Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2007
Atrial fibrillation after aortic arch repair requiring deep hypothermic circulatory arrest: incidence, clinical outcome, and clinical predictors.
To delineate the incidence, outcome impact, and clinical predictors of atrial fibrillation (AF) after adult aortic arch repair requiring deep hypothermic circulatory arrest (AAR-DHCA) AIMS: To determine the incidence of AF after AAR-DHCA, to determine whether AF after AAR-DHCA affects mortality or stay in the intensive care unit (ICU), to determine multivariate predictors for AF after AAR-DHCA, and to determine whether aprotinin protects against AF after AAR-DHCA. ⋯ AF after AAR-DHCA is common but does not independently increase mortality or ICU stay. The risk of AF after AAR-DHCA increases with age but decreases with the degree of hypothermia during DHCA. Aprotinin does not appear to affect the risk of AF after AAR-DHCA.
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J. Cardiothorac. Vasc. Anesth. · Jun 2007
Predictors of perioperative beta-blockade use in vascular surgery: a mail survey of United States anesthesiologists.
It was hypothesized that anesthesiologists' decisions to provide perioperative beta-blockade during vascular surgery would be influenced more by physician factors than by those of their patients. ⋯ Preferences for perioperative beta-blockade use in vascular surgery patients are influenced by anesthesiologists' demographics as well as patient comorbidities or degree of surgical stress. This finding suggests that efforts to increase perioperative beta-blockade in high-risk vascular patients face significant barriers from some groups of clinicians.
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J. Cardiothorac. Vasc. Anesth. · Jun 2007
Establishing extracorporeal membrane oxygenation in a university clinic: case series.
Although extracorporeal membrane oxygenation (ECMO) is well established for respiratory failure in neonates, application in adults is still considered controversial. The survival of patients with acute respiratory distress syndrome and ECMO therapy is 50% to 70%. ⋯ ECMO has been shown to be a successful therapy for acute respiratory distress syndrome when conventional strategies have failed. Pre-ECMO risk assessment may be useful in the evaluation of patients.
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J. Cardiothorac. Vasc. Anesth. · Jun 2007
Patient understanding of the importance of beta-blocker use in the perioperative period.
Perioperative beta-adrenergic blockade has been shown to decrease morbidity and mortality after noncardiac surgery. The objective of this study was to determine patient knowledge of the importance of perioperative beta-blockade in a population already taking chronic therapy and to assess the effectiveness of medical and surgical providers in patient education regarding these benefits. ⋯ This study suggests low patient understanding of the potential importance and reasons for perioperative beta-blockade. Patients who recognized perioperative benefit identified antihypertensive versus cardioprotective effects. Clinicians can improve education of patients already taking daily beta-blockers regarding these potential benefits.