Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2010
Changing from aprotinin to tranexamic acid results in increased use of blood products and recombinant factor VIIa for aortic surgery requiring hypothermic arrest.
Aprotinin, once used to reduce allogeneic blood product transfusion during cardiac surgery, was withdrawn from the market in late 2007 over concerns of causing increased mortality. This study was undertaken to determine what, if any, the impact of changing antifibrinolytic agents (from aprotinin to tranexamic acid) for deep hypothermic circulatory arrest cases would have on blood bank resource utilization. ⋯ Patients treated with tranexamic acid required more clotting factors than the control group receiving aprotinin.
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J. Cardiothorac. Vasc. Anesth. · Dec 2010
History of post-traumatic stress disorder is associated with impaired neuropsychometric performance after coronary artery surgery.
To determine if preoperative history of post-traumatic stress disorder (PTSD) is associated with postoperative cognitive impairment. ⋯ The current findings suggest that patients with a history of PTSD undergoing coronary artery surgery using cardiopulmonary bypass may be especially vulnerable to postoperative cognitive impairment.
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J. Cardiothorac. Vasc. Anesth. · Dec 2010
Outcome in patients who require venoarterial extracorporeal membrane oxygenation support after cardiac surgery.
The authors analyzed hospital mortality in adult cardiac surgery patients who required postoperative venoarterial extracorporeal membrane oxygenation (ECMO) support for circulatory failure and identified perioperative patient variables associated with hospital mortality in these patients. ⋯ Venoarterial ECMO support after cardiac surgery was required in a small fraction of patients and was associated with very high hospital mortality; but among those requiring ECMO, mortality in these patients was lower in younger, nondiabetic patients with cardiogenic shock who had shorter CPB times. The mortality associated patient variables identified are not easily modifiable and do not appear sufficiently robust to define which patients should be selected for this potentially life-saving therapy.
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J. Cardiothorac. Vasc. Anesth. · Dec 2010
Preoperative statin treatment is associated with reduced postoperative mortality after isolated cardiac valve surgery in high-risk patients.
The aim of the present study was to assess the influence of preoperative statin therapy on postoperative mortality in high-risk patients after isolated valve surgery. ⋯ This study suggests that preoperative statin therapy may have a potential beneficial effect on postoperative mortality after isolated cardiac valve surgery in high-risk cardiovascular patients.