Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2006
Clinical TrialRenal dysfunction after thoracic aortic surgery requiring deep hypothermic circulatory arrest: definition, incidence, and clinical predictors.
The purpose of this study was to evaluate renal dysfunction (RD) after thoracic aortic surgery (TAS) requiring deep hypothermic circulatory arrest (DHCA), to determine the influence of definition on RD after TAS-DHCA, to determine univariate predictors of RD after TAS-DHCA, and to determine multivariate predictors for RD TAS-DHCA. RD was defined in 3 ways: (1) >25% reduction in creatinine clearance, (2) >50% increase in serum creatinine, and (3) >50% increase in serum creatinine with an abnormal peak serum creatinine (>1.3 mg/dL for men and >1.0 mg/dL for women). ⋯ Although RD after TAS-DHCA varies substantially because of definition, it is still very common. Its multivariate predictors merit further focused research to enhance perioperative protection of the kidney.
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J. Cardiothorac. Vasc. Anesth. · Oct 2006
Use of cardiopulmonary bypass for lung transplantation: a 10-year experience.
The use of cardiopulmonary bypass (CPB) for lung transplantation (LTx) has been reported previously. This study reports the authors' experience of planned and unplanned use of cardiopulmonary bypass for LTx. ⋯ Scheduled and unscheduled CPB for LTx are associated with an increased mortality at 1 month and 1 year.
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J. Cardiothorac. Vasc. Anesth. · Oct 2006
Hemodynamic effects of lidocaine in the thoracic paravertebral space during one-lung ventilation for thoracic surgery.
There is increasing interest in the use of the thoracic paravertebral block (TPVB) in association with general anesthesia for lung-resection surgery. The aim of the study was to evaluate the hemodynamic effects of a 5-mg/kg lidocaine bolus injected in the thoracic paravertebral space during one-lung ventilation (OLV) in noncardiac patients undergoing thoracic surgery. ⋯ In noncardiac patients, TPVB is associated with good hemodynamic stability, despite a small and transient decrease in myocardial contractility that could be related to the drug's systemic effects after its absorption.
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J. Cardiothorac. Vasc. Anesth. · Oct 2006
Assessment of thoracic epidural analgesia during general anesthesia using pupillary reflex dilation: a preliminary study.
Pupillary reflex dilation (PRD) secondary to noxious stimulation accurately predicts sensory block during combined lumbar epidural/general anesthesia. Therefore, the adequacy of PRD-guided thoracic epidural infusion during general anesthesia for thoracotomy was studied. ⋯ PRD-guided continuous thoracic epidural analgesia under low-dose remifentanil/propofol anesthesia is feasible and ensures good postoperative analgesia.