Abstract:
OBJECTIVE:Because of the lack of data regarding the impact of obesity on propofol pharmacokinetics in patients undergoing cardiac surgery using hypothermic cardiopulmonary bypass (CPB), the authors sought to explore propofol pharmacokinetics and develop a predictive pharmacokinetic model that characterizes and predicts propofol pharmacokinetics in this population. DESIGN:A prospective, observational study. SETTING:A teaching hospital. PARTICIPANTS:The study comprised 17 obese and 17 control (nonobese) patients undergoing hypothermic CPB. INTERVENTION:None. MEASUREMENTS AND MAIN RESULTS:Patients mainly underwent valve surgery. On initiation of hypothermic CPB (28°C-32°C), patients received a propofol (1%) bolus (1 mg/kg) immediately followed by a 2 mg/kg/h infusion. Blood samples were withdrawn at the following times: before dosing; 1, 3, 5, and 7 minutes after the propofol bolus dose; every 20 minutes during infusion; just before discontinuation of the infusion; and at 1, 3, 5, 7, 10, 20, 30, and 60 minutes after discontinuation of the infusion. The plasma propofol concentration was determined using high-performance liquid chromatography, and then data were imported into Monolix (Lixoft, Antony, France) for population pharmacokinetic modeling and pharmacokinetic parameters estimation. A 2-compartment pharmacokinetic model with age as a covariate on the peripheral volume of distribution (V2) best described the pooled data. The pooled data was internally evaluated successfully to describe and predict propofol pharmacokinetics in the addressed population. Propofol clearance, intercompartmental clearance, and central volume of distribution were 805 mL/min, 1140 mL/min and 18.8 L, respectively. V2 was calculated as 9.86×exp.(1.88×[age/40]) L. CONCLUSION:Propofol pharmacokinetic parameters were similar in obese and nonobese patients undergoing hypothermic CPB. Age was the major determinant of propofol V2 in the obese population.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
El-Baraky IA,Abbassi MM,Marei TA,Sabry NAdoi
10.1053/j.jvca.2016.02.003subject
Has Abstractpub_date
2016-08-01 00:00:00pages
876-83issue
4eissn
1053-0770issn
1532-8422pii
S1053-0770(16)00066-5journal_volume
30pub_type
杂志文章abstract:OBJECTIVE:Patients undergoing transapical cardiac procedure are a minority of cardiac surgery patients but represent a challenge for cardiac anesthesiologists because they generally are older and have more comorbidities than do open heart cardiac surgery patients. The aims of this study were to describe the anesthetic ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.10.039
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVES:There is still controversy about whether an infant should have cardiac surgery concomitant with ongoing persistent pneumonia. This study analyzes the outcome of surgical treatment for infants with left-to-right shunt congenital heart disease accompanied with persistent pneumonia and discusses the perioperati...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.05.039
更新日期:2019-02-01 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:The authors compared thoracic epidural with ON-Q infiltrating catheters in patients having open thoracotomy to determine whether one method better relieves postoperative pain and would allow earlier discharge from the hospital and, hence, cost savings. DESIGN:Retrospective chart review. SETTING:University h...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2013.02.017
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:The authors tested the hypothesis that patients with metabolic syndrome are more likely to develop short-term cognitive dysfunction after cardiac surgery with cardiopulmonary bypass. DESIGN:A prospective study. SETTING:Veterans Affairs medical center. PARTICIPANTS:Fifty-six age- and education-balanced pati...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2010.06.008
更新日期:2011-04-01 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 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
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: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 examine the association between blood component transfusions and the incidence of major postoperative infections in patients undergoing esophageal resection surgery. DESIGN:Retrospective cohort study. SETTING:Single academic tertiary referral center. PARTICIPANTS:All patients who underwent esophagectomy...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2011.12.015
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:An association between central venous pressure and acute kidney injury (AKI) has been observed following cardiac surgery, but it is unknown whether this reflects intravascular volume status or impaired right ventricular (RV) myocardial performance. This study was performed to test the hypothesis that decrease...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.09.012
更新日期:2019-03-01 00:00:00
abstract::Near-infrared spectroscopy (NIRS) is an emerging noninvasive monitoring modality based on chromophore absorption of infrared light. Because NIRS provides instantaneous information on cerebral and somatic tissue oxygenation, it becomes mandatory to identify rapidly the etiology of impaired regional oxygenation and thus...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.03.039
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine the best predictors of successful extubation after cardiac surgery, by modifying the rapid shallow breathing index (RSBI) based on patients' anthropometric parameters. DESIGN:Single-center prospective observational study. SETTING:Two general intensive care units at a s...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2014.06.022
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine the incidence and significance of abnormal hepatic Doppler venous flow velocities as signs of an abnormal right ventricular filling pattern before cardiac surgery. DESIGN:Retrospective and prospective validation study. SETTING:Tertiary care hospital. PARTICIPANTS:...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2004.11.052
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVE:To compare methylene blue with hydroxocobalamin as a rescue therapy for vasoplegic syndrome. DESIGN:Retrospective cohort. SETTING:Academic medical center. PARTICIPANTS:Patients undergoing cardiothoracic surgery treated for vasoplegic syndrome. INTERVENTIONS:Thirty-five patients were treated with methylene...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.01.033
更新日期:2020-07-01 00:00:00
abstract::Sotalol is a beta-adrenergic blocking drug with the additional property of lengthening the cardiac action potential. These electrophysiologic properties render the drug attractive for use in the prevention of postoperative supraventricular arrhythmias (SVA), and previous studies have suggested that it was indeed effec...
