Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2010
The effect of the suspension of the license for aprotinin on the care of patients undergoing cardiac surgery: a survey of cardiac anesthesiologists' and surgeons' opinions in the United Kingdom.
The primary aim was to poll the opinions of cardiac anesthesiologists and surgeons as to the effect of the suspension of the license for aprotinin on patients undergoing cardiac surgery. ⋯ While the majority of respondents felt that the suspension of the license for aprotinin had no effect, almost a third felt it had impacted negatively on the care of patients undergoing cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Jun 2010
Randomized Controlled TrialThe effect of thoracic epidural anesthesia on pulmonary shunt fraction and arterial oxygenation during one-lung ventilation.
To compare the effect of thoracic epidural local anesthetic, epidural opioid, and intravenous opioid on pulmonary shunt fraction, arterial oxygenation, and hemodynamic changes during one-lung ventilation (OLV) in patients undergoing thoracic surgery. ⋯ Thoracic epidural bupivacaine, epidural sufentanil, and intravenous remifentanil-combined general intravenous anesthesia have comparable effects on shunt fraction and arterial oxygenation during OLV in patients undergoing thoracic surgery.
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J. Cardiothorac. Vasc. Anesth. · Jun 2010
Weaning mechanical ventilation after off-pump coronary artery bypass graft procedures directed by noninvasive gas measurements.
Partial pressure of carbon dioxide and oxygen were transcutaneously measured in adults after off-pump coronary artery bypass (OPCAB) surgery. The clinical use of such measurements and interchangeability with arterial blood gas measurements for weaning patients from postoperative mechanical ventilation were assessed. ⋯ More than three fourths of the patients were weaned from mechanical ventilation and extubated based on transcutaneous gas values alone after OPCAB surgery. The noninvasive transcutaneous carbon dioxide measurement can be used as a surrogate for arterial carbon dioxide measurement to manage postoperative OPCAB patients.
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J. Cardiothorac. Vasc. Anesth. · Jun 2010
Randomized Controlled TrialA new plasma-adapted hydroxyethyl starch preparation: in vitro coagulation studies.
Preparing hydroxyethyl starch (HES) in a plasma-adapted solution is supposed to improve safety with regard to coagulation. The influence of a new plasma-adapted HES preparation on coagulation was studied. ⋯ Dilution with the nonplasma-adapted HES 130/0.42 was associated with more negative effects on thromboelastometry and platelet aggregation than the same HES 130/0.4 dissolved in a plasma-adapted solution. The benefits of using a plasma-adapted modern HES preparation on blood loss and use of blood/blood products in cardiac surgery need to be studied.