Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2003
Comparative StudyThe relationship between the diameters of the adult cricoid ring and main tracheobronchial tree: a cadaver study to investigate the basis for double-lumen tube selection.
Previous investigation of the adult cadaver larynx has shown that the cricoid diameter never exceeds that of the glottis. This further analysis looks at the anatomic relationships between the diameter of the cricoid ring and those of the main tracheobronchial tree to discover how they relate to double-lumen tube selection. ⋯ The dimensions of the cricoid ring best define those of the main bronchi. Knowing its diameter should assist anesthesiologists with double-lumen tube selection.
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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
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
Randomized Controlled Trial Clinical TrialHeparin-coated versus uncoated extracorporeal circuit in patients undergoing coronary artery bypass graft surgery.
To assess the effect of heparin-coated circuits on bleeding, transfusion, and platelet count in patients undergoing primary coronary artery bypass grafting with full heparinization. ⋯ The use of a heparin-coated or uncoated cardiopulmonary bypass circuit and full heparinization marginally reduced only red blood cell transfusion but was not associated with platelet sparing or reduced perioperative bleeding.