Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 1992
ReviewCon: whole blood transfusions are not useful in patients undergoing cardiac surgery.
Data supporting fresh whole blood transfusion or fresh component therapy are nonblinded, and although both are conceptually attractive, neither can be considered proven. Recent blinded studies reflect fresh blood ineffectiveness. ⋯ Proven methods of blood conservation as well as standardized criteria for transfusion of blood components will more effectively decrease homologous blood transfusion. Transfusion of fresh or banked whole blood, or its components, has yet to be shown to decrease the usage of homologous blood products.
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J. Cardiothorac. Vasc. Anesth. · Dec 1992
Continuous intra-arterial oximetry, pulse oximetry, and co-oximetry during cardiac surgery.
This study evaluated arterial catheter oximetry versus pulse oximetry in eight patients (ASA III-IV) who underwent cardiac surgery. Co-oximeter saturation values served as the standard. Arterial oxygen saturation was determined simultaneously with these three methods at 162 prospectively defined points of measurement before, during, and after cardiopulmonary bypass (CPB). ⋯ The standard deviations of the individual differences between readings of catheter or pulse oximetry and readings of co-oximetry (= precision) were +/- 0.5% to +/- 1.0% for catheter oximetry and +/- 1.0% to +/- 1.2% for pulse oximetry. In summary, catheter oximetry was superior to pulse oximetry with regard to obtaining readings and to reliability of the obtained readings. Invasiveness and high costs influence the decision as to whether to use catheter oximetry, but if reliable and precise measurements of saturation are important at any time during surgery, pulse oximetry is an insufficient method and co-oximetry is a time-consuming method of analysis, whereas catheter oximetry is quick, reliable, and precise.