Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2009
Meta AnalysisSpinal analgesia in cardiac surgery: a meta-analysis of randomized controlled trials.
Controversial results exist on the effects of spinal analgesia in cardiac surgery. The authors conducted a review of randomized studies to show whether there are any advantages in clinically relevant outcomes using spinal analgesia in patients undergoing cardiac surgery. ⋯ This analysis indicated that spinal analgesia does not improve clinically relevant outcomes in patients undergoing cardiac surgery, discouraging further randomized controlled trials on this topic even if changes in techniques, devices, and drugs could modify the outlook of the comparison between spinal and standard anesthesia in this setting.
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J. Cardiothorac. Vasc. Anesth. · Dec 2009
Comparative StudyAssessment of internal thoracic artery patency with transesophageal echocardiography during coronary artery bypass graft surgery.
The purpose of this study was to evaluate intraoperative transesophageal echocardiography (TEE) for assessing patency of internal thoracic artery grafts. ⋯ The authors concluded that the intraoperative assessment of LITA patency with TEE was a markedly useful and powerful tool for anesthesiologists during CABG surgery.
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J. Cardiothorac. Vasc. Anesth. · Dec 2009
Epidural anesthesia in elderly patients undergoing coronary artery bypass graft surgery.
The purpose of this study was to evaluate the effects of thoracic epidural anesthesia on postoperative N-terminal pro B-natriuretic peptide (NT-proBNP) release in elderly patients undergoing elective coronary artery bypass graft (CABG) surgery. ⋯ Epidural anesthesia added to general anesthesia for CABG surgery significantly attenuates NT-proBNP release in elderly patients and reduces the incidence of prolonged intensive care unit stay.
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J. Cardiothorac. Vasc. Anesth. · Dec 2009
Preoperative and intraoperative risk factors for prolonged intensive care unit stay after aortic arch surgery.
The present study was performed to evaluate preoperative and intraoperative risk factors for prolonged intensive care unit (ICU) stay after aortic arch surgery. ⋯ The authors identified 4 preoperative and intraoperative risk factors for prolonged ICU stay. This is helpful to identify patients with increased risk for prolonged ICU stay, implement specific strategies, and allocate medical resources.
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J. Cardiothorac. Vasc. Anesth. · Dec 2009
Predictors of prolonged postoperative endotracheal intubation in patients undergoing thoracotomy for lung resection.
The aim of this study was to identify predictors of delayed endotracheal extubation defined as the need for postoperative ventilatory support after open thoracotomy for lung resection. ⋯ Most predictors of delayed postoperative extubation (ie, red blood cell transfusion, higher preoperative serum creatinine, lower preoperative FEV(1), and more extensive lung resection) are difficult to modify in the perioperative period and probably represent greater severity of underlying lung disease and more advanced comorbid conditions. However, thoracic epidural anesthesia and analgesia is a modifiable factor that was associated with reduced odds for postoperative ventilatory support. Thus, the use of epidural analgesia may reduce the need for post-thoracotomy mechanical ventilation.