Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2004
Intrathecal morphine for off-pump coronary artery bypass grafting.
To determine if preinduction intrathecal morphine is associated with successful intraoperative extubation in patients undergoing off-pump coronary artery bypass grafting. ⋯ It is concluded that intrathecal morphine is associated with a high intraoperative extubation rate in patients undergoing off-pump coronary artery bypass grafting. The authors' practice included 24-hour respiratory monitoring to detect delayed respiratory depression.
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J. Cardiothorac. Vasc. Anesth. · Aug 2004
Effects of hemodilution and phenylephrine on cerebral blood flow and metabolism during cardiopulmonary bypass.
Hypotension resulting from hemodilution on cardiopulmonary bypass is often treated by pressor (eg, phenylephrine) infusion. The effect of phenylephrine on cerebral blood flow (CBF) in this setting is not clear. It was hypothesized that phenylephrine might decrease CBF. ⋯ Phenylephrine redirects blood flow from the bowel and muscle to the brain and liver. Hemodilution increases CBF and pressor administration further increases CBF by elevating perfusion pressure. Maintenance of a higher hematocrit on CPB increases MAP and should decrease the need for vasopressor administration.
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J. Cardiothorac. Vasc. Anesth. · Aug 2004
Relationship between peripheral and central venous pressures in different patient positions, catheter sizes, and insertion sites.
To investigate the relationship between peripheral and central venous pressures in different patient positions (supine, prone, lithotomy, Trendelenburg, and Fowler), different catheter diameters (18 G and 20 G), and catheterization sites (dorsal hand and forearm) during surgical procedures. ⋯ It has been assumed that replacing central venous pressure by peripheral venous pressure would cause problems in clinical interpretation. If the validity of this data is confirmed by further studies, the authors suggest that central venous pressure could be estimated by using regression equations to compare the 2 methods.