Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2001
Endotoxin-neutralizing capacity of serum from cardiac surgical patients.
To determine if endotoxin core antibody (EndoCAb) from the serum of cardiac surgical patients neutralizes endotoxin in an ex vivo biologic assay. ⋯ Anti-EndoCAbs of both classes (IgM and IgG) were able to neutralize lipopolysaccharide from a clinically relevant bacterium in an ex vivo model. Neither Igm nor IgG appeared to be more capable of neutralization in this model. These antibodies did not completely predict neutralization capacity; other endogenous factors in human serum must be capable of lipopolysaccharide neutralization.
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J. Cardiothorac. Vasc. Anesth. · Aug 2001
Randomized Controlled Trial Comparative Study Clinical TrialTarget-controlled infusion or manually controlled infusion of propofol in high-risk patients with severely reduced left ventricular function.
To compare hemodynamics, time to extubation, and costs of target-controlled infusion (TCI) with manually controlled infusion (MCI) of propofol in high-risk cardiac surgery patients. ⋯ In patients with severely reduced left ventricular function, TCI and MCI of propofol in combination with remifentanil showed similar hemodynamics. TCI patients needed inotropic support more often than MCI-treated patients. Although extubation time was longer in TCI patients and costs were higher, both anesthesia techniques can be recommended for early extubation after implantation of a cardioverter-defibrillator.
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J. Cardiothorac. Vasc. Anesth. · Aug 2001
Randomized Controlled Trial Clinical TrialEffect of C1-esterase-inhibitor on capillary leak and inflammatory response syndrome during arterial switch operations in neonates.
To determine if prophylactic administration of C1-esterase-inhibitor would have a beneficial effect on postoperative weight gain and the inflammatory response in neonates undergoing cardiac surgery with cardiopulmonary bypass (CPB). ⋯ Prophylactic application of C1-esterase-inhibitor in neonates undergoing arterial switch operations produces less inflammatory response compared with placebo. This difference may have contributed to improved clinical parameters, including less weight gain postoperatively.
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J. Cardiothorac. Vasc. Anesth. · Aug 2001
Randomized Controlled Trial Clinical TrialDoes isoflurane optimize myocardial protection during cardiopulmonary bypass?
To investigate the possible myocardial protective effect of isoflurane during aortic cross-clamp and cardioplegic cardiac arrest in patients undergoing conventional coronary artery bypass graft surgery. ⋯ The present report suggests that administration of isoflurane before aortic cross-clamping in patients undergoing coronary artery bypass graft surgery may optimize the myocardial protective effect of cardioplegia. Isoflurane may be particularly advantageous whenever prolonged periods of aortic cross-clamping or inadequate delivery of cardioplegia is expected.
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J. Cardiothorac. Vasc. Anesth. · Aug 2001
Randomized Controlled Trial Clinical TrialMyocardial lactate production is not involved in the ischemic preconditioning mechanism in coronary artery bypass graft surgery patients.
To study the relationship between ischemic preconditioning (IP) and lactate production and their impact on coronary artery bypass graft surgery patients. ⋯ The IP effects do not include modulation of lactate production. IP induces lactate production, but it seems not to be involved in the triggering process.