Revista española de anestesiología y reanimación
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Rev Esp Anestesiol Reanim · Aug 2005
Case Reports[Limitations of transesophageal ultrasound in the assessment of intracardiac masses: a case report].
A 72-year-old man who had been treated for 20 years with warfarin for auricular fibrillation was scheduled for resection of a sessile mass (3.5 x 4 cm) on the posterior wall of the left atrium and a smaller mass (1.5 x 2 cm) in the right atrium. The masses were diagnosed by transthoracic ultrasonography and computed tomography. After anesthetic induction, a tube was inserted for transesophageal ultrasound guidance during resection of the masses. ⋯ The smaller, mobile, pediculated mass attached to the right free wall of the atrium or to the tricuspid valve was also confirmed. Given these findings and the patient's history, differential diagnosis with either biatrial myxoma or thrombus was considered. After opening both atria, an organized thrombus in the left atrium and a large hypertrophic trabecula in the trabeculated portion of the right atrium was found to be responsible for the misleading ultrasonographic image suggesting masses.
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Rev Esp Anestesiol Reanim · Aug 2005
Randomized Controlled Trial Comparative Study Clinical Trial[Hemodynamic effects of levosimendan following cardiac surgery].
The hemodynamic effect of levosimendan was compared to that of dobutamine in a trial enrolling 30 adults undergoing scheduled cardiac surgery with cardiopulmonary bypass. Fifteen patients were randomly assigned to receive levosimendan in a single dose of 18 microg x kg(-1) followed in 15 to 20 minutes by start of infusion at a rate of 0.2 microg x kg(-1) min(-1) for 24 hours (levosimendan group). Another 15 randomized patients received dobutamine infused at a rate of 7.5 microg x kg(-1) min(-1). ⋯ We found that mean arterial pressure and both systemic and pulmonary vascular resistance decreased significantly in the levosimendan group (P < 0.05), but not in the dobutamine group. On the other hand, both heart rate and cardiac index increased in the levosimendan group only (P < 0.05). We conclude that levosimendan improves hemodynamic stability in patients who have undergone cardiac surgery and that it is a good alternative for treating postoperative low cardiac output syndrome.
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Rev Esp Anestesiol Reanim · Aug 2005
Case Reports[Intubation with the GlideScope videolaryngoscope in a man with severe cervical spondylolisthesis].
We describe a new videolaryngoscopic device designed for use in cases of difficult airway. The device consists of a plastic blade with a video camera located halfway along its length. A mounted light source assembly means that bleeding ocurring in the airway will not obstruct the view. ⋯ We report the case of a 56-year-old man who underwent surgery for severe cervical spondylolisthesis. We describe a modified approach to managing the videolaryngoscope that facilitated maneuvering and intubation and that offers an effective alternative to techniques with other devices. The advantages and disadvantages reported in the literature are reviewed.