Abstract:
OBJECTIVE:Parameters such as central venous oxygen saturation (ScvO2) are used increasingly to monitor adequate hemodynamic treatment. However, it still remains challenging to identify patients with assumed adequate circulatory status quantified by ScvO2 who suffer from macro- and microcirculatory hypoperfusion. The authors hypothesized that central venous-arterial pCO2 difference (dCO2) could serve as an additional parameter to evaluate the adequacy of perfusion in cardiac surgery patients. DESIGN:Retrospective data analysis of a prospective interventional study. SETTING:University medical center. PARTICIPANTS:Patients undergoing surgery with cardiopulmonary bypass. INTERVENTIONS:The dCO2 was measured postoperatively. The patients with an ScvO2≥70% were divided into 2 groups, the high-dCO2 group (≥8 mmHg) and the low-dCO2 group (<8 mmHg). MEASUREMENTS AND MAIN RESULTS:Sixty patients were included in this analysis. Twenty-five patients had ScvO2≥70%, 4 patients were assigned to the high-dCO2 group. Patients of the high-dCO2 group had significantly longer intensive care unit (ICU) stays (4 d; 1-29 v 1 d; 1-1; p = 0.02), significantly prolonged need for mechanical ventilation (41.5 h; 11-263.5; v 10 h; 7-11; p = 0.03), and higher cardiovascular complication rates in the ICU on postoperative days 3, 4, and 5 (p = 0.02). The mixed venous saturation (SvO2) after 1 hour in the ICU was significantly lower, lactate levels were significantly higher, and the plasma disappearance rate of indocyanine green was significantly lower after 1 hour in the ICU (14.6%/min; 11.6-19.8%/min v 23.6%/min; 22.5-27.3%/min; p = 0.02) in the high-dCO2 group. Cytokines increased significantly postoperatively in the high-dCO2 group. CONCLUSIONS:The authors described dCO2 as a routinely available tool to detect global and microcirculatory hypoperfusion in postoperative cardiac surgical patients. The authors showed that in patients with an ScvO2≥70%, a high dCO2 (≥8 mmHg) was associated with increased postoperative lactate levels and decreased splanchnic function. These findings were associated with a longer need for mechanical ventilation and longer ICU stay.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Habicher M,von Heymann C,Spies CD,Wernecke KD,Sander Mdoi
10.1053/j.jvca.2014.09.006subject
Has Abstractpub_date
2015-01-01 00:00:00pages
646-55issue
3eissn
1053-0770issn
1532-8422pii
S1053-0770(14)00428-5journal_volume
29pub_type
杂志文章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::Anesthesia for thoracic surgery requires specialist intervention to provide adequate operating conditions and one-lung ventilation. The pandemic caused by severe acute respiratory syndrome-associated coronavirus 2 (SARS-CoV-2) is transmitted by aerosol and droplet spread. Because of its virulence, there is a risk of t...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2020.07.049
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To evaluate magnesium as a sole or adjuvant agent with currently used prophylactic drugs in suppressing postoperative atrial tachyarrhythmias (POAT) after coronary artery bypass graft (CABG) surgery. DESIGN:Single-center prospective, randomized clinical trial. SETTING:University hospital. PARTICIPANTS:Pati...
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:10.1053/jcan.2001.21959
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:To investigate the effects of ventilatory mode, injectate temperature, and clinical situation on the precision of cardiac output measurements. DESIGN:Randomized, prospective observational study. SETTING:Single university hospital. PARTICIPANTS:Forty patients undergoing planned cardiac surgery, receiving a ...
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.2014.12.016
更新日期:2015-08-01 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:OBJECTIVES:To determine whether smoking cessation can reduce the incidence of postoperative hypoxemia (POH) after on-pump coronary artery bypass grafting (CABG) surgery. DESIGN:Prospective, single-center, observational study. SETTING:Single-center university teaching hospital. PARTICIPANTS:The study comprised 300 pa...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.05.011
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:To determine which strategies are currently used for (anti)coagulation management and blood conservation during cardiac surgery in Canada. DESIGN:Institutional survey. SETTING:University hospital. PARTICIPANTS:All sites performing cardiac surgery in Canada. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESUL...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2008.02.005
更新日期:2008-10-01 00:00:00
abstract::Intramyocardial hematomas are a rare complication of myocardial infarctions. Normally restricted to the left ventricle, in certain scenarios, such as after a percutaneous coronary intervention, intramyocardial hematomas also can occur in the left atrium. Herein, the case of a 74-year-old man who presented to the autho...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.06.053
更新日期:2020-10-01 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
abstract:OBJECTIVE:To evaluate hemodynamic effects of sternal retractor removal and sternal closure after cardiopulmonary bypass and to correlate these changes with preoperative and intraoperative variables. DESIGN:Prospective. SETTING:University hospital. PARTICIPANTS:Fifty adults undergoing cardiac surgery. MEASUREMENTS A...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2001.26537
更新日期:2001-10-01 00:00:00
abstract:OBJECTIVE:Adequate maintenance of hypnosis during anesthesia throughout surgery using sevoflurane alone was investigated. In addition, sevoflurane pharmacokinetics during cardiopulmonary bypass were analyzed. DESIGN:This was a pilot pharmacokinetic study. SETTING:Tertiary care university hospital. PARTICIPANTS:The s...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.12.018
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To investigate sedation and anesthesia trends and practice patterns for procedures in the cardiac electrophysiology laboratory (EPL). DESIGN:A survey distributed by e-mail. SETTING:US teaching hospitals with a training program in cardiac electrophysiology. PARTICIPANTS:Cardiologists involved in procedures ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2010.11.006
更新日期:2011-08-01 00:00:00
abstract::These cases illustrate the advantages of the laryngeal mask as compared with an endotracheal tube or oxygen face mask for selected patients undergoing therapeutic bronchoscopic procedures. The advantages include a larger internal diameter allowing easier passage of instruments, reduced work of breathing, lack of disco...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(05)80017-5
