Abstract:
OBJECTIVE:To study adult patients in the immediate postoperative period after cardiac surgery and determine whether cardiac output (CO) and systemic vascular resistance (SVR) are generally within normal limits and whether clinical assessment of CO provides an adequate approximation to guide treatment. DESIGN:Prospective study. SETTING:Overnight intensive recovery unit, St Thomas' Hospital, London. PARTICIPANTS:Fifty patients who had undergone cardiac surgery within the previous 5 hours and whose COs were not being measured. INTERVENTIONS:The physician (if present) or nurse managing the patient was asked to make a clinical estimate (as low, normal, or high) of CO and of SVR. CO was measured by lithium dilution. The clinically estimated values were compared with the measured values, after adjusting for patient size. MEASUREMENTS AND MAIN RESULTS:In 29 of 50 (58%) patients, cardiac index (CI) (20 of 50 [40%] patients) or systemic vascular resistance index (SVRI) (22 of 50 [44%] patients) was outside normal limits (CI, 2.7 (plus minus 30%) L/min/m(2); SVRI, 2,500 (plus minus 30%) dyne center dot sec center dot cm(minus sign 5)/m(2)). When CI was outside the normal range, the clinical estimate was usually wrong (13 of 20 [65%]); when SVRI was outside the normal range, the clinical estimate was also usually wrong (16 of 22 [73%]). CONCLUSIONS:In the early postoperative period after cardiac surgery, clinical assessment of the circulatory state is frequently misleading, and there should be a low threshold for measuring CO.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Linton RA,Linton NW,Kelly Fdoi
10.1053/jcan.2002.29631keywords:
subject
Has Abstractpub_date
2002-02-01 00:00:00pages
4-7issue
1eissn
1053-0770issn
1532-8422pii
ajcan0160004journal_volume
16pub_type
杂志文章abstract:OBJECTIVES:The use of monitored anesthesia care (MAC) for transcatheter aortic valve replacement (TAVR) is gaining favor in the United States, although general anesthesia (GA) continues to be common for these procedures. Open surgical cutdown for transfemoral TAVR has been a relative contraindication for TAVR with MAC ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.05.036
更新日期:2019-01-01 00:00:00
abstract::Patients with abdominal aortic aneurysms (AAA) have a high incidence of associated cardiac disease. If a patient presents with both severe coronary artery disease and a large AAA, a staged procedure of cardiac surgery (CS) followed by AAA resection may present too great a risk of aneurysm rupture and death. A combined...
journal_title:Journal of cardiothoracic and vascular anesthesia
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doi:10.1016/1053-0770(94)90163-5
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:To compare outcomes and cost of off-pump coronary artery bypass (OP-CAB) surgery versus cardiopulmonary bypass-assisted coronary artery bypass graft (CABG) surgery. DESIGN:Retrospective review. SETTING:A tertiary care university teaching hospital. PARTICIPANTS:Patients (n = 300) undergoing isolated CABG su...
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doi:10.1053/jcan.2002.31053
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:To assess the value of gastric intramucosal pH measurement in patients with low output after cardiac surgery. DESIGN:Prospective clinical study. SETTING:University hospital. PARTICIPANTS:Fifteen patients with low output after cardiac surgery were included. Those who survived the first postoperative day (n ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(97)90211-1
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVES:To identify the prevalence of and risk factors for inadvertent hypothermia after procedures performed with procedural sedation and analgesia in a cardiac catheterization laboratory. DESIGN:A single-center, prospective observational study. SETTING:A tertiary-care private hospital in Australia. PARTICIPANTS...
journal_title:Journal of cardiothoracic and vascular anesthesia
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doi:10.1053/j.jvca.2015.06.002
更新日期:2015-10-01 00:00:00
abstract::Patients undergoing cardiovascular surgery may be exposed to heparin before surgery, during cardiopulmonary bypass (CPB), or in the immediate postoperative period. For this reason, cardiovascular surgery patients are at increased risk for heparin-induced thrombocytopenia (HIT), occurring in 1 to 3% of patients. The di...
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pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2018.10.035
更新日期:2019-02-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1053/j.jvca.2014.05.028
更新日期:2015-02-01 00:00:00
abstract::Complications associated with pulmonary artery catheters (PACs) include interpretation errors, insertion problems, sepsis, thrombosis, and dysrhythmias. Alternatives to the use of PACs include the central venous pressure catheter, measurement of cardiac output by thoracic electrical bioimpedance, gastric tonometry and...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 评论,杂志文章,评审
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更新日期:1998-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-11-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,随机对照试验
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更新日期:2011-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1053/j.jvca.2010.03.009
更新日期:2010-12-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/1053-0770(93)90094-2
更新日期:1993-08-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
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更新日期:2017-10-01 00:00:00
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doi:10.1016/s1053-0770(99)90219-7
更新日期:1999-08-01 00:00:00
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pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s1053-0770(03)00200-3
更新日期:2003-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1016/1053-0770(92)90011-u
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVE:Mechanical stress during one-lung ventilation (OLV) results in lung injury. This study compared the effects of mechanical ventilation, OLV, and surgical manipulation on diffuse alveolar damage (DAD) after application of different anesthetic regimens. DESIGN:Prospective, randomized, controlled, blinded animal...
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更新日期:2010-08-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章
doi:10.1016/1053-0770(93)90167-j
更新日期:1993-08-01 00:00:00
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pub_type:
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更新日期:2020-12-13 00:00:00
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pub_type: 杂志文章
doi:10.1053/j.jvca.2013.12.003
更新日期:2014-06-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
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更新日期:1998-08-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1991-10-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
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更新日期:1998-10-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
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更新日期:2003-04-01 00:00:00
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journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(96)80055-3
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVES:To understand whether different anesthesia and analgesia methods affected the incidence of chronic postsurgical pain (CPSP) in patients who underwent uniportal video-assisted lung surgery and to explore the influence factors of CPSP. DESIGN:Retrospective study. SETTING AND PARTICIPANTS:A total of 120 patie...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.10.046
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To describe the use of either deep intravenous sedation with propofol or light sedation with midazolam and topical anesthesia during transesophageal echocardiography (TEE) and to report the incidence of respiratory complications and their management. DESIGN:Retrospective study from March 2000 through August ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(03)00147-2
更新日期:2003-08-01 00:00:00
abstract:OBJECTIVE:To investigate the cardioprotective effect of the continuous administration of dexmedetomidine using serum cardiac troponin I (cTnI) and creatine kinase MB (CK-MB) concentrations as biomarkers during off-pump coronary artery bypass grafting (OPCAB) surgery. DESIGN:A prospective, randomized, parallel-group co...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1053/j.jvca.2015.06.026
更新日期:2016-01-01 00:00:00