Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2011
Review Meta AnalysisTranexamic acid is associated with less blood transfusion in off-pump coronary artery bypass graft surgery: a systematic review and meta-analysis.
Tranexamic acid reduces blood loss and transfusion in on-pump coronary artery bypass graft (CABG) surgery. Compared with on-pump, off-pump surgery is associated with less blood loss and transfusion. Therefore, tranexamic acid may be less effective for off-pump surgery, and its safety profile may be different in this setting. The aim of this study was to determine the efficacy and safety of tranexamic acid for off-pump CABG surgery. ⋯ Tranexamic acid reduces blood transfusion after off-pump surgery. Although no association with adverse events was found, the population sample size was too small to detect rare but clinically significant adverse events. A well-designed randomized controlled trial with an appropriate sample size is required to confirm tranexamic acid effectiveness and safety in off-pump CABG surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 2011
Review Meta AnalysisProtective effects of steroids in cardiac surgery: a meta-analysis of randomized double-blind trials.
Cardiac surgery and cardiopulmonary bypass (CPB) induce an acute inflammatory response contributing to postoperative morbidity. The use of steroids as anti-inflammatory agents in surgery using CPB has been tested in many trials and has been shown to have good anti-inflammatory effects but no clear clinical advantages for the lack of an adequately powered sample size. The aim of this study was to evaluate the effects of steroid treatment on mortality and morbidity after cardiac surgery. ⋯ A systematic review of RDB trials reveals that steroid prophylaxis may reduce morbidity after cardiac surgery and does not increase the risk of postoperative infections.
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J. Cardiothorac. Vasc. Anesth. · Feb 2011
Comparative Studyε-Aminocaproic acid and clinical value in cardiac anesthesia.
The primary aim was to compare the "clinical value" of tranexamic acid (TXA) with ε-aminocaproic acid (EACA) when used for blood conservation during high-risk cardiac surgery. ⋯ Considering the substantial difference in costs and with the increasing volume of high-risk cardiac surgery, EACA has increased "clinical value" when compared with TXA. EACA should be the antifibrinolytic medication of choice for high-risk cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 2011
The relationship between cerebral oxygen saturation changes and postoperative cognitive dysfunction in elderly patients after coronary artery bypass graft surgery.
The aim of this study was to evaluate the predictive value of cerebral regional oxygen saturation (rSO(2)) in the occurrence of postoperative cognitive dysfunction (POCD) in elderly patients undergoing coronary artery bypass graft (CABG) surgery. ⋯ Intraoperative cerebral oxygen desaturation is associated with early and late POCD in elderly patients. Cerebral oximetry is a promising tool in the prediction of subtle neuropsychologic deficits and further studies are needed.