Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2000
Postcardiopulmonary bypass hypoxemia: a prospective study on incidence, risk factors, and clinical significance.
To evaluate the clinical significance of low arterial oxygen tension-inspired oxygen concentration (PaO2-FIO2) ratio, as a measure of hypoxemia, in the early period after cardiac surgery with cardiopulmonary bypass (CPB); and to evaluate the preoperative, intraoperative, and postoperative factors contributing to the development of hypoxemia within the first 24 hours after cardiac surgery with CPB. ⋯ This study shows that despite improvements in the technique of CPB, hypoxemia depicted by low PaO2-FIO2 ratios is common in patients after CPB. It is short lived, however, and has minimal effect on the postoperative clinical course of these patients.
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J. Cardiothorac. Vasc. Anesth. · Oct 2000
Randomized Controlled Trial Clinical TrialLidocaine for prevention of reperfusion ventricular fibrillation after release of aortic cross-clamping.
To determine the efficacy of a bolus of lidocaine administered by way of the pump before releasing the aortic cross-clamp (ACC) in preventing the occurrence of reperfusion ventricular fibrillation. ⋯ The results suggest that a bolus of 100 mg of lidocaine administered 2 minutes before release of the ACC can safely decrease the incidence of reperfusion ventricular fibrillation and is associated with better hemodynamics after weaning from cardiopulmonary bypass.
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J. Cardiothorac. Vasc. Anesth. · Oct 2000
Postoperative atrial tachyarrhythmias in patients undergoing coronary artery bypass graft surgery without cardiopulmonary bypass: a role for intraoperative magnesium supplementation.
To determine if intraoperative magnesium supplementation would be associated with a reduction in postoperative atrial tachyarrhythmias (POAT) in patients undergoing coronary artery bypass grafting (CABG) surgery without cardiopulmonary bypass (off-pump CABG surgery). ⋯ Intraoperative magnesium supplementation is associated with a decrease in POAT after off-pump CABG surgery. The combination of a beta-blocker and magnesium may reduce POAT further. It is recommended that intraoperative magnesium supplementation be part of the care of patients undergoing off-pump CABG surgery.
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J. Cardiothorac. Vasc. Anesth. · Oct 2000
Temporal synthesis and release of endothelin within the systemic and myocardial circulation during and after cardiopulmonary bypass: relation to postoperative recovery.
To determine endothelin levels in arterial, pulmonary, and myocardial vascular compartments in patients undergoing coronary artery bypass graft surgery and to examine the influence of endothelin on postoperative recovery. ⋯ Endothelin levels after CPB remained persistently increased for at least 24 hours after surgery and were associated with increased myocardial production of endothelin. These results suggest that the increased endothelin observed in the early postoperative period may contribute to a complex recovery from coronary artery bypass graft surgery.
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J. Cardiothorac. Vasc. Anesth. · Aug 2000
Randomized Controlled Trial Comparative Study Clinical TrialSevoflurane-fentanyl versus etomidate-fentanyl for anesthetic induction in coronary artery bypass graft surgery patients.
To compare the hemodynamic effects of sevoflurane-fentanyl with etomidate-fentanyl during anesthetic induction in patients with coronary artery disease with good left ventricular function. ⋯ Sevoflurane inhalation induction produced minimal changes in cardiac index and no airway complications in patients with coronary artery disease with good left ventricular function. Induction was faster with etomidate, however, and blood pressure remained higher.