Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2011
Usefulness of monitoring platelet function by multiple electrode aggregometry in primary coronary artery bypass surgery.
Antiplatelet therapy commonly is used for the prevention of cardiovascular complications but increases the risk of perioperative bleeding. Multiple-electrode aggregometry (MEA) was investigated for monitoring platelet inhibition by acetylsalicylic acid (ASA) and clopidogrel in patients undergoing elective coronary artery bypass graft (CABG) surgery with regard to clinical outcome as measured by postoperative blood loss and transfusion requirements. ⋯ MEA is a suitable method for the detection of platelet inhibition by ASA and clopidogrel in patients undergoing CABG surgery. In these patients, preoperative ADP MEA seems to indicate patients at risk for postoperative transfusion requirements.
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J. Cardiothorac. Vasc. Anesth. · Feb 2011
Comparative StudySeizures after open heart surgery: comparison of ε-aminocaproic acid and tranexamic acid.
Although the lysine analogs tranexamic acid (TXA) and aminocaproic acid (EACA) are used widely for antifibrinolytic therapy in cardiac surgery, relatively little research has been performed on their safety profiles, especially in the setting of cardiac surgery. Two antifibrinolytic protocols using either TXA or aminocaproic acid were compared according to postoperative outcome. ⋯ Both lysine analogs are associated with significant side effects, which must be taken into account when performing risk-benefit analyses of their use. Their use should be restricted to patients at high risk for bleeding; routine use on low-risk patients undergoing standard surgeries should face renewed critical reappraisal.
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J. Cardiothorac. Vasc. Anesth. · Feb 2011
Uncalibrated arterial pulse cardiac output measurements in patients with moderately abnormal left ventricular function.
The aim of the study was to evaluate the accuracy and precision of the Vigileo/FloTrac system (Edwards Lifesciences, Irvine, CA) when compared with the intermittent cardiac output and continuous cardiac output measurements obtained from pulmonary arterial catheters in patients with moderately abnormal left ventricular function undergoing elective coronary artery bypass graft surgery. ⋯ In cardiac surgical patients with moderately abnormal left ventricular function, the Vigileo/FloTrac 2nd generation software sensor device showed mild intraoperative and postoperative agreement when compared with a pulmonary arterial catheter.
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J. Cardiothorac. Vasc. Anesth. · Feb 2011
Intrathecal lactate concentration and spinal cord injury in thoracoabdominal aortic surgery.
The aim of this study was to evaluate the role of lactate as an early predictor of spinal cord injury during thoracoabdominal aortic aneurysm repair. ⋯ This study has the potential to elucidate the time course of early lactate level elevation during thoracoabdominal aortic aneurysm repair and its clinical use in predicting the development of postoperative spinal cord injury.
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J. Cardiothorac. Vasc. Anesth. · Feb 2011
Pulse contour analysis to assess hemodynamic response to passive leg raising.
The authors evaluated the ability of 2 pulse contour cardiac output (CO) techniques to track CO changes during passive leg raising (PLR) to assess fluid loading responsiveness. ⋯ Changes in COm, COli, SVV, and PPV track COtd changes during PLR with a high degree of accuracy in sedated, ventilated, postoperative cardiac surgery patients. Changes in pulse contour CO after PLR can be used to predict fluid loading responsiveness.