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
Randomized Controlled TrialMyocardial protection with isoflurane during off-pump coronary artery bypass grafting: a randomized trial.
To analyze the hemodynamic effects and myocardial injury using troponin-T and creatine phosphokinase (CPK-MB) with isoflurane and compare it with a control group in patients undergoing off-pump coronary artery bypass (OPCAB) surgery. ⋯ Isoflurane provides protection against myocardial damage in a clinically used dosage as documented by lower levels of troponin-T in patients undergoing OPCAB surgery.
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J. Cardiothorac. Vasc. Anesth. · Feb 2011
Randomized Controlled TrialThe effect of nasogastric tube application during cardiac surgery on postoperative nausea and vomiting--a randomized trial.
Postoperative nausea and vomiting (PONV) are significant morbidities following cardiac surgery. The purpose of this study was to determine if application of a nasogastric (NG) tube during cardiac surgery can reduce the prevalence of postoperative PONV. ⋯ Use of an NG tube during cardiac surgery may reduce the incidence of postoperative vomiting.
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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.
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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.