Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2009
Comparative StudySubglottic stenosis in children undergoing repair of congenital heart defects.
To examine the incidence of subglottic stenosis in children with congenital heart disease undergoing surgical repair and the contributing factors to such a complication. ⋯ Subglottic stenosis is an uncommon complication in children undergoing surgical repair of congenital heart defects. The most important risk factors are younger age and prolonged postoperative ventilation. Early diagnosis, referral, and intervention resulted in a favorable outcome in most of the authors' patients.
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J. Cardiothorac. Vasc. Anesth. · Oct 2009
Randomized Controlled Trial Comparative StudyKetamine attenuates delirium after cardiac surgery with cardiopulmonary bypass.
To determine if ketamine attenuates postoperative delirium concomitant with an anti-inflammatory effect in patients undergoing cardiac surgery using cardiopulmonary bypass. ⋯ After cardiac surgery using cardiopulmonary bypass, ketamine attenuates postoperative delirium concomitant with an anti-inflammatory effect.
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J. Cardiothorac. Vasc. Anesth. · Oct 2009
Meta Analysis Comparative StudyEsmolol reduces perioperative ischemia in cardiac surgery: a meta-analysis of randomized controlled studies.
beta-Blockers were associated with a reduction of mortality and morbidity in noncardiac surgery until recently when the POISE trial showed that beta-blockers could be harmful in the perioperative period because of hypotension and bradycardia. Esmolol is an ultra-short-acting beta-blocker mostly used in emergency and high-risk patients. The authors performed a meta-analysis to evaluate the clinical effects of esmolol in cardiac surgery. ⋯ Esmolol reduces the incidence of myocardial ischemia and arrhythmias in cardiac surgery. An increase in bradycardia was noted as well.
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J. Cardiothorac. Vasc. Anesth. · Oct 2009
Randomized Controlled Trial Comparative StudyMorphine reduces the threshold of helium preconditioning against myocardial infarction: the role of opioid receptors in rabbits.
Brief, repetitive administration of helium before prolonged coronary artery occlusion and reperfusion protects myocardium against infarction. Opioid receptors mediate the cardioprotective effects of ischemic pre- and postconditioning, but whether these receptors also play a role in helium preconditioning is unknown. The authors tested the hypotheses that opioid receptors mediate helium preconditioning and that morphine (a mu(1)-opioid receptor agonist with delta(1)-opioid agonist properties) lowers the threshold of cardioprotection produced by helium in vivo. ⋯ The results indicate that morphine lowers the threshold of helium preconditioning. Opioid receptors mediate helium preconditioning and its augmentation by morphine in vivo.