Abstract:
OBJECTIVE:Controversial results exist on the effects of spinal analgesia in cardiac surgery. The authors conducted a review of randomized studies to show whether there are any advantages in clinically relevant outcomes using spinal analgesia in patients undergoing cardiac surgery. DESIGN:Meta-analysis. SETTING:Multiple hospitals. PARTICIPANTS:A total of 1,106 patients from 25 randomized trials. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULT:PubMed, BioMedCentral, CENTRAL, EMBASE, Cochrane Central Register of Controlled Trials, and conference proceedings were searched (updated January 2009) for randomized trials that compared general anesthesia with an anesthetic plan including spinal analgesia in cardiac surgery. Four independent reviewers performed data extraction, with divergences resolved by consensus. A total of 1,106 patients from 25 randomized studies were included in the analysis. Overall analysis showed that there were no differences in terms of mortality (2/562 [0.4%] in the spinal group v 2/514 [0.4%] in the control arm [risk difference (RD) = 0.00 [-0.02, +0.02], p = 1.0), perioperative myocardial infarction (9/421 [2.1%] in the spinal group v 11/407 [2.7%] in the control arm [RD = 0.00, -(0.03, +0.02), p = 0.77), and the length of hospital stay (WMD = -0.28 days [-0.68, -0.13], p = 0.18, with 419 included patients). CONCLUSIONS:This analysis indicated that spinal analgesia does not improve clinically relevant outcomes in patients undergoing cardiac surgery, discouraging further randomized controlled trials on this topic even if changes in techniques, devices, and drugs could modify the outlook of the comparison between spinal and standard anesthesia in this setting.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Zangrillo A,Bignami E,Biondi-Zoccai GG,Covello RD,Monti G,D'Arpa MC,Messina M,Turi S,Landoni Gdoi
10.1053/j.jvca.2009.07.002subject
Has Abstractpub_date
2009-12-01 00:00:00pages
813-21issue
6eissn
1053-0770issn
1532-8422pii
S1053-0770(09)00266-3journal_volume
23pub_type
杂志文章,meta分析abstract::Tissue edema, in particular pulmonary edema, increasingly is recognized as a perioperative complication affecting outcome. Management strategies directed at avoiding excessive fluid administration, reducing inflammatory response, and decreasing capillary permeability commonly are advocated in perioperative care protoc...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2017.02.018
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVES:To investigate the association between adenosine diphosphate (ADP)-induced platelet aggregation measured by single-platelet count testing and postoperative blood loss in clopidogrel-treated patients with acute coronary syndromes undergoing coronary artery bypass grafting (CABG). DESIGN:Prospective observati...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2013.10.007
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVES:Helium produces preconditioning by activating prosurvival kinases, but the roles of reactive oxygen species (ROS) or mitochondrial adenosine triphosphate-regulated potassium (K(ATP)) channels in this process are unknown. The authors tested the hypothesis that ROS and mitochondrial K(ATP) channels mediate hel...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2008.04.005
更新日期:2008-08-01 00:00:00
abstract:OBJECTIVE:To re-evaluate the effects of perioperative beta-blockade on mortality and major outcomes after surgery. DESIGN:A meta-analysis of parallel randomized, controlled trials published in English. SETTING:A university-based electronic search. PARTICIPANTS:Patients undergoing surgery. INTERVENTIONS:Two interven...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,meta分析
doi:10.1053/j.jvca.2013.01.009
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:Clinical handover is a critical moment in patient care. The authors tested the hypothesis that handover of anesthesia care is associated with increased mortality and morbidity in patients undergoing cardiac surgery. DESIGN:This was a single-center, retrospective cohort study of prospectively collected data. ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2014.05.018
更新日期:2015-02-01 00:00:00
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:Prospecti...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2002.29631
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:To review the use of Von Willebrand Factor (VWF) concentrate for treatment of acquired Von Willebrand syndrome (VWS)-related bleeding in adult extracorporeal membrane oxygenation (ECMO) patients and determine if it was associated with improved VWF laboratory parameters. DESIGN:Retrospective observational coh...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.06.083
更新日期:2020-07-03 00:00:00
abstract:OBJECTIVE:To discover the possible effects of methylprednisolone on the systemic inflammatory response during aprotinin treatment. DESIGN:Randomized, double-blinded study. SETTING:University-affiliated heart center. PARTICIPANTS:Fifty-two patients scheduled for elective coronary artery bypass grafting. INTERVENTION...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1053-0770(99)90081-2
更新日期:1999-04-01 00:00:00
abstract::Temporary left ventricular support aims to decompress the left ventricle and provide adequate forward flow into the arterial circulation. This can be accomplished with endovascular devices such as the Impella with an internal motor, or with the implementation of cannulae to drain the left ventricle or left atrium and ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type:
doi:10.1053/j.jvca.2020.12.009
更新日期:2020-12-13 00:00:00
abstract:OBJECTIVE:The central sympatholytic effects of alpha2-adrenergic agonists are believed to be beneficial during myocardial ischemia, but the peripheral vasoconstrictive effects are controversial. The aim of this study was to investigate the coronary vascular effects of dexmedetomidine (DM) during reactive hyperemia. DE...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(96)80140-6
更新日期:1996-08-01 00:00:00
abstract::This study investigated whether the prophylactic administration of methylprednisolone sodium succinate (MPSS) could prevent an increase in plasma endotoxin levels during cardiac surgery with cardiopulmonary bypass. MPSS (1 g/patient) or saline was given intravenously with induction in the steroid (n = 6) and control (...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/1053-0770(93)90113-y
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVE:To compare the determination of stroke volume (SV) and cardiac output (CO) using 2-dimensional (2D) versus 3-dimensional (3D) transesophageal echocardiography (TEE). DESIGN:Prospective observational study. SETTING:Tertiary care university hospital. PARTICIPANTS:35 patients without structural valve abnormal...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2013.11.005
