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Adult Cardiac Anesthesia

Paulo Gabriel Melo Brandão, Francisco Ricardo Lobo, Serginando Laudenir Ramin, Yasser Sakr, Mauricio Nassau Machado, Suzana Margareth Lobo
Objective: α-2-agonists cause sympathetic inhibition combined with parasympathetic activation and have other properties that could be beneficial during cardiac anesthesia. We evaluated the effects of dexmedetomidine as an anesthetic adjuvant compared to a control group during cardiac surgery. Methods: We performed a retrospective analysis of prospectively collected data from all adult patients (> 18 years old) undergoing cardiac surgery. Patients were divided into two groups, regarding the use of dexmedetomidine as an adjuvant intraoperatively (DEX group) and a control group who did not receive α-2-agonist (CON group)...
May 2016: Brazilian Journal of Cardiovascular Surgery
Torben Esser, Gerburg Keilhoff, Uwe Ebmeyer
OBJECTIVE: Our asphyxia cardiac arrest (ACA) rat model is well established. The original model was designed in the 1990(th) using halothane and nitrous oxide for pre-insult anesthesia. Because of its hepato-toxicity and its potential to induce severe liver failures, halothane is no longer used in clinical anesthesia for several years. In order to minimize the health risk for our laboratory staff as well as to keep the experimental settings of our model on a clinically oriented basis we decided to replace halothane by sevoflurane...
October 7, 2016: Brain Research
Masoud Ghorbanlo, Mahmoud Reza Mohaghegh, Forozan Yazdanian, Mehrdad Mesbah, Ziya Totonchi
BACKGROUND: The need for muscle relaxants in general anesthesia in different surgeries including cardiac surgeries, and the type of relaxant to be used considering its different hemodynamic effects on patients with heart disease can be of considerable importance. In this study, the hemodynamic effects of two muscle relaxants, Cisatracurium and Atracurium in patients whit low function of left ventricle who are candidate for open heart surgery have been considered. METHOD: This study has been designed as a randomized prospective double-blind clinical trial...
July 27, 2016: Medical Archives
João Santos, Vera Santos, Paula Gago, Nuno Cortez-Dias
Inhalatory anesthetic agents are frequently used for anesthesia maintenance. Sevoflurane is considered one of the safest regarding its cardiac effects. We report a case of a cardiac arrhythmia induced by sevoflurane in an otherwise healthy adult and discuss sevoflurane's cardiac effects.
November 2016: Journal of Clinical Anesthesia
Aly Mohamed Ahmed
The left ventricular hypertrophy (LVH) occurs in response to the hemodynamic overload in some physiological and pathological conditions. This study was designed to investigate the possible cardioprotective effect of simvastatin (SIM) treatment against isoproterenol (ISO)-induced LVH and the probable underlying mechanism in adult male Wistar rats. Animals were allocated into 4 groups. Rats of control group received normal saline orally for 30 days and intraperitoneally for the last 7 days. Rats of SIM group received SIM orally (10 mg/kg/day in saline) for 30 days...
September 26, 2016: Folia Morphologica (Warsz)
Christina Hafner, Jing Wu, Akos Tiboldi, Moritz Hess, Goran Mitulovic, Christoph Kaun, Konstantin Alexander Krychtiuk, Johann Wojta, Roman Ullrich, Eva Verena Tretter, Klaus Markstaller, Klaus Ulrich Klein
Supplemental oxygen (O2) is used as adjunct therapy in anesthesia, emergency and intensive care medicine. We hypothesized that excessive O2 levels (hyperoxia) can directly injure human adult cardiac myocytes (HACMs). HACMs obtained from the explanted hearts of transplantation patients were exposed to constant hyperoxia (95% O2), intermittent hyperoxia (alternating 10 min exposures to 5% and 95% O2), constant normoxia (21% O2), or constant mild hypoxia (5% O2) using a bioreactor. Changes in cell morphology, viability as assessed by lactate dehydrogenase (LDH) release and trypan blue (TB) staining, and secretion of vascular endothelial growth factor (VEGF), macrophage migration inhibitory factor (MIF), and various pro-inflammatory cytokines (interleukin, IL; chemokine C-X-C motif ligand, CXC; granulocyte-colony stimulating factor, G-CSF; intercellular adhesion molecule, ICAM; chemokine C-C motif ligand, CCL) were compared among treatment groups at baseline (0 h) and after 8 h, 24 h, and 72 h of treatment...
