Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2001
Randomized Controlled Trial Comparative Study Clinical TrialNormothermic versus hypothermic cardiopulmonary bypass during repair of congenital heart disease.
To compare normothermic cardiopulmonary bypass (CPB) versus hypothermic CPB in pediatric patients undergoing repair of congenital heart disease with focus on biochemical markers for brain damage. ⋯ No difference was found in the release of brain-specific proteins between normothermic and hypothermic CPB, but blood loss was higher after normothermic CPB.
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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
Comparative StudyComparison of bioimpedance versus thermodilution cardiac output during cardiac surgery: evaluation of a second-generation bioimpedance device.
To compare a second-generation thoracic electrical bioimpedance (TEB) hemodynamic monitoring system with the clinically used pulmonary artery catheter thermodilution (TD-PAC) system. ⋯ TEB reporting of cardiac index during coronary artery surgery generally agreed with TD-PAC cardiac index except at the end of the case (time 4).
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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.