Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2007
Review Meta AnalysisDesflurane and sevoflurane in cardiac surgery: a meta-analysis of randomized clinical trials.
The authors performed a meta-analysis to investigate whether the cardioprotective effects of volatile anesthetics translate into decreased morbidity and mortality in patients undergoing cardiac surgery. ⋯ Desflurane and sevoflurane have cardioprotective effects that result in decreased morbidity and mortality. The present data show for the first time that the choice of an anesthetic regimen based on administration of halogenated anesthetics is associated with a better outcome after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Aug 2007
Randomized Controlled Trial Comparative StudyComparison of the modulatory effects of four different fast-track anesthetic techniques on the inflammatory response to cardiac surgery with cardiopulmonary bypass.
To test the hypothesis that the choice of anesthesia technique for coronary artery surgery influences the degree and magnitude of the subsequent inflammatory response and its consequences. ⋯ Supplementation of a fast-track anesthetic technique with epidural analgesia preserves hemodynamic stability and is associated with faster extubation times (p = 0.003) and less postoperative pain (p = 0.045). Thoracic epidural analgesia was associated with significantly higher levels of IL-6 throughout the study period as compared with the total intravenous anesthesia groups. The exact clinical relevance of this finding remains unclear.
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J. Cardiothorac. Vasc. Anesth. · Aug 2007
Comparative StudyTransmitral flow propagation velocity and assessment of diastolic function during abdominal aortic aneurysm repair.
In the perioperative arena, pronounced changes in cardiac loading conditions can make assessment of diastolic parameters difficult. A number of Doppler techniques have been introduced to assess perioperative diastolic function. ⋯ Vp assessment identified the majority (93%) of cases of diastolic dysfunction identified by traditional methods. Furthermore, the incidence of diastolic dysfunction increased with application of the AXC but returned to baseline after removal.
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J. Cardiothorac. Vasc. Anesth. · Aug 2007
Comparative StudyKaolin-based activated coagulation time measured by sonoclot in patients undergoing cardiopulmonary bypass.
In vivo data for the kaolin-based ACT test from the Sonoclot Analyzer (SkACT, Sienco Inc, Arvada, CO) are lacking. The aim of this study was to compare SkACT with an established kaolin-based ACT from Hemochron (HkACT) and anti-Xa activity in patients undergoing cardiopulmonary bypass (CPB). ⋯ Accuracy and performance of SkACT and HkACT were comparable for heparin monitoring in patients undergoing CPB for elective cardiac surgery. However, both tests were affected significantly after initiating CPB and aprotinin infusion.