September 19, 2016: Shock
Raghuram Chava, Menekhem Zviman, Madhavan Srinivas Raghavan, Henry Halperin, Farhan Maqbool, Romergryko Geocadin, Alfredo Quinones-Hinojosa, Aravindan Kolandaivelu, Benjamin A Rosen, Harikrishna Tandri
Early induction of therapeutic hypothermia (TH) is recommended in out-of-hospital cardiac arrest (CA); however, currently no reliable methods exist to initiate cooling. We investigated the effect of high flow transnasal dry air on brain and body temperatures in adult porcine animals. Adult porcine animals (n = 23) under general anesthesia were subject to high flow of transnasal dry air. Mouth was kept open to create a unidirectional airflow, in through the nostrils and out through the mouth. Brain, internal jugular, and aortic temperatures were recorded...
September 16, 2016: Therapeutic Hypothermia and Temperature Management
Adriana D Oprea, Frederick W Lombard, Wen-Wei Liu, William D White, Jörn A Karhausen, Yi-Ju Li, Timothy E Miller, Solomon Aronson, Tong J Gan, Manuel L Fontes, Miklos D Kertai
BACKGROUND: Increased pulse pressure (PP) is an important independent predictor of cardiovascular outcome and acute kidney injury (AKI) after cardiac surgery. The objective of this study was to determine whether elevated baseline PP is associated with postoperative AKI and 30-day mortality after noncardiac surgery. METHODS: We evaluated 9125 adult patients who underwent noncardiac surgery at Duke University Medical Center between January 2006 and December 2009. Baseline arterial blood pressure was defined as the mean of the first 5 measurements recorded by the automated record keeping system before inducing anesthesia...
September 7, 2016: Anesthesia and Analgesia
Dirk Rüsch, Tilo Koch, Florian Seel, Leopold Eberhart
OBJECTIVES: Local infiltration with lidocaine is a frequently used measure to prevent pain during arterial cannulation. Its administration is associated with pain. Vapocoolants like ethyl chloride or alkanes also affect rapid-onset anesthesia. However, their administration causes less discomfort compared with administration of lidocaine. The effectiveness of vapocoolants in mitigating discomfort associated with arterial cannulation never has been studied. The authors therefore compared vapocoolant with lidocaine for reducing discomfort caused by arterial cannulation...
June 8, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Ruchika Goel, Melissa M Cushing, Aaron A R Tobian
Red blood cell transfusions are a common life-saving intervention for neonates and children with anemia, but transfusion decisions, indications, and doses in neonates and children are different from those of adults. Patient blood management (PBM) programs are designed to assist clinicians with appropriately transfusing patients. Although PBM programs are well recognized and appreciated in the adult setting, they are quite far from standard of care in the pediatric patient population. Adult PBM standards cannot be uniformly applied to children, and there currently is significant variation in transfusion practices...
October 2016: Transfusion Medicine Reviews
Pavel I Lenkin, Alexey A Smetkin, Ayyaz Hussain, Andrey I Lenkin, Konstantin V Paromov, Alexey A Ushakov, Maria M Krygina, Vsevolod V Kuzkov, Mikhail Y Kirov
OBJECTIVE: To assess the accuracy and applicability of a novel system, not requiring calibration, for continuous lactate monitoring with intravascular microdialysis in high-risk cardiac surgery. DESIGN: Single-center prospective observational study. SETTING: City Hospital #1 of Arkhangelsk, Russian Federation. PARTICIPANTS: Twenty-one adult patients undergoing elective complex repair or replacement of two or more valves or combined valve and coronary artery cardiac surgery...
April 13, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Roberto Alberto De Blasi, Stefano Romagnoli, Monica Rocco
OBJECTIVE: Blood volume reserve for venous return and the effects of cardiopulmonary bypass (CPB) on microvascular bed partitioning and blood flow were examined in patients with valvular diseases. DESIGN: Prospective, consecutive, case-control study. SETTING: Single university hospital. PARTICIPANTS: The study comprised 20 adult cardiac surgery patients and 20 healthy volunteers. INTERVENTIONS: Cardiovascular and microvascular variables were collected soon after the induction of anesthesia, after commencement of CPB, 20 minutes after separation from CPB, and in the intensive care unit...
June 3, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Yang Shen, Mei-Hua Cai, Wei Ji, Jie Bai, Yue Huang, Ying Sun, Lin Lin, Jing Niu, Ma-Zhong Zhang
BACKGROUND: Pathophysiologic changes in children with congenital heart disease may alter the effect of drugs by influencing the pharmacokinetics (PK). Considering the limited literature that describes the PK of etomidate in pediatric patients, especially in those with tetralogy of Fallot (TOF), our aim was to characterize the PK of etomidate and explore the effects of TOF. METHODS: Twenty-nine pediatric patients (15 with TOF and 14 with normal cardiac anatomy) scheduled to undergo elective surgery under general anesthesia were recruited in the study...
