Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2008
Randomized Controlled TrialAprotinin reduces cardiac troponin I release and inhibits apoptosis of polymorphonuclear cells during off-pump coronary artery bypass surgery.
In addition to blood-sparing effects, aprotinin may have cardioprotective and anti-inflammatory effects during cardiopulmonary bypass-assisted cardiac surgery. In this study, the authors examined whether aprotinin had cardioprotective and/or anti-inflammatory effects in patients undergoing off-pump coronary artery bypass grafting. ⋯ The authors conclude that aprotinin reduces perioperative cardiac troponin I release and attenuates apoptosis in polymorphonuclear cells but has no significant effects on plasma cytokine levels in patients undergoing off-pump coronary artery bypass graft surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 2008
Comparative StudyComparison of central venous to mixed venous oxygen saturation in patients with low cardiac index and filling pressures after coronary artery surgery.
To evaluate the correlation and agreement between mixed venous oxygen saturation (SvO(2)) and central venous oxygen saturation (ScvO(2)) in patients with low cardiac index and filling pressures after coronary artery surgery. ⋯ In patients with low cardiac index and filling pressures after coronary artery surgery, ScvO(2) could not be used as a direct alternative for SvO(2). After fluid therapy and normalization of the cardiac index, differences between individual values remained large, and the disagreement between ScvO(2) and SvO(2) changes was significant.
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J. Cardiothorac. Vasc. Anesth. · Feb 2008
Randomized Controlled Trial Comparative StudyJugular bulb venous oxygen saturation during one-lung ventilation under sevoflurane- or propofol-based anesthesia for lung surgery.
During one-lung ventilation (OLV), systemic oxygenation can be compromised. In such a scenario, if anesthetic techniques were used that adversely affected cerebral oxygen balance, the risk for impaired cerebral oxygen balance may be increased. In this study, jugular bulb venous oxygen saturation (SjO(2)) during OLV under sevoflurane- or propofol-based anesthesia for lung surgery was investigated. ⋯ Cerebral oxygen desaturation was more frequently detected during OLV under propofol- versus sevoflurane-based anesthesia. Cerebral oxygen balance during OLV for lung surgery was less impaired under sevoflurane-based anesthesia compared with propofol; however, the clinical outcome or implications for cognitive function need to be determined.
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J. Cardiothorac. Vasc. Anesth. · Feb 2008
Comparative StudyClopidogrel treatment before coronary artery bypass graft surgery increases postoperative morbidity and blood product requirements.
An increasing number of patients are referred for coronary artery bypass graft surgery while treated with clopidogrel. This agent inhibits the platelet P2Y12 adenosine-5'-diphosphate (ADP) receptor, which results in an inhibition of platelet aggregation. The aim of this study was to determine the effect of preoperative clopidogrel treatment on postoperative bleeding, mortality, and morbidity in patients after coronary artery bypass graft surgery. ⋯ Preoperative clopidogrel is associated with increased transfusion requirement after coronary artery bypass graft surgery. The present data suggest that all-cause mortality and major morbidity may also increase in these patients. In clopidogrel-treated patients, coronary artery bypass graft surgery should be delayed in the absence of specific medical indications as recommended by recent American Heart Association guidelines.