Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2007
Clinical TrialInhaled nitric oxide in the preoperative evaluation of pulmonary hypertension in heart transplant candidates.
The goal of this study was to evaluate the efficacy of 100% oxygen and inhaled nitric oxide (iNO) in decreasing pulmonary vascular resistance (PVR) and transpulmonary gradient (TPG) in dilated cardiomyopathy patients being evaluated for orthotopic heart transplantation (OHT); who, despite maximal intravenous (IV) dilator therapy, had persistent moderate-to-severe pulmonary hypertension. ⋯ iNO can further improve right ventricular hemodynamics even after presumed optimization with IV vasodilators and serves as a test of PVR reversibility during the preoperative assessment of OHT candidates.
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J. Cardiothorac. Vasc. Anesth. · Feb 2007
Heparin-induced thrombocytopenia following cardiac surgery is associated with poor outcome.
The outcome of cardiac surgical patients with clinically diagnosed heparin-induced thrombocytopenia (HIT) was studied. ⋯ The incidence of HIT in association with low-molecular-weight heparin use after cardiac surgery was low. HIT was associated with perioperative platelet transfusions and carried a remarkably high risk of thromboembolic complications and death. In order to reduce morbidity and mortality, early recognition of heparin-associated antiplatelet antibodies and alternative anticoagulation strategies need to be implemented.
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J. Cardiothorac. Vasc. Anesth. · Feb 2007
A survey of tracheostomy practice in a cardiothoracic intensive care unit.
The purpose of this study was to assess current practice of performing tracheostomies in critically ill cardiac surgical patients, to establish complication rates, and to identify areas of this clinical practice that could be improved. ⋯ The percutaneous dilational technique of tracheostomy was used predominantly in this unit. The median time from tracheal intubation to tracheostomy was 5 days. The most common complications were bleeding at the time of insertion, obstruction of the tracheostomy tube, and stomal infection.