Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2011
Cardiac output determination from endotracheally measured impedance cardiography: clinical evaluation of endotracheal cardiac output monitor.
To evaluate the accuracy, precision, and trending of a new endotracheally sourced impedance cardiography-based cardiac output (CO) monitor (ECOM; ConMed Corp, Irvine, CA). ⋯ ECOM CO shows an acceptable bias with wide limits of agreement and a large percent error when compared with TD CO or TEE CO; however, it shows acceptable trending of CO to both modalities in patients undergoing cardiac surgery. Further studies are required to evaluate ECOM in other patient populations and clinical situations.
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J. Cardiothorac. Vasc. Anesth. · Oct 2011
Comparative StudyA comparison of cardiac output by thoracic impedance and direct fick in children with congenital heart disease undergoing diagnostic cardiac catheterization.
To evaluate the measurement of cardiac output (CO) using continuous electrical bioimpedance cardiography (Physioflow; Neumedx, Philadelphia, PA) (CO(PF)) with a simultaneous direct Fick measurement (CO(FICK)) in children with congenital heart disease. ⋯ Compared with measurements made by direct Fick, CO measured using the Physioflow device was unreliable in anesthetized children with congenital heart disease.
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J. Cardiothorac. Vasc. Anesth. · Oct 2011
HbA1c and diabetes predict perioperative hyperglycemia and glycemic variability in on-pump coronary artery bypass graft patients.
Perioperative hyperglycemia and glycemic variability are considered independent predictors of morbidity and mortality in critically ill patients. The purpose of this study was to investigate the relation of HbA1c and/or a prior diagnosis of diabetes mellitus and intra- and postoperative hyperglycemia and glycemic variability. ⋯ Diabetic status and/or elevated HbA1c are predictors of postoperative glucose variability and hyperglycemia in CABG surgery patients. However, in the intraoperative period, these groups show similar glycemic responses to operative stress.
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J. Cardiothorac. Vasc. Anesth. · Oct 2011
Functional hemodynamic parameters do not reflect volume responsiveness in the immediate phase after acute myocardial ischemia and reperfusion.
Functional preload parameters such as stroke-volume variation (SVV) and pulse-pressure variation (PPV) are superior to filling pressures when assessing volume responsiveness in mechanically ventilated patients. This investigation studied their application in the setting of acute myocardial ischemia and reperfusion (I/R). ⋯ SVV and PPV did not reflect volume responsiveness in an experimental model of acute myocardial I/R.