Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2006
The kaolin-activated Thrombelastograph predicts bleeding after cardiac surgery.
The objective of this study was to determine the relationship of the kaolin-activated Thrombelastograph (TEG) with postoperative bleeding and laboratory tests of coagulation in the setting of cardiac surgery with the routine use of -aminocaproic acid. ⋯ In conclusion, the kaolin-activated TEG is associated with early coagulopathic bleeding. It may reflect the severity of a global coagulopathy affecting both platelets and coagulation factors and be a guide to incremental prohemostatic therapy in this setting.
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J. Cardiothorac. Vasc. Anesth. · Aug 2006
Randomized Controlled Trial Multicenter Study Comparative StudyMyocardial damage prevented by volatile anesthetics: a multicenter randomized controlled study.
The purpose of this study was to evaluate the effects of volatile anesthesia versus total intravenous anesthesia on cardiac troponin release in off-pump coronary artery bypass grafting (OPCAB). ⋯ Myocardial damage measured by cardiac troponin release could be reduced by volatile anesthetics during OPCAB. Because patients underwent cardiac surgery on the beating heart, these results could have implications for cardiac patients undergoing noncardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Aug 2006
Randomized Controlled TrialOpioids and cardioprotection: the impact of morphine and fentanyl on recovery of ventricular function after cardiopulmonary bypass.
Experimental studies have shown that opioids protect the myocardium from ischemic injury and that opioid cardioprotection is enhanced by the coadministration of volatile anesthetics. Previous data suggest that morphine produces a more potent cardioprotective effect than fentanyl. The present study investigated the effect of the choice of intraoperative opioid (morphine or fentanyl) on recovery of myocardial function after coronary artery bypass graft (CABG) surgery. ⋯ In patients undergoing CPB, global ventricular function is enhanced by the administration of morphine prior to the ischemic insult of cardioplegic arrest.
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J. Cardiothorac. Vasc. Anesth. · Aug 2006
Randomized Controlled TrialA prospective, randomized platelet-function study of heparinized oxygenators and cardiotomy suction.
The purpose of this study was to determine if substitution of a heparin-coated oxygenator and salvaged autologous blood for cardiotomy suction would improve platelet function. ⋯ The authors concluded that the effects of these changes to the CPB circuit were small and inconsequential in this cohort of patients.