Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 1995
Cerebral complications after cardiac surgery assessed by S-100 and NSE levels in blood.
Assessment of the value of blood analysis of the astroglia protein, S-100, and neuron-specific enolase for the detection of nervous system dysfunction after cardiac surgery. ⋯ S-100 and neuron-specific enolase levels after cardiac surgery are associated with neurologic complications. The results have implications on patient-related treatment and prognosis as well as for the development of safer perfusion techniques.
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J. Cardiothorac. Vasc. Anesth. · Dec 1995
Effects of hypothermic cardiopulmonary bypass on the pharmacodynamics and pharmacokinetics of rocuronium.
To study the influence of hypothermic cardiopulmonary bypass (CPB) on the pharmacodynamics and pharmacokinetics of rocuronium. ⋯ Hypothermic CPB prolongs the duration of action of maintenance doses and alters the plasma concentration-response relationship of rocuronium. These changes may be the result of, on the one hand, an increased sensitivity of the neuromuscular transmission and/or decreased muscle contractility and, on the other hand, the result of a reduced plasma clearance during hypothermia.
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J. Cardiothorac. Vasc. Anesth. · Dec 1995
Comparative StudyClinical estimation of left and right ventricular volume with open chest compared with transesophageal echocardiography and fast-response thermodilution.
A clinical measure--inspection of the relation of the heart (acute margin) to the diaphragm--has shown a strong positive correlation to transesophageal echocardiographic (TEE) determination of left ventricular end-diastolic area (LVEDA) during weaning from cardiopulmonary bypass (CPB). The present study examines the correlation between right ventricular end-diastolic volumes (RVEDV) before and after CPB when using the same clinical measure of left ventricular dimension. ⋯ It is concluded that there is only a weak correlation regarding RVEDV before and after CPB when the patient is transfused to the line of contact, whereas this clinical measure correlates well with LVEDA.
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J. Cardiothorac. Vasc. Anesth. · Dec 1995
Randomized Controlled Trial Comparative Study Clinical TrialEffects of dobutamine versus insulin on cardiac performance, myocardial oxygen demand, and total body metabolism after coronary artery bypass grafting.
The purpose was to study whether the hemodynamic benefit of a catabolic catecholamine (dobutamine) induces a certain oxygen cost for the myocardial energy demand and whether this effect would be less pronounced if an anabolic intervention, such as the administration of insulin, was used. ⋯ It is concluded that dobutamine as well as insulin administration increase cardiac performance. However, in contrast to dobutamine, insulin does not appear to increase myocardial oxygen demand. Therefore, the anabolic insulin administration may represent a more economic pattern of energy-consuming hemodynamic intervention than does the catabolic catecholamine administration.