Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2008
Fenoldopam reduces the incidence of renal replacement therapy after cardiac surgery.
To investigate whether a continuous 48-hour infusion of fenoldopam, 0.1 mug/kg/min, reduced the need for renal replacement therapy in patients with acute renal injury after cardiac surgery. ⋯ Given the limitations of case-matched studies, fenoldopam may be useful in avoiding renal replacement therapy in patients who develop acute renal injury after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 2008
Randomized Controlled TrialWarming of intravenous fluids prevents hypothermia during off-pump coronary artery bypass graft surgery.
Even mild perioperative hypothermia (34 degrees -36 degrees C) can cause numerous adverse outcomes, including morbid cardiac events, coagulopathy with increased blood loss, and a decreased resistance to surgical wound infection. The purpose of this study was to evaluate the effect of fluid warming on preventing hypothermia during off-pump coronary artery bypass (OPCAB) surgery. ⋯ The results show that the warming of intravenous fluids by using the Hotline system prevents decreases in systemic temperatures during OPCAB surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 2008
Review Meta AnalysisFenoldopam reduces the need for renal replacement therapy and in-hospital death in cardiovascular surgery: a meta-analysis.
Acute renal failure is a common and threatening complication in patients undergoing cardiovascular surgery. To determine the efficacy of fenoldopam in the prevention of acute renal failure, the authors performed a systematic review of randomized, controlled trials and propensity-matched studies in patients undergoing cardiovascular surgery. ⋯ This meta-analysis provides evidence that fenoldopam may confer significant benefits in preventing renal replacement therapy and reducing mortality in patients undergoing cardiovascular surgery.
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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.