Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2008
The effects of vasodilation on cardiac output measured by PiCCO.
The purpose of this study was to investigate the effects of vasodilation on cardiac output (CO) measured by pulse contour method using PiCCO (Pulsion Medical Systems AG, Munich, Germany) in comparison with CO by the thermodilution method. ⋯ PiCCO may not be an alternative to thermodilution measurement without recalibration when SVR decreases by infusion of PGE1 > or = 0.02 microg/kg/min.
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J. Cardiothorac. Vasc. Anesth. · Oct 2008
Acute Physiology and Chronic Health Evaluation (APACHE) III outcome prediction after major vascular surgery.
To investigate the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) III scoring system in patients admitted to the intensive care unit (ICU) after major vascular surgery. ⋯ The APACHE III scoring system discriminates well between survivors and nonsurvivors after major vascular surgery, but calibration of the model is poor.
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J. Cardiothorac. Vasc. Anesth. · Oct 2008
Randomized Controlled TrialLevosimendan in aortic valve surgery: cardiac performance and recovery.
The aim of the present study was to test the hypothesis that levosimendan has beneficial effects on cardiac performance and that the need for other vasoactive medications during and after cardiac surgery would be reduced by levosimendan in patients with severe aortic stenosis (AS) and left ventricular (LV) hypertrophy. ⋯ Low output is a result of myocardial stunning and is common after cardiopulmonary bypass. According to the present results, levosimendan may be useful in patients with severe AS and LV hypertrophy because it may prevent LV function from dropping to a critically low level postoperatively. Levosimendan causes vasodilation and thereby decreases mean arterial pressure, but this can be controlled with the use of norepinephrine.
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J. Cardiothorac. Vasc. Anesth. · Oct 2008
Perioperative coagulation management and blood conservation in cardiac surgery: a Canadian Survey.
To determine which strategies are currently used for (anti)coagulation management and blood conservation during cardiac surgery in Canada. ⋯ The majority of Canadian institutions do not use point-of-care tests other than ACT. Most institutions do not have algorithms for management of bleeding following cardiac surgery and at least 30% do not monitor their transfusion practice perioperatively. Cardiac surgery patients in Canada may benefit from a standardized approach to blood conservation in the perioperative period.