Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2003
Comparative StudyComparison of thermodilution bolus cardiac output and Doppler cardiac output in the early post-cardiopulmonary bypass period.
To evaluate the accuracy of measuring cardiac output (CO) in the early post-cardiopulmonary bypass (CPB) period by comparing thermodilution with Doppler methods. ⋯ This study adds further support that DCO is a clinically acceptable method to accurately assess the CO in patients even during periods of uneven regional body temperatures as may occur in the early post-CPB period.
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J. Cardiothorac. Vasc. Anesth. · Apr 2003
High thoracic epidural anesthesia as the sole anesthetic for performing multiple grafts in off-pump coronary artery bypass surgery.
The feasibility of the use of high thoracic epidural anesthesia as a sole anesthetic in patients undergoing beating heart coronary revascularization avoiding general anesthesia was studied. ⋯ Experience confirms the feasibility of performing multiple coronary artery bypasses in conscious patients without endotracheal general anesthesia.
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J. Cardiothorac. Vasc. Anesth. · Apr 2003
Comparative StudyCardiac output measurement after coronary artery bypass grafting using bolus thermodilution, continuous thermodilution, and whole-body impedance cardiography.
To test the feasibility of continuous cardiac output (CO) monitoring with whole-body impedance cardiography after coronary artery bypass grafting and to compare the values obtained with those measured using the bolus and continuous thermodilution methods. ⋯ Agreement between whole-body impedance cardiography and bolus thermodilution is slightly inferior to that between the bolus and continuous thermodilution methods but not to the extent that it hampers the use of whole-body impedance cardiography for the continuous monitoring of CO after coronary artery bypass surgery.
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J. Cardiothorac. Vasc. Anesth. · Apr 2003
Randomized Controlled Trial Clinical TrialManagement of heparin resistance during cardiopulmonary bypass: the effect of five different anticoagulation strategies on hemostatic activation.
Attenuation of hemostatic activation is a central goal during CPB. However, this poses a problem in patients insensitive to heparin. The present investigation was performed to assess different strategies of managing patients with heparin resistance during CPB. ⋯ Activation of hemostasis during CPB in heparin-resistant patients most likely has to be attributed to stimulation of the tissue factor pathway. Even the sole use of high concentrations of UFH does not effectively inhibit this activation. Therefore, in these patients anticoagulation during CPB with UFH should be supplemented with either AT III, a short-acting direct thrombin inhibitor, or a short-acting platelet glycoprotein IIb/IIIa antagonist.
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J. Cardiothorac. Vasc. Anesth. · Apr 2003
Comparative StudyContinuous measurement of cardiac output by inert gas throughflow: comparison with thermodilution.
The throughflow method is a new technique for continuous and minimally invasive measurement of cardiac output by the Fick principle, which uses ventilation of the 2 lungs with unequal inspired gas concentrations by means of a double-lumen endobronchial tube. It exploits steady-state gas exchange and thus permits rapid repetition of measurement. ⋯ The throughflow method showed good agreement with thermodilution. It permits continuous cardiac output measurement without the need for sampling of mixed venous blood, using techniques of lung isolation, which are readily available in clinical anesthetic practice.