Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2006
Cardiac output estimation with a new Doppler device after off-pump coronary artery bypass surgery.
To compare cardiac output (CO), stroke volume (SV), and cardiac index (CI) as estimated with a new, noninvasive Doppler device (Ultrasonic Cardiac Output Monitor [USCOM]; USCOM Ltd, Sydney, Australia) with those measured with the bolus thermodilution (TD) technique. ⋯ This study showed excellent agreement between the values for CO, SV, and CI as determined with USCOM and TD. Since there was only 1 time period for CO estimation in each patient with both methods, the stability of this correlation needs to be further investigated over time.
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J. Cardiothorac. Vasc. Anesth. · Jun 2006
Randomized Controlled TrialLevosimendan or milrinone in the type 2 diabetic patient with low ejection fraction undergoing elective coronary artery surgery.
The purpose of this study was to compare the hemodynamic profiles and the postoperative insulin requirements in 2 groups of type 2 diabetic patients with depressed myocardial function who underwent elective surgery for coronary artery disease and who received levosimendan or milrinone for postcardiopulmonary bypass low-output syndrome. ⋯ Levosimendan was more efficient than milrinone for treating the hemodynamic manifestations of the postcardiopulmonary bypass low-output syndrome. However, all the values in the milrinone treatment group were normalized. In this small population, both treatment groups had similar postoperative insulin requirements.
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J. Cardiothorac. Vasc. Anesth. · Jun 2006
Clinical outcomes of low-risk patients undergoing beating-heart surgery with or without pulmonary artery catheterization.
For patients who undergo off-pump coronary artery bypass (OPCAB) surgery, pulmonary artery catheterization (PAC) has been proposed as a useful intraoperative monitoring tool. This study was designed to determine if the choice of PAC versus central venous pressure monitoring (CVP) had any effect on outcome after OPCAB. This study compared these 2 methods of hemodynamic monitoring in low-risk patients undergoing beating-heart surgery via a median sternotomy and evaluated their effect on morbidity and in-hospital mortality. ⋯ This single-institution, retrospective study suggests that in low-risk patients undergoing beating-heart surgery, CVP monitoring may be sufficient.
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J. Cardiothorac. Vasc. Anesth. · Jun 2006
Wedging the pulmonary artery catheter: changes in left atrial and pulmonary artery pressures and risk for perforation.
Clinical and experimental data indicate that when there is lung disease, wedging the pulmonary artery catheter (PAC) could cause decreases in cardiac output and systemic arterial blood pressure and an increase in mean pulmonary artery pressure (PAP). The authors studied whether wedging would alter mean left atrial pressure (LAP), and report perforations with PACs in their unit since 1975. ⋯ In adult patients undergoing cardiac surgery, wedging of a PAC resulted in a small decrease in mean LAP and a small increase in mean PAP. The wedging maneuver carries a small risk. How wedging is performed could influence the risk for perforation.
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J. Cardiothorac. Vasc. Anesth. · Jun 2006
The impact of intra-aortic balloon pumping on cardiac output determination by pulmonary arterial and transpulmonary thermodilution in pigs.
The aim of this study was to evaluate the impact of intra-aortic balloon pumping (IABP) on the comparison of simultaneous measurements of cardiac output via pulmonary arterial and transpulmonary thermodilution (PiCCO; Pulsion Medical Systems, Munich, Germany). ⋯ Transpulmonary thermodilution is suitable for cardiac output measurement during IABP. Hence, in critically ill patients with cardiac pump failure, blood flow may be determined as accurately with the less-invasive transpulmonary method as with the traditional pulmonary arterial thermodilution one.