Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2007
Comparative StudyEvaluation of partial carbon dioxide rebreathing cardiac output measurement during thoracic surgery.
Noninvasive partial CO2 rebreathing (NICO; Novametrix Medical Systems, Inc, Wallingford, CT) is a relatively new alternative to thermodilution (TDCO) for measurement of cardiac output. This study compares the 2 methods during thoracic surgery and one-lung ventilation. ⋯ There was a moderate agreement between cardiac output measurements obtained with the NICO and TDCO. The present data suggest that the NICO technique may be useful during thoracic surgery.
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J. Cardiothorac. Vasc. Anesth. · Oct 2007
Comparative StudyUncalibrated arterial pulse contour analysis versus continuous thermodilution technique: effects of alterations in arterial waveform.
To compare an arterial pressure-derived cardiac output (APCO) (Vigileo software version 1.07; Edwards Lifesciences, Irvine, CA) and a thermodilution cardiac output (CCO) as methods for measuring cardiac output under different pathologic and experimental conditions that induce changes in arterial waveform morphology. ⋯ Cardiac output measurement based on uncalibrated pulse contour analysis is able to reflect cardiac output measured with the continuous thermodilution method in patients undergoing uncomplicated coronary artery surgery. However, in situations in which the arterial pressure waveform is changed, agreement between techniques may be altered and data obtained with uncalibrated pulse contour analysis may become less reliable.
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J. Cardiothorac. Vasc. Anesth. · Oct 2007
Comparative StudyThe level of cardiac output affects the relationship and agreement between pulmonary artery and transpulmonary aortic thermodilution measurements in an animal model.
The authors investigated the relationship between pulmonary artery and transpulmonary aortic thermodilution cardiac output measurements under conditions of increasing cardiac output (CO). ⋯ The authors concluded that the amount of CO differentially affects the relationship between aortic and PAC thermodilution CO. TL and recirculation may be the explanation for this finding.
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J. Cardiothorac. Vasc. Anesth. · Oct 2007
Global end-diastolic volume as a variable of fluid responsiveness during acute changing loading conditions.
Dynamic variables of preload such as stroke volume variation (SVV) have been shown to be good predictors of fluid responsiveness. They are, however, not applicable during spontaneous breathing and cardiac arrhythmias. Volumetric variables of preload, such as global end-diastolic volume (GEDV) and left ventricular end-diastolic area (LVEDA), might be alternative variables of preload to guide fluid administration. Therefore, the present study was designed to evaluate whether GEDV and LVEDA are suitable parameters of preload and fluid responsiveness during rapidly changing loading conditions. ⋯ In this animal model, GEDV and LVEDA were superior to SVV in accurately reflecting hemorrhage. However, GEDV and SVV but not LVEDA were suitable to predict fluid responsiveness.
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J. Cardiothorac. Vasc. Anesth. · Oct 2007
Dexmedetomidine produces dual alpha2-adrenergic agonist and alpha1-adrenergic antagonist actions on human isolated internal mammary artery.
To investigate the direct effects of dexmedetomidine (DEX) on isolated human internal mammary artery (IMA). ⋯ These data suggest that DEX causes contraction by activating alpha2-adrenoceptors at lower concentrations, but it may also activate alpha1-adrenoceptors at higher concentrations in IMA. The action of DEX on phenylephrine-induced contraction may be related to an alpha1-adrenoceptor antagonistic effect produced via partial alpha1-adrenoceptor agonistic action.