Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2006
Randomized Controlled TrialComparison of systemic and renal effects of dopexamine and dopamine in norepinephrine-treated septic shock.
Vasopressor-induced vasoconstriction may compromise renal and splanchnic blood flow in patients with septic shock, resulting in secondary organ failures. The authors compared the effects of the vasodilatatory agent dopexamine against renal-dose dopamine and placebo in patients with norepinephrine therapy and septic shock, using 24-hour serum creatinine clearance (C(crea)) as a major endpoint. The primary hypothesis to be tested was that dopexamine is more effective than dopamine and that dopamine shows better effects than placebo regarding organ failures and C(crea). ⋯ Dopexamine is no more effective than dopamine or placebo regarding renal function in patients with septic shock requiring norepinephrine. Both therapies do not influence organ-failure scores.
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J. Cardiothorac. Vasc. Anesth. · Apr 2006
Editorial Comment Comparative StudyIs supplemental oxygen necessary?
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J. Cardiothorac. Vasc. Anesth. · Apr 2006
Comparative StudyPredictive factors of hemodynamic collapse after coronary artery bypass grafting: a case-control study.
Sudden hemodynamic collapse after coronary artery bypass graft (CABG) surgery is a complication with high morbidity and mortality. The aim of this study was to explore factors possibly predictive of this major complication. ⋯ Inadequate tissue perfusion, postoperative myocardial ischemia, and increased need for inotropic and mechanical support preceded hemodynamic collapse. Interventions to improve tissue perfusion and to prevent and treat myocardial ischemia may result in a more favorable outcome.
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J. Cardiothorac. Vasc. Anesth. · Apr 2006
Comparative StudyImpact of vasopressin on hemodynamic and metabolic function in the decompensatory phase of hemorrhagic shock.
To explore how the potent vasoconstrictive features of vasopressin impact the rate of cardiovascular collapse and metabolic derangements associated with prolonged hemorrhagic shock. ⋯ Administration of vasopressin used as an adjunct to maintain blood pressure in the decompensatory phase of hemorrhagic shock slows cardiovascular collapse, but has an adverse effect on metabolic and hemodynamic function. Further investigation is warranted to clarify the role of vasopressin in the delayed management of severe hemorrhagic shock.