Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2001
Clinical applicability of the substitution of mixed venous oxygen saturation with central venous oxygen saturation.
To examine the clinical applicability of substituting central venous oxygen saturation (ScvO2) for mixed venous oxygen saturation (SmvO2) in monitoring global tissue oxygenation. ⋯ Pulmonary artery blood sampling should not be replaced with central venous blood. Hypocapnia and increased oxygen extraction ratio seem to be the major factors that worsen the relationship between ScvO2 and SmvO2.
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J. Cardiothorac. Vasc. Anesth. · Oct 2001
Randomized Controlled Trial Clinical TrialThe effects of aprotinin and steroids on generation of cytokines during coronary artery surgery.
To compare the efficacy of aprotinin and methylprednisolone in reducing cardiopulmonary bypass (CPB)-induced cytokine release, to evaluate the effect of myocardial cytokine release on systemic cytokine levels, and to determine the influence of cytokine release on perioperative and postoperative hemodynamics. ⋯ This study showed that methylprednisolone suppresses TNF-alpha, IL-6, and IL-8 release; however, aprotinin attenuates IL-8 release alone. Methylprednisolone does not produce any additional positive hemodynamic and pulmonary effects. An improved postoperative AaDO2 was observed with the use of aprotinin.
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J. Cardiothorac. Vasc. Anesth. · Oct 2001
Less isoflurane is required after than before cardiopulmonary bypass to maintain a constant bispectral index value.
To test whether patients require less volatile anesthetic after cardiopulmonary bypass (CPB). ⋯ Because the level of surgical stimulation was relatively constant and minimal at the times of the measurements, these results are consistent with a reduced need for isoflurane after compared with before CPB.
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J. Cardiothorac. Vasc. Anesth. · Oct 2001
Subjective assessment of left ventricular preload using transesophageal echocardiography: corresponding pulmonary artery occlusion pressures.
To record pulmonary artery occlusion pressures (PAOPs) in patients whose left ventricular preload reserve was subjectively determined using transesophageal echocardiography (TEE). ⋯ In patients with well-preserved left ventricular function and normal wall thickness, preload reserve volumes subjectively determined by TEE corresponded to a range of filling pressures historically targeted to maximize cardiac performance (13 to 19 mmHg). In a subset of patients with increased wall thickness, however, subjective determination of preload reserve was associated with filling pressures that were higher than traditionally considered optimal (20 to 25 mmHg). Similarities in left ventricular fractional area change and end-diastolic area between these 2 groups suggest that patients with elevated filling pressures had decreased ventricular compliance and were managed correctly with higher than usual PAOPs.
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J. Cardiothorac. Vasc. Anesth. · Oct 2001
Comparative StudyAssessment of intrathoracic blood volume as an indicator of cardiac preload: single transpulmonary thermodilution technique versus assessment of pressure preload parameters derived from a pulmonary artery catheter.
To analyze the clinical value of a new device (PiCCO) for cardiac output measurement and volume preload parameter assessment, based on transpulmonary thermodilution technique, as an alternative to the pulmonary artery thermodilution technique and assessment of pressure preload parameters derived from the pulmonary artery catheter. ⋯ These results suggest that increased cardiac preload is more reliably reflected by ITBV than by CVP or PCWP. The assessment of ITBV by the transpulmonary single indicator dilution technique is an interesting alternative to the pressure preload parameters.