Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Aug 2011
Randomized Controlled TrialEffects of different doses of remifentanil infusion on hemodynamics and recovery in children undergoing pediatric diagnostic cardiac catheterization.
The present study aimed to compare 2 different doses of remifentanil infusion on hemodynamics, recovery period, and complications in children undergoing diagnostic pediatric cardiac catheterization. ⋯ After oral midazolam premedication and local prilocaine infiltration, 0.2 μg/kg/min of remifentanil provided adequate sedation without any hemodynamic compromise during pediatric diagnostic cardiac catheterization.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2011
ReviewRecent advances in chronic thromboembolic pulmonary hypertension.
Surgical excellence in pulmonary thromboendarterectomy (PTE) for chronic thromboembolic pulmonary hypertension (CTEPH) has begun to spread around the world. The perioperative mortality for this procedure is typically under 10%. The maximal benefit from PTE is derived in those patients who have a high proximal clot burden that is surgically accessible, as outlined by the Jamieson classification. ⋯ Prolonged mechanical ventilation after PTE remains common in part because of reperfusion pulmonary edema. Careful perioperative management can reduce the incidence of this syndrome. Because ventilator-associated pneumonia is also a common complication after PTE, it represents a major opportunity for outcome improvement, particularly because there are multiple modalities for its prevention and prompt diagnosis.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2011
Vasopressin deficiency and vasodilatory state in end-stage liver disease.
Relative vasopressin deficiency, a contributor to vasodilatory septic shock, also may be a cause of the vasodilatory state in liver disease. This study assessed endogenous vasopressin levels in patients with liver disease and their hemodynamic response to exogenous vasopressin. ⋯ Patients with liver disease have lower vasopressin levels than controls and respond with a brisk vasoconstrictor response to exogenous vasopressin. Therefore, relative endogenous vasopressin deficiency may contribute to vasodilatory shock in liver disease similar to what has been observed in septic shock.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2011
Incidence- and mortality-related risk factors of acute kidney injury requiring hemofiltration treatment in patients undergoing cardiac surgery: a single-center 6-year experience.
To evaluate the incidence and mortality risk factors of severe acute kidney injury (AKI) requiring hemofiltration treatment after cardiac surgery. ⋯ The risk of developing severe AKI depended on the type of cardiac surgical procedure. Thirty-day mortality was associated with severe perioperative circulation impairment or bleeding, but overall long-term mortality was additionally predicted by age, postoperative myocardial infarct, and preoperative circulation status.