Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2007
Biography Historical ArticlePioneering cardiac anesthesia: the life and work of Emerson Moffitt, MD.
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J. Cardiothorac. Vasc. Anesth. · Apr 2007
Randomized Controlled TrialEffects of hemodilution on outcome after modified Blalock-Taussig shunt operation in children with cyanotic congenital heart disease.
Cyanotic congenital heart diseases (CCHD) with secondary polycythemia and hyperviscosity state are associated with a reduction in blood flow, stagnation of blood, and thrombosis. Sufficient hemodilution in cyanotic children results in higher blood flow and significant reductions in perioperative blood loss. The aim of this study was to investigate similar beneficial effects of hemodilution in preventing shunt thrombosis and decreasing postoperative blood loss after modified Blalock-Taussig (BT) shunt operations in children with CCHD. ⋯ Hemodilution in CCHD patients undergoing modified BT shunt surgery has beneficial effects including improved shunt patency because of higher blood flow through the graft and less postoperative blood loss, which may be attributed to the lower viscosity produced by hemodilution.
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J. Cardiothorac. Vasc. Anesth. · Apr 2007
Controlled Clinical TrialExtravasation of albumin after cardiopulmonary bypass in newborns.
The systemic inflammatory response to cardiopulmonary bypass (CPB) possibly increases microvascular permeability to plasma proteins, leading to capillary leak syndrome. The study was conducted to elucidate any protein leakage in newborns using Evans blue dye as tracer. ⋯ In contrast to the expectation, the escape rate of Evans blue, reflecting the extravasation of albumin, was not increased after CPB. However, reduced COP, hypothermia, and also a reduced lymphatic drainage may contribute to edema formation. The present data do not support the hypothesis of a capillary leak after CPB in newborns.
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J. Cardiothorac. Vasc. Anesth. · Apr 2007
Comparative StudyUniversal leukocyte reduction of transfused red cells does not provide benefit to patients undergoing cardiac surgery.
A policy of universal leukocyte reduction of the blood supply in Finland was implemented at the beginning of 2003. The aim of the present evaluation was to determine the potential role of leukocyte-reduced red blood cells in decreasing postoperative infections. ⋯ No beneficial effect of the universal leukocyte reduction in cardiac surgery was found for culture-positive infection rates, 90-day mortality, or length of intensive care stay.
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J. Cardiothorac. Vasc. Anesth. · Apr 2007
Perioperative serum interleukins in neonates with hypoplastic left-heart syndrome and transposition of the great arteries.
The primary study objective was to examine the impact of diagnosis on the inflammatory response in neonates with congenital heart disease undergoing cardiac surgery. The secondary objective was to study the impact of the inflammatory response on postoperative outcome in these neonates. ⋯ All neonates with TGA or HLHS have a significant inflammatory response after CPB. Neonates with HLHS have evidence of an activated inflammatory response before CPB, which remains significant in the postoperative period. Accelerated interleukin expression and an abnormal cytokine balance correlate with longer time to extubation, longer ICU length of stay, and increased peritoneal fluid volume.