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVE:Most-Care (powered by the pressure-recording analytic method [PRAM]; Vytech HealthTM, Padova, Italy) is a minimally invasive cardiac output monitoring. This system already has been studied and validated in cardiac surgery and in children. It already showed a correlation with thermodilution methods in hemodyna...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2010.09.027
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the pretreatment effect of simvastatin on spinal cord ischemia-reperfusion injury. DESIGN:Prospective, interventional study. SETTING:University research laboratory. PARTICIPANTS:Forty-five male Sprague-Dawley rats. INTERVENTIONS:Rats were treated with oral simvastatin...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2012.01.025
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:The value of a simplified, focused intraoperative transesophageal echocardiography (TEE) protocol in patients undergoing liver transplantation (LT) is unknown. We sought to create and assess a 5-view LT TEE examination focused on 5 prespecified common causes of hypotension during LT. DESIGN:Retrospective coh...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.01.028
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:To compare patients undergoing valve surgery through a minithoracotomy approach with a matched group undergoing conventional valve surgery. DESIGN:Control study. SETTING:University hospital, single center. PARTICIPANTS:Forty-one consecutive patients scheduled for valve surgery by minithoracotomy approach w...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/s1053-0770(03)00051-x
更新日期:2003-06-01 00:00:00
abstract::This study examined the effects of global normothermic hypoperfusion on the compressed spectral array (CSA) processed electroencephalogram (EEG) during high-dose narcotic anesthesia. Fifteen patients undergoing cardiac electrophysiologic surgery were studied. The patients were anesthetized with a standard high-dose na...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(91)90276-y
更新日期:1991-06-01 00:00:00
abstract:OBJECTIVE:To compare a remifentanil-clonidine-propofol regimen with conventional sufentanil-propofol anesthesia. DESIGN:Randomized, nonblinded trial. SETTING:A single university hospital. PARTICIPANTS:Male patients scheduled for coronary artery bypass graft (CABG) surgery. INTERVENTIONS:In the control group, anesth...
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:10.1053/jcan.2002.128415
更新日期:2002-12-01 00:00:00
abstract:OBJECTIVE:The authors aimed to investigate whether immediate postoperative hypoalbuminemia could be associated with outcomes after off-pump coronary artery bypass graft (OPCAB) surgery. DESIGN:A retrospective analysis of the medical data. SETTING:Cardiac operating room and adult cardiovascular intensive care unit at ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2010.09.008
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVES:The authors hypothesized that bioimpedance cardiography measured by the Endotracheal Cardiac Output Monitor (ECOM; ConMed, Utica, NY) is a convenient and reliable method for both cardiac index (CI) assessment and prediction in fluid responsiveness. DESIGN:A prospective observational study. SETTING:A teachi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2011.06.023
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVES:The objectives of this study were to evaluate the effect of ventricular morphology on perioperative outcomes during Fontan surgery. DESIGN:Retrospective cohort study. SETTING:Single standing, not-for-profit pediatric hospital. PARTICIPANTS:A total of 72 patients who underwent Fontan surgery using cardiopu...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.07.024
更新日期:2017-02-01 00:00:00
abstract::A stuck mechanical valve leaflet is a well-known cardiovascular complication; however, a stuck bioprosthetic valve is a rare but potentially fatal complication. Herein a case of stuck bioprosthetic mitral valve caused by a loop of suture, which was detected on intraoperative 3-dimensional (3D) transesophageal echocard...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type:
doi:10.1053/j.jvca.2020.07.007
更新日期:2020-07-08 00:00:00
abstract:OBJECTIVES:The use of steroid therapy in cardiac surgical patients remains controversial. The aim of this clinical investigation was to determine the effect of small-dose dexamethasone therapy on patient-perceived quality of recovery (QoR) scores in elective cardiac surgical patients. In addition, the authors assessed ...
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.2011.03.002
更新日期:2011-12-01 00:00:00
abstract::Study objectives were (1) to compare the hemodynamic effects of increasing doses of vecuronium, given as a bolus during induction of anesthesia using high-dose fentanyl, in patients undergoing myocardial revascularization; and (2) to determine whether increasing the dose of vecuronium would decrease the onset time to ...
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(91)90008-h
更新日期:1991-12-01 00:00:00
abstract::The care of patients undergoing cardiac surgery is becoming more complex, in part owing to the increasing burden of comorbid disease, frailty, and psychosocial issues. Many risk factors for postoperative morbidity and mortality are potentially modifiable if identified and treated in a timely fashion before surgery. Ca...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.01.023
更新日期:2019-08-01 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...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2002.31053
更新日期:2002-04-01 00:00:00
abstract:OBJECTIVE:To evaluate if increasing age is a major determinant of long-term neuropsychologic (NP) dysfunction in patients undergoing coronary artery bypass graft (CABG) surgery. DESIGN:Prospective cohort study. SETTING:A single university hospital. PARTICIPANTS:Three hundred eighty-one patients undergoing elective C...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2000.7941
更新日期:2000-08-01 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:OBJECTIVE:At the authors' institution, before 2015, patients cannulated for peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) did not undergo left ventricular (LV) decompression with the use of an LV vent. After 2015, the authors' institution began using the Impella device to vent the left ventricle...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.05.019
更新日期:2018-12-01 00:00:00