Abstract:
OBJECTIVES:Bleeding into the chest is a major cause of blood transfusion and adverse outcomes following cardiac surgery. The authors investigated predictors of bleeding following cardiac surgery to identify potentially correctable factors. DESIGN:Data were retrieved from the medical records of patients undergoing cardiac surgery over the period of 2002 to 2008. Multivariate analysis was used to identify the independent predictors of chest tube drainage. SETTING:Tertiary hospital. PARTICIPANTS:Two thousand five hundred seventy-five patients. INTERVENTIONS:Cardiac surgery. RESULTS:The individual operating surgeon was independently associated with the extent of chest tube drainage. Other independent factors included internal mammary artery grafting, cardiopulmonary bypass time, urgency of surgery, tricuspid valve surgery, redo surgery, left ventricular impairment, male gender, lower body mass index and higher preoperative hemoglobin levels. Both a history of diabetes and administration of aprotinin were associated with reduced levels of chest tube drainage. CONCLUSIONS:The individual operating surgeon was an independent predictor of the extent of chest tube drainage. Attention to surgeon-specific factors offers the possibility of reduced bleeding, fewer transfusions, and improved patient outcomes.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Dixon B,Reid D,Collins M,Newcomb AE,Rosalion A,Yap CH,Santamaria JD,Campbell DJdoi
10.1053/j.jvca.2013.09.010subject
Has Abstractpub_date
2014-04-01 00:00:00pages
242-6issue
2eissn
1053-0770issn
1532-8422pii
S1053-0770(13)00517-Xjournal_volume
28pub_type
杂志文章abstract:OBJECTIVE:To determine whether patients receiving pegorgotein preoperatively would be less likely than patients receiving placebo to demonstrate postoperative cerebral or myocardial dysfunction and thus would be less likely to (1) demonstrate a decline in neuropsychologic testing after cardiopulmonary bypass, (2) recei...
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)90121-0
更新日期:1999-12-01 00:00:00
abstract:OBJECTIVE:In minimally invasive surgical ablation for atrial fibrillation during video-assisted thoracoscopy surgery, one-lung ventilation (OLV) with a double- lumen tube is commonly employed. In contrast with the majority of thoracic procedures, the patient lies supine; thus, the protective effect of gravity is lost a...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.03.064
更新日期:2020-11-01 00:00:00
abstract::The mechanisms leading to left ventricular (LV) asynchronies are incompletely understood, and reports on the functional significance of asynchronies for the affected segments are conflicting. To characterize LV asynchronies, 16 anesthetized dogs with critical stenosis of the left anterior descending coronary artery (L...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(93)90055-p
更新日期:1993-12-01 00:00:00
abstract:OBJECTIVES:In the present study, the authors have investigated whether rotational thromboelastometry (ROTEM) could predict thrombocytopenia and hypofibrinogenemia in cardiac surgery using the clot amplitude after 5 minutes (A5). Another parameter, PLTEM, in which the contribution of fibrinogen is eliminated by subtract...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2013.12.004
更新日期:2014-04-01 00:00:00
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:OBJECTIVE:Investigate how a multitude of patient demographics and extracorporeal membranous oxygenation (ECMO)-related complications affect 30-day survival or survival to discharge. DESIGN:Retrospective observational study. SETTING:Urban university hospital, quaternary care center. PARTICIPANTS:Patients who underwen...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.08.193
更新日期:2019-04-01 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::The vascular endothelium is intimately involved in a wide variety of normal physiological processes, including coagulation/anticoagulation, the maintenance of vascular tone, and pathological processes, including reperfusion injury, inflammatory syndromes, and tumor cell metastasis. This review discusses the importance...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s1053-0770(97)90101-4
更新日期:1997-05-01 00:00:00
abstract::Survival of patients with congenital heart disease has significantly improved over the last 2 decades, confronting interventionalists, surgeons, anesthesiologists, cardiologists, and intensivists with often unfamiliar complex pathophysiology in the perioperative setting. Aside from cardiac catheterization, echocardiog...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.11.036
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:Reducing mortality is a key target in critical care and perioperative medicine. The authors aimed to identify all nonsurgical interventions (drugs, techniques, strategies) shown by randomized trials to increase mortality in these clinical settings. DESIGN:A systematic review of the literature followed by a c...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.03.022
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVES:To examine pump-prime aprotinin action on coagulation and fibrinolysis in patients undergoing primary coronary revascularization. DESIGN:A prospective randomized study. SETTING:A university hospital. PARTICIPANTS:Forty-three patients were randomly assigned to either group A, 21 patients treated with 2 x 1...
