Journal of cardiothoracic and vascular anesthesia
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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
Dose-response relationship between plasma ionized calcium concentration and thrombelastography.
To establish the threshold value for calcium at which coagulation commenced and to investigate the range over which changes in ionized calcium influenced coagulation. ⋯ Ca(2+) of <0.33 mmol/L is necessary to prevent coagulation. Ca(2+) > 0.56 is unlikely to be the cause of coagulation abnormalities during surgical procedures in which calcium metabolism is deranged. Between these values, Ca(2+) may exert an effect on the rate of clot formation, but final clot strength should be unaffected.