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:Patients undergoing aortic surgery with deep hypothermic circulatory arrest (DHCA) usually are associated with a high rate of allogeneic blood transfusion, and their red blood cell (RBC) transfusion threshold is unclear and controversial. The purpose of this study was to explore whether a restrictive transfus...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.03.128
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:To compare the agreement of cardiac index measurements between transesophageal echocardiography across the prosthetic mitral valve and the continuous thermodilution method through a pulmonary artery catheter (PAC-TD) in patients undergoing double-valve replacement. DESIGN:Observational prospective study. SE...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2015.10.022
更新日期:2016-04-01 00:00:00
abstract::This study investigated the feasibility of transmyocardially pacing the heart using one temporary epicardial pacing lead and one endocardial lead of a pacing pulmonary artery catheter. Twenty patients undergoing cardiopulmonary bypass with cardioplegic arrest were studied 10 to 45 minutes and 18 to 30 hours after disc...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(92)90047-b
更新日期:1992-12-01 00:00:00
abstract:OBJECTIVES:The primary objective of this study was to analyze perioperative intra-aortic balloon pump (IABP) insertion in patients undergoing cardiac surgery in the authors' institution from 1995 to 2005 and to propose an explanation for changes in use over this period. A secondary objective was to assess patient varia...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2008.12.027
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:Prophylactic administration of tranexamic acid (TA), an antifibrinolytic agent, decreases bleeding after cardiac surgery with systemic hypothermia (25 degrees C to 29 degrees C). Warmer systemic temperatures during cardiopulmonary bypass (CPB) may reduce bleeding and thus alter the requirement for TA. The eff...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1053-0770(98)90235-x
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVES:Recent studies have demonstrated that perioperative myocardial ischemia, detected by electrocardiography, is a risk factor for myocardial infarction. ST-segment analyzers and hemodynamic monitors may be useful for on-line detection in perioperative and critical care environments. However, independent perform...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(05)80230-7
更新日期:1995-12-01 00:00:00
abstract::Hospital CEOs are concerned about more than just cost of services to their patients. The advancement of patient car along with maintaining or improving patient safety are also key elements to the CEO, to limit patient risks, hospital liability, and negative public relations. The CEO is accountable to the hospital staf...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2004.06.003
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the incidence of postoperative atrial fibrillation (POAF), the predisposing factors, the results of treatment before discharge, and the impact on duration and costs of hospitalization. DESIGN:A prospective observational study. METHODS:Patients who underwent cardiac surgery from January 1, 2007 t...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2010.03.009
更新日期:2010-12-01 00:00:00
abstract::Currently, hemostasis is one of the most widely researched topics in perioperative medicine. As investigators learn more about the complexity of coagulation, developing tests with the ability to rapidly monitor coagulation and guide targeted therapy is the key to optimizing hemostasis management. There is mounting evi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2017.05.037
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:Pulmonary resection may be associated with considerable alterations of the cardiorespiratory system. The ideal anesthetic regimen for these patients is not yet definitely determined. DESIGN:Prospective, randomized study. SETTING:Single-institutional, clinical investigation in a thoracic anesthesia departmen...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1053-0770(96)80045-0
更新日期:1996-12-01 00:00:00
abstract::Although a wide variety of positive inotropic agents have been administered to cardiac surgery patients, few of them have been carefully studied in controlled clinical trials, in surgical patient populations. The limited data available suggest that one of the more widely used agents, calcium, may lack efficacy and pos...
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
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
doi:
更新日期:1998-04-01 00:00:00
abstract::Pentamorphone is a new, highly potent opioid reported to have minimal cardiovascular effects in humans and a high therapeutic index in animals. Pentamorphone was injected intravenously (IV) as the sole anesthetic in 10 patients with left ventricular ejection fractions greater than 0.35 who were undergoing elective cor...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(92)90192-a
更新日期:1992-04-01 00:00:00
abstract:OBJECTIVE:To perform three-dimensional surface reconstructions to provide spatial delineations of a normal and an aneurysmatic left ventricle, using transesophageal echocardiography. DESIGN:Prospective study. SETTING:University hospital. PARTICIPANTS:Eight patients in cardiogenic shock admitted to the intensive care...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/s1053-0770(00)90006-5
更新日期:2000-04-01 00:00:00
abstract::Appropriate anesthesia for LVAD placement needs to incorporate an understanding of the surgical procedure and LVAD physiology, the altered physiology and pharmacology of the cardiac failure patient, and a knowledge of the interaction of anesthesia with the potent cardiac drugs used in end-stage heart failure therapy. ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:To investigate the effect of the combination of oxycodone and dexmedetomidine for patient-controlled analgesia (PCA) after video-assisted thoracoscopic (VATS) lobectomy. DESIGN:A prospective, randomized, double-blind, controlled trial. SETTING:Shandong Cancer Hospital and Institute in Jinan, China. PARTICI...
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.2016.03.127
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVES:To characterize existing practice patterns for intraoperative evaluation and grading of diastolic dysfunction in patients undergoing cardiac surgery. DESIGN:A 14-question, multiple-choice survey of current practice for patients with diastolic dysfunction and the use of intraoperative transesophageal echocar...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2015.11.002
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of two anesthetic agents (sevoflurane or propofol) on postoperative delirium (POD) in patients undergoing off-pump coronary artery bypass grafting (CABG). DESIGN:Retrospective observational design. SETTING:University hospital. PARTICIPANTS:Two hundred ninety-two patients undergoing o...
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.2017.02.047
更新日期:2017-12-01 00:00:00