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)90283-6
更新日期:1994-08-01 00:00:00
abstract::This article is the third of an annual series reviewing the research highlights of the year pertaining to the subspecialty of perioperative echocardiography for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief, Dr. Kaplan, and the editorial board for the opportunity to conti...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.03.034
更新日期:2019-09-01 00:00:00
abstract::This study was designed to compare the cardiovascular effects of pipecuronium bromide (PIP) to vecuronium (V) when combined with sufentanil (SF) in patients undergoing coronary artery bypass surgery. Eighty-two patients were studied; 40 were normotensive and 42 had hypertension currently controlled by pharmacological ...
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)90321-j
更新日期:1991-04-01 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:The authors conducted a review of randomized controlled trials to identify advantages in clinically relevant outcomes in patients undergoing cardiac surgery with remifentanil. DESIGN:Meta-analysis. SETTING:Hospitals. PARTICIPANTS:A total of 1,473 patients from 16 randomized trials. INTERVENTIONS:None. ME...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1053/j.jvca.2011.05.007
更新日期:2012-02-01 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::Left atrial or pulmonary capillary wedge pressure V waves are used immediately after mitral valve replacement to evaluate valve competence. However, their correlation with hemodynamically significant regurgitation has not been established. Transesophageal echocardiography (TEE) was used to prospectively examine whethe...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(91)90035-r
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVE:To describe detailed perioperative features of combined heart and kidney transplant (HKT). DESIGN:Retrospective study. SETTING:Tertiary care university hospital. PARTICIPANTS:All consecutive HKT recipients aged 18 years and older. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:After approval of the In...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2017.09.018
更新日期:2018-02-01 00:00:00
abstract::Pulmonary thromboendarterectomy (PTE) remains the only curative surgery for patients with chronic thromboembolic pulmonary hypertension (CTEPH). Postoperative intensive care unit care challenges providers with unique disease physiology, operative sequelae, and the potential for detrimental complications. Central conce...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.03.005
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVES:This study was conducted to compare continuous cardiac output (CCO) with bolus thermodilution cardiac output (BTD) at steady state, and to compare the response time of STAT CCO with that of trend CCO, mean arterial pressure, and mixed venous oxygen saturation [SvO2] during an acute hemodynamic change. DESIG...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(97)90050-1
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVE:Mortality and morbidity of acute kidney injury (AKI) after cardiac surgery still remain high. The authors undertook the present study to evaluate the utility of early postoperative urinary albumin (uAlb) as a diagnostic marker for predicting occurrence of AKI and its severity in pediatric patients undergoing ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2015.05.194
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:There has been controversy regarding the beneficial effects of calcium on myocardial contractility and the harmful effects on myocardial cells, especially in children. The aim of this study was to investigate an association between ionized calcium concentration (iCa) and outcomes for pediatric patients after ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2017.11.006
更新日期:2018-08-01 00:00:00
abstract::Nine NYHA class III-IV patients awaiting heart transplantation (HTx) were studied with a right ventricular ejection fraction (RVEF) catheter. The first aim of the study was to explore the pulmonary and systemic circulatory effects of dobutamine (D) and/or nitroprusside (N) in these patients. The second aim was to sear...
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)90013-b
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine whether or not perioperative administration of sodium bicarbonate had a preventive effect on cardiac surgery-associated acute kidney injury (CSA-AKI) as shown in randomized controlled trials. DESIGN:The authors conducted a systematic review and meta-analysis using MEDLI...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1053/j.jvca.2015.03.007
更新日期:2015-10-01 00:00:00
abstract::Despite improvements in surgical techniques and perioperative care, cardiac surgery still is burdened by relatively high mortality and frequent major postoperative complications, including myocardial dysfunction, pulmonary complications, neurologic injury, and acute kidney injury. Although the surgeon's skills and vol...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2020.03.054
更新日期:2020-04-20 00:00:00