Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2004
Randomized Controlled Trial Clinical TrialOpioid-sparing effects of diclofenac and paracetamol lead to improved outcomes after cardiac surgery.
This study assessed the analgesic efficacy, side effects, time to extubation, and oxygenation of 3 analgesic regimens after coronary artery bypass surgery using diclofenac, paracetamol, and placebo suppositories. ⋯ Diclofenac alone or with paracetamol has a significant opioid-sparing effect after CABG, producing more rapid extubation and better oxygenation.
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J. Cardiothorac. Vasc. Anesth. · Dec 2004
Clinical TrialImproving glycemic control in the cardiothoracic intensive care unit: clinical experience in two hospital settings.
Recent studies suggest that strict perioperative glycemic control improves clinical outcomes after cardiothoracic surgery. However, optimal methods and targets for controlling blood glucose (BG) levels in this setting have not been established. Currently published intensive insulin infusion protocols (IIPs) have important practical limitations, which may affect their utility. In this article, the authors present their experience with a safe, effective, nurse-driven IIP, which was implemented simultaneously in 2 cardiothoracic intensive care units (CTICUs). ⋯ The IIP safely and effectively improved glycemic control in 2 CTICUs, with minimal hypoglycemia. Based on prior studies showing the benefits of strict glycemic control, the implementation of this IIP should help to reduce morbidity and mortality in CTICU patients.
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J. Cardiothorac. Vasc. Anesth. · Dec 2004
Randomized Controlled Trial Clinical TrialEffects of amiodarone and thoracic epidural analgesia on atrial fibrillation after coronary artery bypass grafting.
This study was designed to assess the effects of a perioperative dosing regimen of amiodarone administration, high thoracic epidural anesthesia (TEA), or a combination of the 2 regimens on atrial fibrillation (AF) after coronary artery bypass grafting (CABG). ⋯ The perioperative amiodarone regimen used in this study was effective in reducing the incidence of AF after CABG while TEA was not.
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J. Cardiothorac. Vasc. Anesth. · Dec 2004
Comparative Study Clinical TrialOff-pump versus on-pump coronary artery bypass surgery and postoperative pulmonary dysfunction.
To investigate how off-pump coronary artery bypass grafting (CABG) affects postoperative pulmonary function when compared with on-pump CABG. ⋯ Off-pump CABG does not confer major protection from postoperative pulmonary dysfunction compared with CABG surgery with CPB. Strategies for minimizing pulmonary impairment after CABG surgery should be directed to factors other than the use of CPB.
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J. Cardiothorac. Vasc. Anesth. · Dec 2004
Alterations of mesenteric blood flow after cardiopulmonary bypass: a Doppler sonographic study.
Mesenteric ischemia after cardiopulmonary bypass is a serious complication associated with high mortality. It was the aim of this study to investigate mesenteric blood flow with the help of Doppler sonography in asymptomatic patients before and after cardiopulmonary bypass and cardiac surgery. ⋯ The postoperative changes in the flow velocities and the increases of the resistive and pulsatility index are indications of rigidity of the mesenteric vascular bed and decreased mesenteric perfusion after cardiopulmonary bypass.