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(97)90116-6
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to assess the feasibility and effects on perioperative management of a focused transthoracic echocardiogram performed by anesthesiologists. DESIGN:A prospective observational study of all patients having a focused cardiovascular ultrasound (FoCUS). SETTING:A single tertiary referr...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2009.01.018
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:Right-sided heart failure develops in lung transplantation candidates on prolonged peripheral extracorporeal membrane oxygenation support and is a major determinant of mortality. The use of central venoarterial extracorporeal membrane oxygenation for bridging of right-sided heart failure to lung transplantati...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.01.059
更新日期:2019-07-01 00:00:00
abstract::This article reviews and updates the recent modifications in patient selection and revisions in the anesthetic approach to MIDCAB surgery. It outlines the changing surgical selection criteria, current ways to assess graft patency, and evolving anesthetic management. A promising new advancement in coronary artery bypas...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s1053-0770(97)90019-7
更新日期:1997-08-01 00:00:00
abstract::In the perioperative management of patients with hemophilia A, emicizumab prevents the accurate measurement of common clotting assays, including the activated clotting time (ACT), which is essential for high-dose heparin monitoring during cardiopulmonary bypass surgery. The authors describe the successful perioperativ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.08.058
更新日期:2020-08-27 00:00:00
abstract::During the insertion of an automatic implantable cardioverter defibrillator, repeated induction of ventricular tachycardia or ventricular fibrillation and subsequent defibrillation is performed to determine the defibrillation threshold. In this study, the influence of these testing episodes on myocardial function was ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(93)90167-j
更新日期:1993-08-01 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 evaluate drug costs, time of mechanical ventilation, complications, and hospital length of stay comparing propofol-based with fentanyl-isoflurane-based anesthesia. DESIGN:A prospective, randomized study. SETTING:A university-affiliated, tertiary care community hospital. PARTICIPANTS:Seventy patients und...
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)90328-7
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVE:Intraoperative Doppler-determined renal resistive index (RRI) is a promising early acute kidney injury (AKI) biomarker. As RRI continues to be studied, its clinical usefulness and robustness in research settings will be linked to the ease, efficiency, and precision with which it can be interpreted. Therefore,...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.04.014
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:The aging brain shows decreased venous oxygenation predominantly in the frontal cortex, which seems sex- dependent. The authors hypothesized that age and sex would influence baseline regional cerebral oxygen saturation (rScO2) measured by the INVOS 5100. DESIGN:Subanalysis of published data. SETTING:Tertia...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.06.025
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:The authors aimed to assess determinants of intubation time and evaluate its impact on 30-day and 1-year postoperative survival in Surgical Treatment for Ischemic Heart Failure (STICH) trial patients. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS:A multivariable Cox proportional hazards model was used amo...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2017.12.038
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:The diagnosis of perioperative myocardial infarction (PMI) after cardiac surgery remains an important issue. The present study was designed to determine the relevance of the measurement of serum cardiac troponin I (cTnI, a biochemical marker with high cardiospecificity. Therefore, cTnI was compared with creat...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(98)90008-8
更新日期:1998-06-01 00:00:00
abstract::To avoid intraoperative awareness and postoperative respiratory depression from high-dose opioid anesthesia, propofol (P), or isoflurane (I) has been combined with moderate-dose opioid with varying results. However, the effects of both P and I on myocardial contractility and left ventricular afterload have not been co...
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(05)80050-3
更新日期:1995-02-01 00:00:00
abstract:OBJECTIVE:To assess the accuracy of respiratory-induced systolic pressure variation and its components to detect low left ventricular preload. DESIGN:Prospective study. SETTING:University hospital. PARTICIPANTS:Sixty-seven patients undergoing major surgery under general anesthesia. INTERVENTIONS:Transesophageal ech...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2003.45
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVE:Cerebral near-infrared spectroscopy (NIRS) was evaluated for use in monitoring global oxygenation in adult patients after cardiac surgery. DESIGN:Prospective, randomized clinical monitoring study. SETTING:Intensive care unit for cardiac surgery; university hospital. PARTICIPANTS:The study included 35 patie...
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.2006.09.010
更新日期:2007-08-01 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:To investigate an association between the preoperative plasma B-type natriuretic peptide (BNP) concentration and cerebral regional saturation (rSO2) measured using the INVOS oximeter (Medtronic, Minneapolis, MN). DESIGN:A retrospective data analysis. SETTING:Single university hospital. PARTICIPANTS:Patien...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2017.04.018
更新日期:2018-02-01 00:00:00
abstract::Aprotinin has been reported to reduce bleeding in cardiac surgery patients. Its mechanisms of action on coagulation have not been fully elucidated. In a prospectively randomized study of 40 patients undergoing elective aortocoronary bypass grafting, the influence of high-dose aprotinin (2 million IU of aprotinin befor...
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(94)90164-3
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVE:Prolonged mechanical ventilation (PMV) is closely associated with higher morbidity and mortality after total cavopulmonary surgery. The aim of the present study was to identify the clinical risk factors for PMV. DESIGN:A retrospective case-control study. SETTING:Fuwai Hospital. PARTICIPANTS:The study compr...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.10.043
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To compare the effects of levosimendan with milrinone in cardiac surgical patients with pulmonary hypertension and left ventricular dysfunction. DESIGN:A prospective, randomized study. SETTING:Tertiary care teaching hospital. PARTICIPANTS:The study included patients with valvular heart disease and pulmonar...
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.2016.01.015
更新日期:2016-06-01 00:00:00