Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2016
Randomized Controlled Trial Multicenter StudySevoflurane Versus Total Intravenous Anesthesia for Isolated Coronary Artery Bypass Surgery with Cardiopulmonary Bypass: A Randomized Trial.
Several studies have suggested that the cardioprotective effects of halogenated anesthetics in cardiac surgery result in reduced cardiac biomarker release compared with total intravenous anesthesia (TIVA). These findings came from relatively small randomized clinical trials and meta-analyses. The authors of this study hypothesized that the beneficial effects of volatile anesthetics translate into a reduced length of hospital stay after coronary artery bypass grafting surgery (CABG) with cardiopulmonary bypass. ⋯ Anesthesia with sevoflurane reduced cardiac biomarker release and length of hospital stay after CABG with cardiopulmonary bypass surgery compared with propofol-based TIVA with a possible reduction in 1-year mortality.
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J. Cardiothorac. Vasc. Anesth. · Oct 2016
Increasing Occurrence of Postoperative Atrial Fibrillation in Contemporary Cardiac Surgery.
Patients referred for cardiac surgery are increasingly older, with a higher prevalence of significant comorbidities and undergoing more extensive surgery. The aim of the study was to ascertain the incidence and presentation of postoperative atrial fibrillation in contemporary patients. ⋯ The authors report high, 10% to 20% greater than previously described, occurrence of postoperative atrial fibrillation in contemporary patients undergoing cardiac surgery. Most patients with postoperative atrial fibrillation experienced prolonged duration or recurrence of the arrhythmia. The type of surgery, advanced age, and previous atrial fibrillation were the most important risk factors.
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J. Cardiothorac. Vasc. Anesth. · Oct 2016
Observational StudyA Pharmacokinetic Model for Protamine Dosing After Cardiopulmonary Bypass.
This study investigated postoperative hemostasis of patients subjected to conventional protamine dosing compared with protamine dosing based on a pharmacokinetic (PK) model following cardiopulmonary bypass. ⋯ This study showed that patient-tailored protamine dosing based on a PK model was associated with a reduction in protamine dosing, with better hemostatic test results when compared with fixed-ratio protamine dosing.
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J. Cardiothorac. Vasc. Anesth. · Oct 2016
A Score for Predicting Acute Kidney Injury after Coronary Artery Bypass Graft Surgery in an Asian Population.
To develop a scoring system to predict acute kidney injury in Asian patients after coronary artery bypass grafting. ⋯ The Singapore Acute Kidney Injury score is a simple way to predict, at the time of admission to the intensive care unit, an Asian patient's risk of developing acute kidney injury after coronary artery bypass surgery.