump coronary artery bypass grafting. The authors' practice included 24-hour respiratory monitoring to detect delayed respiratory depression.
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J. Cardiothorac. Vasc. Anesth. · Aug 2004
Effects of hemodilution and phenylephrine on cerebral blood flow and metabolism during cardiopulmonary bypass.
Hypotension resulting from hemodilution on cardiopulmonary bypass is often treated by pressor (eg, phenylephrine) infusion. The effect of phenylephrine on cerebral blood flow (CBF) in this setting is not clear. It was hypothesized that phenylephrine might decrease CBF. ⋯ Phenylephrine redirects blood flow from the bowel and muscle to the brain and liver. Hemodilution increases CBF and pressor administration further increases CBF by elevating perfusion pressure. Maintenance of a higher hematocrit on CPB increases MAP and should decrease the need for vasopressor administration.