Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 1998
Vectorcardiographic changes as predictors of cardiac complications during major vascular surgery.
To elucidate the relation of changes in computerized vectorcardiographic trend parameters indicating perioperative myocardial ischemia with perioperative cardiac complications. ⋯ Vectorcardiographic signs of myocardial ischemia were significantly increased intraoperatively, but most pronounced postoperatively in the patients subsequently suffering cardiac events. The changes could be related to the individual cardiac morbidity with acceptable precision. Thus, continuous vectorcardiographic monitoring may be beneficial for patients at risk of developing perioperative ischemia.
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J. Cardiothorac. Vasc. Anesth. · Feb 1998
Estimation of the pulmonary capillary wedge pressure from transesophageal pulsed Doppler echocardiography of pulmonary venous flow: influence of the respiratory cycle during mechanical ventilation.
Pulsed Doppler measurement of pulmonary venous flow (PVF) in the left superior pulmonary vein has been suggested as a noninvasive method to evaluate pulmonary capillary wedge pressure (PCWP). In previous studies, PVF was measured at end-expiration, and it is unknown to what extent PVF is affected by the respiratory cycle. It is hypothesized that phasic variations of PVF during mechanical ventilation may be used to estimate PCWP. ⋯ It has been documented that PVF velocity is influenced by the respiratory cycle during mechanical ventilation in patients undergoing cardiac surgery, and the magnitude of this variation is influenced by PCWP. However, it is not actually possible to predict PCWP accurately using these findings. Further studies are needed in which preload is varied acutely to confirm the usefulness of the results.
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J. Cardiothorac. Vasc. Anesth. · Dec 1997
Randomized Controlled Trial Clinical TrialA pump-prime aprotinin dose in cardiac surgery: appraisal of its effects on the hemostatic system.
To examine pump-prime aprotinin action on coagulation and fibrinolysis in patients undergoing primary coronary revascularization. ⋯ Pump-prime aprotinin minimized, even if not completely inhibited, the activation of coagulation and fibrinolysis during CPB, possibly ensuring a less complicated and safer postoperative recovery. It seemed to allow the maintenance of a correct balance of hemostatic systems, avoiding the risk of thrombotic phenomena.
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J. Cardiothorac. Vasc. Anesth. · Dec 1997
Comparative StudyComparison of the effects of red cell separation and ultrafiltration on heparin concentration during pediatric cardiac surgery.
To determine the effects of red cell separation and ultrafiltration on heparin concentration. ⋯ The plasma concentration of heparin increased after veno-venous modified UF of the patient. Heparin concentration also increased after UF of residual CPB circuit blood. In contrast, circuit blood hemoconcentrated by CS contained minimal heparin, and, when infused, did not increase patient's heparin concentration. ACT and thrombin time did not correlate with heparin concentration.