Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2004
Comparative Study Clinical TrialArterial versus venous sampling for activated coagulation time measurements during cardiac surgery: a comparative study.
Activated coagulation times (ACTs) are widely used for monitoring anticoagulation during cardiac surgery. Significant variability of this test is well known. Variability in test results was studied, which may arise from the sample drawing site. ⋯ During the period of systemic anticoagulation, there is great individual variability between ACT measures obtained from venous and arterial samples. Further studies are required to analyze the cause of differences at the baseline and the source of variable coagulation times after heparin.
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J. Cardiothorac. Vasc. Anesth. · Oct 2004
Clinical TrialMidlatency auditory-evoked potentials in the assessment of sedation in cardiac surgery patients.
Midlatency auditory-evoked potentials (MLAEPs) may provide an objective measure of depth of sedation. The aim of this study was to evaluate MLAEPs for measuring sedation in cardiac surgery patients. ⋯ MLAEP latencies can reflect subtle changes in auditory perception, while amplitudes seem to change with transition between deep levels of sedation.
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J. Cardiothorac. Vasc. Anesth. · Oct 2004
Transcranial Doppler emboli count predicts rise in creatinine after coronary artery bypass graft surgery.
To examine the correlation between transcranial Doppler ultrasonography-detected emboli during coronary artery bypass graft surgery with cardiopulmonary bypass and renal dysfunction as determined by the postoperative change in creatinine. ⋯ Increased numbers of Doppler-detected emboli during coronary artery bypass graft surgery are associated with postoperative renal dysfunction.
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J. Cardiothorac. Vasc. Anesth. · Oct 2004
Clinical TrialSimvastatin blunts the increase of circulating adhesion molecules after coronary artery bypass surgery with cardiopulmonary bypass.
Endothelial dysfunction has been shown to be a critical early component of organ injury after myocardial ischemia and reperfusion. Circulating levels of adhesion molecules have been regarded as a valid index of endothelial activation. Recent reports suggest that statins, widely used in the control of hypercholesterolemia, exert a protective effect on the endothelium reflected by a reduced level of circulating adhesion molecules. In this study, the effects of preoperative simvastatin treatment, at doses equivalent to those used orally for cholesterol control, were studied on plasma levels of VCAM-1, ICAM-1, and ELAM-1. ⋯ Pretreatment with simvastatin significantly reduces the increase of ICAM-1 and ELAM-1 after coronary artery bypass surgery, by a mechanism that seems not related to its efficacy in lowering cholesterol levels.
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J. Cardiothorac. Vasc. Anesth. · Oct 2004
Clinical TrialAccuracy and performance of a modified continuous intravascular blood gas monitoring device during thoracoscopic surgery.
The only commercially available continuous intravascular blood gas monitoring system for adults, the Paratrend (Diametrics Medical Inc, High Wycombe, UK), was modified by the manufacturer to the Paratrend 7+ (PT7+) in 1999. The aim of this study was to evaluate the modified probe over a wide range of blood gas and pH values during thoracoscopic surgery in a similar setup as done with the previous model. ⋯ In patients undergoing thoracoscopic surgery with rapidly changing blood gas parameters, the PT7+ device is a valuable trend indicator and hence may be helpful for clinical decision making. However, the underestimation of PO(2) values by 20 mmHg on average and the wide limits of agreement documented in this study must be regarded as limiting factors.