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
ReviewThe year in cardiothoracic and vascular anesthesia: selected highlights from 2010.
The aortic valve treatment revolution continues with the maturation of aortic valve repair and the dissemination of transcatheter aortic valve implantation. The recent publication of comprehensive multidisciplinary guidelines for diseases of the thoracic aorta has assigned important roles for the cardiovascular anesthesiologist and perioperative echocardiographer. Although intense angiotensin blockade improves outcomes in heart failure, it might further complicate the maintenance of perioperative systemic vascular tone. ⋯ Furthermore, the development and evaluation of pediatric-specific ventricular assist devices likely will revolutionize the mechanical management of pediatric heart failure. A multidisciplinary review has highlighted the priorities for future perioperative trials in congenital heart disease. These pervasive developments likely will influence the future training models in pediatric cardiac anesthesia.
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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.