Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Dec 1997
Comparative StudyPlatelet concentrate effects on thromboelastography.
This study evaluated platelet effects on thromboelastography to determine how morphologically abnormal platelets affected native whole blood analysis. ⋯ Viscoelastic changes in whole blood coagulation after the addition of platelet concentrates are not dependent on morphologically intact or functionally normal platelets. This in vitro study predicts that transfusion of poorly preserved platelet concentrates as well as fresh platelets would increase clot strength on thromboelastography if the recipient's blood were tested immediately after administration.
-
J. Cardiothorac. Vasc. Anesth. · Dec 1997
Coagulation tests predict bleeding after cardiopulmonary bypass.
To determine the accuracy of coagulation profile laboratory tests, thromboelastography, and Sonoclot (SCT) values for predicting microvascular bleeding after cardiopulmonary bypass (CPB). ⋯ Contrary to previous studies, coagulation profile tests had the greatest sensitivity and specificity to differentiate patients with excessive bleeding (abnormal) from those without excessive bleeding (normal) after CPB. Therefore, these tests should be used to guide transfusion therapy in patients who have excessive bleeding after CPB.
-
J. Cardiothorac. Vasc. Anesth. · Dec 1997
The incidence of artery puncture with central venous cannulation using a modified technique for detection and prevention of arterial cannulation.
Cannulation of the central circulation is essential for management of patients who require major surgery, and for patients who are critically ill. Arterial puncture is the most frequent complication associated with central venous cannulation, and is potentially fatal. Detection of arterial puncture can be problematic, especially in patients with cyanotic congenital heart disease. ⋯ Pressure transduction of the steel needle is a useful technique for detecting arterial puncture and preventing arterial cannulation during attempts to achieve central venous cannulation.
-
J. Cardiothorac. Vasc. Anesth. · Oct 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of isoflurane and midazolam as hypnotic supplementation to moderately high-dose fentanyl during coronary artery bypass grafting: effects on systemic hemodynamics and early postoperative recovery profile.
The aim of this study was to compare isoflurane and midazolam as hypnotic adjuncts to moderately high-dose fentanyl during coronary artery bypass grafting (CABG) with regard to perioperative hemodynamics and early postoperative recovery profile. ⋯ Midazolam supplementation to fentanyl required more frequent antihypertensive escape during the pre-CPB period than isoflurane. However, more frequent cessation of isoflurane caused by hypotension was needed in the post-CPB period. No difference in awakening and ICU discharge was found.
-
J. Cardiothorac. Vasc. Anesth. · Oct 1997
Randomized Controlled Trial Clinical TrialProinflammatory cytokine release during pediatric cardiopulmonary bypass: influence of centrifugal and roller pumps.
It has been proposed that nonocclusive centrifugal pumps may elicit less blood cell trauma and hence a reduced inflammatory response than standard roller pumps. However, there have been no reports describing the impact of such pumps on proinflammatory cytokine release in pediatric cohorts. ⋯ The current study confirms the proinflammatory nature of pediatric CPB surgery, but failed to show a significant advantage of centrifugal pumping over roller perfusion in terms of the inflammatory response.