Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2015
Review Meta AnalysisLevosimendan Treatment for Heart Failure: A Systematic Review and Meta-Analysis.
Emerging studies suggest that administration of levosimendan therapy may be better than dobutamine or placebo in decompensated heart failure. The authors performed an updated meta-analysis of trials to obtain the best estimates of the efficacy and safety of levosimendan for the initial treatment of decompensated heart failure. ⋯ As compared to placebo or dobutamine, levosimendan in patients with heart failure seemed to have hemodynamic and cardiac benefits. It reduced total mortality and was associated with an increased risk of cardiovascular adverse events.
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J. Cardiothorac. Vasc. Anesth. · Dec 2015
Observational StudyUrinary Neutrophil Gelatinase-Associated Lipocalin as Predictor of Short- or Long-Term Outcomes in Cardiac Surgery Patients.
To determine the ability of urinary neutrophil gelatinase-associated lipocalin (uNGAL) to predict cardiac surgery-associated acute kidney injury (CSA-AKI), continuous renal replacement therapy (CRRT), mortality, and a composite outcome of major adverse kidney events at 365 days (MAKE365), and to investigate the influence of cardiopulmonary bypass (CPB) on NGAL release. ⋯ uNGAL had a limited predictive ability for CSA-AKI or other relevant clinical outcomes after cardiac surgery and appeared to be more closely related to the use and duration of CPB. Thus, its levels may represent the aggregate effect of an inflammatory response to CPB as well as a renal response to cardiac surgery and inflammation.
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J. Cardiothorac. Vasc. Anesth. · Dec 2015
Observational StudyPulmonary Artery Acceleration Time in Cardiac Surgical Patients.
To examine the potential for using pulmonary Doppler to assess the hydraulic forces opposing right ventricular ejection in a perioperative setting. ⋯ Flow reversal occurred frequently in the main pulmonary artery. AT in the right pulmonary artery yielded the best correlation with invasive hemodynamic parameters that were strengthened in patients with elevated PCWP. The addition of a PCWP measurement improved the reliability of AT in this patient population.