Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2003
Randomized Controlled Trial Comparative Study Clinical TrialFenoldopam for renal protection in patients undergoing cardiopulmonary bypass.
To evaluate the possible protective effects of fenoldopam on renal function in patients undergoing cardiopulmonary bypass. ⋯ In this study, fenoldopam was an effective agent in the prevention of renal dysfunction after cardiopulmonary bypass.
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J. Cardiothorac. Vasc. Anesth. · Aug 2003
Comparative StudyA comparison of bleeding and transfusion in patients who undergo coronary artery bypass grafting via sternotomy with and without cardiopulmonary bypass.
To determine whether there is a difference between on-pump cardiopulmonary bypass (CABG) and off-pump coronary artery bypass grafting (OPCAB) without heparin reversal with regard to bleeding, transfusion requirements, and incidence of surgical re-exploration of the mediastinum. ⋯ Despite not reversing the heparin at the end of the OPCAB surgery, OPCAB surgery was associated with an overall reduction in allogeneic transfusion requirements.
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J. Cardiothorac. Vasc. Anesth. · Aug 2003
Comparative StudyA prospective evaluation of hemodynamic instability during off-pump coronary artery bypass surgery.
Despite recognized hemodynamic derangements during cardiac displacement, most patients appear to tolerate the off-pump procedure well. However, some patients unpredictably become hemodynamically unstable requiring emergency cardiopulmonary bypass or intra-aortic balloon pump support. After an experience of 5306 multivessel off-pump coronary artery bypasses (OPCABs), this study was undertaken to determine the factors that would identify the patients who were at a higher risk for the procedure. ⋯ Patients with low left ventricular ejection fraction <25%, myocardial infarction of <1-month duration, congestive heart failure, or preoperative hemodynamic instability constitute the high-risk group for OPCAB.
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J. Cardiothorac. Vasc. Anesth. · Aug 2003
Comparative StudyThe in vitro effects of remifentanil and fentanyl on isolated human right atria and saphenous veins.
To determine the myocardial and vascular effects of remifentanil and fentanyl in human atria and saphenous veins. ⋯ Remifentanil has no direct effect on the contraction of myocardium. Fentanyl inhibits the electrical stimulation-induced contraction in human right atrial muscles in vitro. Remifentanil and fentanyl produce "concentration-dependent" relaxation in human saphenous vein strips independent from the endothelium.
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J. Cardiothorac. Vasc. Anesth. · Aug 2003
Comparative StudyUse of deep intravenous sedation with propofol and the laryngeal mask airway during transesophageal echocardiography.
To describe the use of either deep intravenous sedation with propofol or light sedation with midazolam and topical anesthesia during transesophageal echocardiography (TEE) and to report the incidence of respiratory complications and their management. ⋯ Deep sedation with intravenous propofol can provide both excellent patient comfort and optimal conditions for TEE examination, particularly in patients who may require more lengthy procedures or in whom other techniques have failed. Although the incidence of respiratory depression was higher in patients receiving deep sedation with propofol than in patients who were lightly sedated (17.6% versus 12.5%, respectively), all six patients who had respiratory depression while under deep sedation with propofol were successfully ventilated using the LMA trade mark, without the need to remove the TEE probe and without terminating the examination prematurely. In contrast, in the one patient in the light sedation group who had respiratory depression, the TEE probe had to be removed to ventilate the patient via a face mask, and the procedure was cancelled.