Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2009
Comparative StudyThe influence of the preoperative immune response on blood transfusion requirements in patients undergoing cardiac surgery.
The purpose of this study was to evaluate the influence of preoperative type I and II immune responses on blood transfusion requirements. ⋯ A low preoperative Th1 immune response, as assessed by the proportion of CD4+ T-helper-producing TNF-alpha, was associated with a higher blood transfusion rate.
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J. Cardiothorac. Vasc. Anesth. · Jun 2009
Randomized Controlled Trial Multicenter Study Comparative StudyA phase II multicenter double-blind placebo-controlled study of ethyl pyruvate in high-risk patients undergoing cardiac surgery with cardiopulmonary bypass.
Ethyl pyruvate (EP) is an investigational drug that has been shown to protect animals in several models of critical illness including myocardial or mesenteric ischemia/reperfusion injury, sepsis, and hemorrhagic shock. The purpose of this study was to assess the safety of EP administration to patients undergoing higher-risk cardiac surgery and to obtain preliminary efficacy data for the prevention of single and multisystem organ dysfunction. ⋯ Despite positive results in numerous animal models, the administration of EP does not appear to confer any benefit to cardiac surgical patients undergoing CPB.
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J. Cardiothorac. Vasc. Anesth. · Jun 2009
Randomized Controlled Trial Comparative StudyTwo large preoperative doses of erythropoietin do not reduce the systemic inflammatory response to cardiac surgery.
Cardiac surgery and cardiopulmonary bypass (CPB) induce an inflammatory reaction that may lead to tissue injury. Experimental studies suggest that recombinant human erythropoietin (EPO) independent of its erythropoietic effect may be used clinically as an anti-inflammatory drug. This study tested the hypothesis that 2 large doses of EPO administered shortly before CPB ameliorate the systemic inflammatory response to CPB. ⋯ Two large doses of EPO given shortly before CPB do not reduce perioperative release of inflammatory cytokines. In contrast, EPO may augment the TNF-alpha and NT-proBNP response. Although the long-term clinical impact remains unknown, the findings do not support use of EPO as an anti-inflammatory drug in patients undergoing cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Jun 2009
Randomized Controlled Trial Comparative StudyTranexamic acid reduces blood loss in off-pump coronary artery bypass surgery.
This study was designed to evaluate the hemostatic effect of tranexamic acid in off-pump coronary artery bypass surgery. ⋯ Bleeding and hemorrhagic complications and the consequent need for allogeneic transfusion are still major problems after off-pump coronary artery bypass surgery. Tranexamic acid appears to be effective in reducing postoperative bleeding and the need for allogeneic blood products.