September 2016: Anesthesia and Analgesia
Srdjan Jelacic, Laurent Bollag, Andrew Bowdle, Cyril Rivat, Kevin C Cain, Philippe Richebe
OBJECTIVES: The authors hypothesized that intravenous acetaminophen as an adjunct analgesic would significantly decrease 24-hour postoperative opioid consumption. DESIGN: Double-blind, randomized, placebo-controlled trial. SETTING: A single academic medical center. PARTICIPANTS: The study was comprised of 68 adult patients undergoing cardiac surgery. INTERVENTIONS: Patients were assigned randomly to receive either 1,000 mg of intravenous acetaminophen or placebo immediately after anesthesia induction, at the end of surgery, and then every 6 hours for the first 24 hours in the intensive care unit, for a total of 6-1,000 mg doses...
August 2016: Journal of Cardiothoracic and Vascular Anesthesia
Philip M Jones, Daniel Bainbridge, Michael W A Chu, Philip S Fernandes, Stephanie A Fox, Ivan Iglesias, Bob Kiaii, Ronit Lavi, John M Murkin
PURPOSE: Volatile anesthetics possess cardioprotective properties, but it is unknown if the cardioprotective effects extend equally to all members of the class. Although sevoflurane is a relatively newer anesthetic than isoflurane, its introduction into practice was not preceded by a head-to-head comparison with isoflurane in a trial focusing on clinically important outcomes. Our objective was to determine whether sevoflurane was non-inferior to isoflurane on a clinically important primary outcome in a heterogeneous group of adults undergoing cardiac surgery...
October 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Valery V Likhvantsev, Giovanni Landoni, Dmitry I Levikov, Oleg A Grebenchikov, Yuri V Skripkin, Rostislav A Cherpakov
OBJECTIVE: Several studies have suggested that the cardioprotective effects of halogenated anesthetics in cardiac surgery result in reduced cardiac biomarker release compared with total intravenous anesthesia (TIVA). These findings came from relatively small randomized clinical trials and meta-analyses. The authors of this study hypothesized that the beneficial effects of volatile anesthetics translate into a reduced length of hospital stay after coronary artery bypass grafting surgery (CABG) with cardiopulmonary bypass...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
Camila Takao Lopes, Evelise Helena Fadini Reis Brunori, Agueda Maria Ruiz Zimmer Cavalcante, Sue Ann Moorhead, Juliana de Lima Lopes, Alba Lucia Bottura Leite de Barros
OBJECTIVE: To identify predictors of red blood cell transfusion (RBCT) after cardiac surgery. METHOD: A prospective cohort study performed with 323 adults after cardiac surgery, from April to December of 2013. A data collection instrument was constructed by the researchers containing factors associated with excessive bleeding after cardiac surgery, as found in the literature, for investigation in the immediate postoperative period. The relationship between risk factors and the outcome was assessed by univariate analysis and logistic regression...
December 2015: Revista da Escola de Enfermagem da U S P
Grayson A Doss, Christoph Mans, Rebecca L Stepien
Alpha2-agonist anesthetic combinations are often used in rodent anesthesia but no information about their effects on cardiac function in chinchillas exists. The purpose of this study was to utilize echocardiography to evaluate the cardiovascular effects of dexmedetomidine-ketamine anesthesia in chinchillas. Echocardiographic examinations were performed in eight adult chinchillas under manual restraint and following dexmedetomidine (0.015 mg/kg) and ketamine (4 mg/kg) administration. Dexmedetomidine-ketamine anesthesia resulted in a significantly decreased heart rate, fractional shortening, cardiac output, and flow velocity across the aortic and pulmonic valves, and significantly increased left ventricular internal diameter in systole...
July 1, 2016: Laboratory Animals
T-H Shih, C-E Huang, Y-E Lee, C-L Chen, C-H Wang, C-J Huang, K-W Cheng, S-C Wu, S-E Juang, B Jawan, S-C Yang
BACKGROUND: The aim of this study is to determine whether preoperative portal vein flow velocity or size has any correlative effect on hemodynamic changes during clamping of the inferior vena cava in liver transplantation. PATIENTS AND METHODS: A total of 42 anesthesia charts of adult patients who underwent living donor liver transplantation (LDLT) were analyzed and compared retrospectively. Preoperative portal vein (PV) flow velocity and sizes were obtained using Doppler ultrasound...
May 2016: Transplantation Proceedings
S-E Juang, C-E Huang, C-L Chen, C-H Wang, C-J Huang, K-W Cheng, S-C Wu, T-H Shih, S-C Yang, Z-W Wong, B Jawan, Y-E Lee
BACKGROUND: Hyperkalemia, defined as a serum potassium level higher than 5 mEq/L, is common in the liver transplantation setting. Severe hyperkalemia may induce fatal cardiac arrhythmias; therefore, it should be monitored and treated accordingly. The aim of the current retrospective study is to evaluate and indentify the predictive risk factors of hyperkalemia during living-donor liver transplantation (LDLT). METHODS AND PATIENTS: Four hundred eighty-seven adult LDLT patients were included in the study...
May 2016: Transplantation Proceedings
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