Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 1998
Teaching successful central venous cannulation in infants and children: audio Doppler versus anatomic landmarks.
To determine if vein localization with an audio Doppler increases successful central venous cannulation and decreases complications in infants and children when performed by inexperienced operators, compared with vein localization by anatomic landmarks (ALs). ⋯ Vein localization by audio Doppler significantly increases the rate of successful central venous cannulation and decreases the number of needle passes in pediatric patients when used by inexperienced operators.
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J. Cardiothorac. Vasc. Anesth. · Oct 1998
Perioperative cardiovascular morbidity in patients with coronary artery disease undergoing vascular surgery after percutaneous transluminal coronary angioplasty.
Patients with coronary artery disease (CAD) who undergo noncardiac surgery are at increased risk for perioperative myocardial infarction (PMI). Undergoing successful coronary artery bypass grafting (CABG) before such surgery has been shown to decrease perioperative cardiac morbidity and mortality. Percutaneous transluminal coronary angioplasty (PTCA) is an alternative treatment for these patients. Perioperative cardiac morbidity in patients with CAD who underwent PTCA before their vascular surgery was reviewed. ⋯ High-risk cardiac patients undergoing vascular surgery who have had PTCA performed up to 18 months preoperatively have a low incidence of perioperative cardiac morbidity. Prophylactic PTCA may be beneficial in patients with CAD who are at high risk for perioperative cardiac complications.
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J. Cardiothorac. Vasc. Anesth. · Oct 1998
Ischemic liver dysfunction after elective repair of infrarenal aortic aneurysm: incidence and outcome.
To assess the frequency of early postoperative liver dysfunction in patients undergoing elective infrarenal aortic aneurysm repair, their hospital course, and outcome. ⋯ Liver enzyme levels acutely increased in 1.5% of patients after elective infrarenal aortic aneurysm repair with infrarenal cross-clamping. In patients with moderately elevated serum liver enzyme levels, postoperative recovery was relatively uncomplicated, whereas all three patients with AIH developed acute renal failure and had a more complicated postoperative course. Those with postoperative liver dysfunction had a longer duration of intraoperative hypotension and more pronounced metabolic acidosis.
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J. Cardiothorac. Vasc. Anesth. · Aug 1998
Comparative StudySafety and efficacy of early extubation of elderly coronary artery bypass surgery patients.
Early extubation and fast-track management protocols on younger, low-risk patients result in shorter hospital stays and decreased costs. The impact of such protocols on elderly patients undergoing coronary artery bypass graft (CABG) surgery is not presently known. ⋯ This study confirms the safety and efficacy of early extubation among elderly patients undergoing CABG. Elderly patients have more comorbid conditions, yet a significant number can be extubated early, with resultant shortened LOSs.
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J. Cardiothorac. Vasc. Anesth. · Aug 1998
Effect of mild hypothermia during cardiopulmonary bypass on erythrocytic hemoglobin oxygen delivery.
To observe and define the degree of change in hemoglobin oxygen affinity induced by hypothermic extracorporeal circulation (ECC). ⋯ Mild hypothermia to 32 degrees C during ECC does not result in in vivo alterations in oxyhemoglobin dissociation and thus does not induce changes in oxygen delivery to peripheral tissues. However, oxygen usage appears to be markedly increased after cardiopulmonary bypass.