Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2011
Comparative StudyComparison of 5 different remifentanil strategies against myocardial ischemia-reperfusion injury.
The purpose of this study was to investigate the effects of various remifentanil strategies (preconditioning, postconditioning, or continuous infusion) against myocardial ischemia-reperfusion injury. ⋯ Preconditioning or postconditioning by remifentanil and the continuous infusion of remifentanil effectively reduce myocardial infarction, whereas reperfusion targeting ischemic targeting or reperfusion targeting remifentanil does not. Remifentanil preconditioning better preserves myocardial function, especially LVDP, than other remifentanil strategies.
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J. Cardiothorac. Vasc. Anesth. · Dec 2011
Hypoactive delirium after cardiac surgery as an independent risk factor for prolonged mechanical ventilation.
The authors' intention was to evaluate the incidence of the three subtypes of delirium, the risk factors of the subtypes in cardiac surgery, and the impact of the subtypes on clinical outcomes. ⋯ Hypoactive delirium itself is a strong predictor for a longer ICU stay and a prolonged period of mechanical ventilation. Some of the risk factors related to the intraoperative and postoperative setting are suitable for preventive action.
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J. Cardiothorac. Vasc. Anesth. · Dec 2011
Multimodal brain monitoring reduces major neurologic complications in cardiac surgery.
Although adverse neurologic outcomes are common complications of cardiac surgery, intraoperative brain monitoring has not received adequate attention. The aim of the present study was to evaluate the effectiveness of multimodal brain monitoring in the prevention of major brain injury and reducing the duration of mechanical ventilation, intensive care unit, and postoperative hospital stays after cardiac surgery. ⋯ This preliminary study suggests that multimodal brain monitoring can reduce the incidence of neurologic complications as well as hospital costs associated with post-cardiac surgery patient care. Furthermore, intraoperative brain monitoring provides useful information about brain functioning, blood flow velocity, and metabolism, which may guide the anesthesiologist during surgery.
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J. Cardiothorac. Vasc. Anesth. · Dec 2011
Outcomes after rigid bronchoscopy in children with suspected or confirmed foreign body aspiration: a retrospective study.
To identify the determinants of immediate outcome after rigid bronchoscopy for suspected or confirmed foreign body (FB) aspiration. The outcome may be affected by the duration of bronchoscopy, the type of FB, the time between inhalation and removal of the FB, and the type of anesthetic induction. Arterial desaturation, bronco-laryngospasm, and the need for tracheal reintubation as complications were investigated. ⋯ Reducing the bronchoscopy time may not be an option, but an awareness of the risk of complications may prompt a more intense postanesthesia monitoring strategy.