Journal of cardiothoracic and vascular anesthesia
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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
Clinical predictors for prolonged intensive care unit stay in adults undergoing thoracic aortic surgery requiring deep hypothermic circulatory arrest.
The purpose of this study was to describe clinical predictors for prolonged length of stay in the intensive care unit (PLOS-ICU) after adult thoracic aortic surgery requiring standardized deep hypothermic circulatory arrest (DHCA); and to determine the incidence of PLOS-ICU after DHCA, univariate predictors for PLOS-ICU, and multivariate predictors for PLOS-ICU. ⋯ PLOS-ICU after DHCA is common. The identified multivariate predictors merit further hypothesis-driven research to enhance perioperative protection of the brain, kidney, and cardiovascular system.
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J. Cardiothorac. Vasc. Anesth. · Feb 2006
Perioperative outcome in adults undergoing elective deep hypothermic circulatory arrest with retrograde cerebral perfusion in proximal aortic arch repair: evaluation of protocol-based care.
The purpose of this study was to describe perioperative outcome in adults undergoing elective proximal aortic arch repair with protocol-based deep hypothermic circulatory arrest (DHCA) with retrograde cerebral perfusion (RCP). ⋯ The above parameters establish a baseline incidence for major perioperative complications in adults undergoing elective DHCA with RCP for elective proximal aortic arch repair. In approaching the open aortic arch for short periods of circulatory arrest, deep hypothermia with adjunctive RCP is safe and effective.
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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.