Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2009
Comparative StudyTwo-lung high-frequency jet ventilation as an alternative ventilation technique during transthoracic esophagectomy.
The aim of this study was to evaluate two-lung high-frequency jet ventilation during esophagectomy and evaluate the influence of high-frequency jet ventilation on pulmonary complications as compared with one-lung ventilation. ⋯ High-frequency jet ventilation to 2 lungs, using a single-lumen tube, is a safe and adequate ventilation technique for use during esophagectomy. High-frequency jet ventilation had no influence on the incidence of postoperative pulmonary complications but reduced perioperative blood loss and led to a decreased need for fluid replacement.
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J. Cardiothorac. Vasc. Anesth. · Aug 2009
Randomized Controlled Trial Comparative StudyA comparison of the deflecting-tip bronchial blocker with a wire-guided blocker or left-sided double-lumen tube.
To compare a new bronchial blocker, the Cohen blocker, with the Arndt blocker and a left double-lumen tube (DLT). ⋯ There was a trend toward a difference between times to place a bronchial blocker and the DLT. The Cohen blocker is more difficult to position in the left main bronchus than in the right one.
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J. Cardiothorac. Vasc. Anesth. · Aug 2009
Epidemiology of deep sternal wound infection in cardiac surgery.
The aim of this study was to investigate the incidence and predictors of deep sternal wound infection (DSWI) in a contemporary cohort of patients undergoing cardiac surgery. The early and late outcomes of patients with this complication also were analyzed. ⋯ DSWI remains a rare but devastating complication and is associated with significant comorbidity, increased hospital mortality, and reduced long-term survival.
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J. Cardiothorac. Vasc. Anesth. · Aug 2009
The feasibility of speckle tracking for intraoperative assessment of regional myocardial function by transesophageal echocardiography.
The authors aimed to examine the feasibility of intraoperative transesophageal echocardiography (TEE) acquisition of a non-Doppler-based, speckle tracking-derived myocardial deformation parameter (strain) immediately before and after coronary artery bypass graft (CABG) surgery in patients with reduced left ventricular (LV) function. ⋯ Strain calculation from TEE images is feasible during cardiac surgery and correlates well with WMS but has better interobserver agreement. Strain analysis, but not WMS, detected wall motion differences between normally perfused and ischemic segments. This simple method allows objective intraoperative quantification of myocardial segment function and may become an important monitoring tool in the future.
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J. Cardiothorac. Vasc. Anesth. · Aug 2009
Focused cardiovascular ultrasound performed by anesthesiologists in the perioperative period: feasible and alters patient management.
The aim of this study was to assess the feasibility and effects on perioperative management of a focused transthoracic echocardiogram performed by anesthesiologists. ⋯ Anesthesiologists with a cardiac and echocardiography background can successfully perform a FoCUS in almost all patients when indicated, which provides valuable new diagnostic information guiding changes in perioperative management in the majority of patients.