Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Oct 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the effects of sodium nitroprusside and isoflurane during rewarming on cardiopulmonary bypass.
Afterdrop in core temperatures after discontinuation of cardiopulmonary bypass (CPB) is reported to be a sign of inadequate total body rewarming on CPB. The purpose of this study was to compare the effects of three different drug regimens on hemodynamic stability and the uniformity of rewarming during the rewarming period of CPB. ⋯ Isoflurane produced more stable hemodynamic conditions than SNP during the rewarming period, improved the uniformity of rewarming, and permitted earlier extubation in the intensive care unit (ICU). It is concluded that isoflurane alone is capable of fulfilling the anesthesia needs during hypothermia and the rewarming period of CPB.
-
J. Cardiothorac. Vasc. Anesth. · Oct 1997
Randomized Controlled Trial Clinical TrialOral transmucosal fentanyl citrate as an additional premedicant for adult cardiac surgery patients.
To investigate the efficacy of a combination of midazolam and oral transmucosal fentanyl citrate (OTFC) as a preoperative medication for adult cardiac surgery patients compared with the use of midazolam alone. ⋯ The OTFC Oralet provides effective analgesia and sedation when combined with midazolam for invasive catheter placement in adult cardiac surgery patients. The OTFC Oralet with its gradual onset lessens the possibility of overmedicating with fentanyl, and it offers a very acceptable mode of delivery for a preemptive analgesic.
-
J. Cardiothorac. Vasc. Anesth. · Oct 1997
Letter Case ReportsChoice of double-lumen tube in Kartagener's syndrome.
-
Switching from two-lung to one-lung ventilation would be expected to have large effects on lung mechanical properties, and these effects may depend on tidal volume and respiratory frequency. These changes in lung mechanics with one-lung ventilation may be similar to pulmonary edema. Deteriorating lung mechanics during pulmonary edema have been attributed to a loss of ventilated lung units. Therefore, changes in lung mechanics caused by one-lung ventilation were measured and compared with those previously seen during pulmonary edema. ⋯ The lack of tidal volume dependence in EL and lack of large-frequency dependence in RL during one-lung ventilation are inconsistent with changes induced by severe pulmonary edema. Although decreases in ventilatable lung volume may contribute to increases in lung elastance, other characteristics of mechanical behavior during one-lung ventilation differ from those of pulmonary edema; therefore, other additional mechanisms must be involved in determining lung mechanical properties during severe pulmonary edema.
-
J. Cardiothorac. Vasc. Anesth. · Aug 1997
The effects of cardiopulmonary bypass on total and unbound plasma concentrations of propofol and midazolam.
To examine the effects of cardiopulmonary bypass (CPB) on total and unbound plasma concentrations of propofol and midazolam when administered by continuous infusion during cardiac surgery. ⋯ Unbound concentrations of propofol and midazolam are not affected by cardiopulmonary bypass. Total intravenous anesthesia algorithms do not need to be changed to achieve stable unbound plasma concentrations when initiating CPB.