Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2006
Cardiac output measurement during infrarenal aortic surgery: echo-esophageal Doppler versus thermodilution catheter.
Aortic surgery is associated with various hemodynamic and cardiac output modifications. These disorders may be partly caused by blood flow redistribution between supra-aortic and descending aorta regions during clamping and unclamping. A new echo-esophageal Doppler (Hemosonic 100; Arrow, Reading, PA) calculates cardiac output from a simultaneous measurement of blood flow velocity and diameter of the descending aorta. This calculation may be affected by blood redistribution during aortic clamping. The aim of this study was to compare cardiac output measured by echo-esophageal Doppler and by bolus thermodilution catheter during infrarenal aortic surgery. ⋯ Bias between both methods was clinically acceptable, and limits of agreement were not significantly modified by aortic clamping. However, larger studies including homogenous aortic pathologies are necessary to validate this method during infrarenal aortic surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 2006
Serum lactate level has prognostic significance after pediatric cardiac surgery.
The determination of postoperative course after cardiac surgery has always been a challenging issue. It is more sophisticated in the pediatric age group. The aim of this investigation was to identify whether increased concentrations of lactate in arterial blood has a predictive value for postoperative morbidity and mortality after heart surgery. ⋯ Blood lactate concentration of 4.8 mmol/L or higher during the early postoperative hours identifies a group of patients with increased risk of postoperative morbidity and mortality.
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J. Cardiothorac. Vasc. Anesth. · Feb 2006
Comparative StudyDirect versus guidewire-assisted pediatric radial artery cannulation technique.
Radial artery cannulation is a more difficult procedure in pediatric patients. Direct technique commonly fails in these patients, and several techniques have been developed for successful arterial cannulation. The purpose of this study was to compare direct radial artery cannulation with guidewire-assisted cannulation in children undergoing cardiac or aortic surgery. The hypothesis was that the guidewire-assisted technique would lead to fewer attempts and provide better long-term blood pressure monitoring and blood sampling. ⋯ The authors recommend the use of a guidewire-assisted radial artery cannulation technique rather than a direct technique. The guidewire-assisted technique provided easy, safe, and quick cannulation and allowed for long-term satisfactory blood pressure monitoring and blood sampling because of the longer length of the Teflon catheter advanced into the artery over the guidewire, and a low rate of dissection of the radial artery.