Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 1998
Randomized Controlled Trial Comparative Study Clinical TrialPleural bupivacaine placement for optimal postthoracotomy pulmonary function: a prospective, randomized study.
To determine dependent chest tube losses of bupivacaine with paravertebral versus interpleural administration, thereby helping to explain the significant differences in pulmonary function that exist between these two techniques. ⋯ Local anesthetic on the diaphragm might actively impair respiratory function through diaphragmatic and abdominal muscle weakness, while failing to contribute to pain relief.
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J. Cardiothorac. Vasc. Anesth. · Apr 1998
Randomized Controlled Trial Comparative Study Clinical TrialPropofol-based versus fentanyl-isoflurane-based anesthesia for cardiac surgery.
To evaluate drug costs, time of mechanical ventilation, complications, and hospital length of stay comparing propofol-based with fentanyl-isoflurane-based anesthesia. ⋯ Fentanyl-isoflurane provides an inexpensive anesthetic that permits as prompt an extubation as propofol, thus conserving resources for other patients.
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J. Cardiothorac. Vasc. Anesth. · Apr 1998
Randomized Controlled Trial Clinical TrialThe effect of etomidate induction on plasma cortisol levels in children undergoing cardiac surgery.
To investigate the effect of a single induction dose of etomidate on plasma cortisol and adrenocorticotrophic hormone (ACTH) levels in pediatric patients with congenital heart disease. ⋯ These results show that etomidate is a suitable agent for suppressing the increase in cortisol levels associated with the stress response caused by cardiopulmonary bypass in children with congenital heart defects, and can be used safely.
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J. Cardiothorac. Vasc. Anesth. · Apr 1998
Comparative StudyThe interaction between applied PEEP and auto-PEEP during one-lung ventilation.
To investigate the relationship between applied external positive end-expiratory pressure (PEEP) and auto-PEEP and the resultant total PEEP experienced by the patient during one-lung ventilation (OLV). ⋯ The change in end-expiratory pressure experienced by the ventilated lung during OLV when external PEEP is applied depends on the preexisting level of auto-PEER This may explain some of the inconsistencies in the clinical results of application of external PEEP during OLV. The total PEEP delivered to the patient should be measured whenever external PEEP is applied during OLV.
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J. Cardiothorac. Vasc. Anesth. · Apr 1998
Respiratory mechanics and gas exchange during one-lung ventilation for thoracic surgery: the effects of end-inspiratory pause in stable COPD patients.
To examine the effects of end-inspiratory pause (EIP) of different durations on pulmonary mechanics and gas exchange during one-lung ventilation (OLV) for thoracic surgery. ⋯ During the period of OLV in the lateral position of patients with preexisting pulmonary hyperinflation, the magnitude of PEEPi increased and oxygenation decreased significantly, whereas the efficacy of ventilation was not changed by the addition of an end-inspiratory pause to the ventilatory pattern. Because arterial oxygenation is affected by the presence of pulmonary hyperinflation, the method of ventilation should take into account the magnitude of preoperative pulmonary hyperinflation.