Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2007
Randomized Controlled TrialEffect of dexamethasone on atrial fibrillation after cardiac surgery: prospective, randomized, double-blind, placebo-controlled trial.
The purpose of this study was to assess the effect of preoperative dexamethasone (DEX) on the occurrence of postoperative atrial fibrillation (AF). ⋯ DEX did not affect the incidence of AF in patients undergoing combined CABG and valve surgery. However, it did modulate the release of several inflammatory and acute-phase response mediators that are associated with adverse outcomes.
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J. Cardiothorac. Vasc. Anesth. · Feb 2007
Comparative Study Clinical TrialCardiac output determination from the arterial pressure wave: clinical testing of a novel algorithm that does not require calibration.
The purpose of this study was to evaluate the accuracy and precision of a novel algorithm that evaluates cardiac output by using arterial pressure waveform characteristics. ⋯ This novel arterial pressure cardiac output algorithm provides cardiac output assessments that agree satisfactorily for clinical purposes with intermittent and continuous thermodilution techniques in postoperative cardiac surgical patients. Further study is required for other patient populations and clinical situations.
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J. Cardiothorac. Vasc. Anesth. · Feb 2007
Effects of intravenous anesthetics on the human radial artery used as a coronary artery bypass graft.
Intravenous anesthetics are often used for anesthesia, sedation, and analgesia in the intraoperative and postoperative periods of coronary artery bypass graft (CABG) surgery. This study was designed to investigate the direct effects of intravenous anesthetics on the human radial artery (RA). ⋯ These findings indicate that thiopental, ketamine, etomidate, and propofol produce concentration-dependent relaxation on RA rings from humans. Thiopental and ketamine are more potent relaxant agents than etomidate and propofol. Intravenous anesthetics may be effective as alternative vasodilators for treatment of intraoperative and postoperative spasm of coronary artery grafts.
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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.