Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 1991
Systolic and diastolic pressure-volume relationships during cardiac surgery.
Seven patients undergoing elective coronary artery bypass surgery were studied to assess left ventricular (LV) performance by pressure-volume loops. LV pressure was measured by micromanometry and instantaneous LV volume by a conductance catheter. Continuous pressure-volume relationships were determined during preload reduction before and after cardiopulmonary bypass (CPB). ⋯ From pre-CPB to post-CPB, Ees increased in three patients with a decrease of V75 in two patients, and Ees decreased in four patients with a concomitant increase in V75. Ed increased significantly (P less than 0.01) following CPB, demonstrating a decrease of ventricular distensibility. It is concluded that continuous measurement of LV pressure-volume relationships using the conductance catheter is feasible and may be a useful tool to estimate LV performance during cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Dec 1991
Comparative StudyLeft ventricular end-systolic pressure estimated from measurements in a peripheral artery.
Aortic and radial arterial pressure measurements were compared after cannulation and before cardiopulmonary bypass in 26 patients scheduled for coronary artery bypass grafting. The radial artery blood pressure range was 89 to 147 mm Hg systolic and 44 to 75 mm Hg diastolic. A difference was found between the central and peripheral dicrotic notch pressures, the former being 7.9 +/- 2.7 (SD) mm Hg higher than the latter. ⋯ The mean difference was -0.15 mm Hg with a 95% confidence interval of -1.2 to 0.9 mm Hg. It was not possible to calculate peak systolic aortic pressure with the same accuracy from the systolic and diastolic pressure measurements in the radial artery. It is concluded that left ventricular end-systolic pressure measured as the aortic dicrotic notch pressure can be calculated from the dicrotic notch pressure in the radial artery with reasonable accuracy.
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J. Cardiothorac. Vasc. Anesth. · Dec 1991
Randomized Controlled Trial Comparative Study Clinical TrialAnesthesia for elective cardioversion: a comparison of four anesthetic agents.
Elective cardioversion is a short procedure performed under general anesthesia for the treatment of cardiac dysrhythmias. Selection of the anesthetic agent is important, because a short duration of action and hemodynamic stability are required. Forty-four patients scheduled for elective cardioversion in the coronary care unit were studied prospectively. ⋯ Etomidate produced myoclonus and pain on injection; however, it was the only agent that did not decrease arterial blood pressure. Thiopental reduced blood pressure but otherwise seemed an appropriate anesthetic for this procedure. In conclusion, all four anesthetic agents were acceptable for cardioversion, although their pharmacological differences suggest specific indications for individual patients.