Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2008
Randomized Controlled Trial Comparative StudyMyocardial metabolism altered by ischemic preconditioning and enflurane in off-pump coronary artery surgery.
During off-pump coronary artery bypass (OPCAB) surgery, the heart is subjected to ischemia and reperfusion. The authors hypothesized that the volatile anesthetics are as effective as ischemic preconditioning (IPC) in preserving myocardial function during off-pump cardiac surgery, and this effect is because of multiple mechanisms of action. Therefore, the effects of enflurane with its calcium inhibition and antioxidative properties were compared with mechanical IPC in preserving myocardial cellular markers. ⋯ Coronary occlusion during OPCAB surgery results in increased production of ischemia-related metabolic products. The application of methods such as IPC or volatile anesthesia appears to reduce the metabolic deficit, free-radical production, and physiologic changes.
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J. Cardiothorac. Vasc. Anesth. · Jun 2008
Comparative Study Controlled Clinical TrialMonocyte activation in on-pump versus off-pump coronary artery bypass surgery.
Monocyte activation plays a key role in amplifying both inflammatory and coagulopathic sequelae in patients undergoing on-pump coronary artery bypass graft (CABG) surgery. Off-pump CABG diminishes, but does not eliminate, the systemic inflammatory response and its influence on monocyte activation remains unclear. This study was performed to determine if off-pump CABG suppresses all features of monocyte activation. ⋯ Off-pump CABG surgery attenuates monocyte secreted cytokines and completely suppresses activation-dependent monocyte cell-surface changes (CD11b, monocyte-platelet conjugate formation). Whether these pathophysiologic differences in monocyte activation translate into a reduction in adverse events after CABG surgery warrants a larger, randomized, outcomes study.
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J. Cardiothorac. Vasc. Anesth. · Jun 2008
Comparative StudyCan femoral artery pressure monitoring be used routinely in cardiac surgery?
The purpose of this study was to evaluate the safety of femoral arterial pressure monitoring in cardiac surgery. ⋯ Femoral artery pressure monitoring was associated with a low complication rate and, therefore, it can be used routinely in cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Jun 2008
Comparative StudySex-related differences in outcome after high-risk vascular surgery after the administration of beta-adrenergic-blocking drugs.
Beta-adrenergic-blocking medications may have a cardioprotective effect after high-risk vascular surgery. This effect has been shown primarily in men and has not been independently shown in women. ⋯ In this retrospective analysis, women did not benefit from perioperative beta-blockade. Women at high risk appeared to have a worse outcome because of a higher incidence of CHF.