Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2008
Comparative StudyContinuous monitoring of central venous oxygen saturation (Pediasat) in pediatric patients undergoing cardiac surgery: a validation study of a new technology.
Mixed venous oxygen saturation and central venous oxygen saturation are considered possible indicators of the adequacy of oxygen delivery with respect to the oxygen needs of critically ill adult and pediatric patients. The present study was aimed at validating the accuracy of a new technology (Pediasat central venous catheter) in providing a continuous measurement of the central venous oxygen saturation in pediatric patients. ⋯ Because of the minimal bias and the acceptable value of percentage error, the Pediasat may be considered as an accurate tool for the continuous measurement of the central venous oxygen saturation in neonates and pediatric patients during and after cardiac operations.
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J. Cardiothorac. Vasc. Anesth. · Dec 2008
Comparative StudyTransesophageal echocardiography utilization in high-volume liver transplantation centers in the United States.
Transesophageal echocardiography (TEE) during liver transplantation (LT) has been shown to be helpful in managing fluid therapy, monitoring myocardial function, and identifying intraoperative LT complications. The present study sought to investigate the current utilization of TEE by anesthesiologists during LT as well as issues of training and credentialing in this monitoring modality. ⋯ There is high utilization of intraoperative TEE by anesthesiologists to perform limited-scope examinations during LT cases. Training to perform such examinations is mostly informal, and credentialing processes are lacking. An opportunity exists to establish guidelines, training programs, and standards for quality assurance in the use of this valuable monitoring modality.
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J. Cardiothorac. Vasc. Anesth. · Dec 2008
Comparative StudyCardiopulmonary bypass duration is an independent predictor of morbidity and mortality after cardiac surgery.
The aim of this study was to determine if there is a direct relationship between the duration of cardiopulmonary bypass (CPB time [CPBT]) and postoperative morbidity and mortality in patients undergoing cardiac surgery. ⋯ Prolonged CPB duration independently predicts postoperative morbidity and mortality after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Dec 2008
Comparative StudyCentral venous oxygen saturation cannot replace mixed venous saturation in patients undergoing cardiac surgery.
It has been argued that venous oxygen saturation from a central venous catheter (ScvO(2)) could be an inexpensive alternative to mixed venous oxygen saturation (SvO(2)). The aim was to evaluate whether ScvO(2) measurements could replace SvO(2) readings after cardiac surgery and to analyze factors influencing any differences found. ⋯ The ScvO(2) and SvO(2) measurements are not interchangeable, and, especially in patients undergoing aortic valve surgery, this lack of agreement is crucial. However, the present data indicate that ScvO(2) may be used in CABG patients, although it is not completely accurate in terms of absolute venous saturations. A low SAT, low hemoglobin, or low cardiac index increased the venous gap.