Abstract:
STUDY OBJECTIVE:Cardiac surgery is complicated by decreased postoperative respiratory muscle strength and spirometry with accompanying increased atelectasis. The specific respiratory symptoms attributable to these physiologic changes are unknown, and this study looked at the symptoms and underlying physiology. DESIGN:Convenience sampling of observational cohort. SETTING:Tertiary care university hospital. PATIENTS:One hundred thirty-eight patients undergoing elective surgery were enrolled. INTERVENTIONS:Changes from admission to 8-week postoperative values in atelectasis, pleural effusions, spirometry (forced vital capacity and forced expiratory volume in one second), and respiratory muscle strength (negative inspiratory pressure) were measured. These physiologic changes were compared with changes in respiratory symptoms of cough, wheeze, phlegm, and dyspnea on walking up a slight hill noted from admission to 8-week follow-up by stepward logistic regression. MEASUREMENTS AND RESULTS:Spirometry and negative inspiratory pressure decreased and atelectasis increased from admission to discharge. These disturbances had only incompletely resolved at 8-week follow-up. Some patients reported fewer symptoms of cough (11%), phlegm (9%), wheeze (35%), and dyspnea (46%) at 8 weeks follow-up. Other patients reported increased symptoms of cough (15%), phlegm (10%), wheeze (6%), and dyspnea (4%) at 8 weeks follow-up. Residual atelectasis at 8 weeks was predictive of fewer symptoms of dyspnea (odds ratio [OR] 0.335, p = 0.199; 95% confidence interval [CI] 0.188, 0.597), increased symptoms of dyspnea (OR 855, p = 0.006; 95% CI 6.6, 11052), and increased symptoms of cough (OR 260, p = 0.023; 95% CI 2.13, 31829). Negative inspiratory pressure at 8 weeks was predictive of fewer symptoms of dyspnea (OR 1.05, p = 0.032; 95% CI 1.02, 1.09) and increased symptoms of wheeze (OR 0.7, p = 0.45; 95% CI 0.533, 0999). Forced vital capacity at 8 weeks was predictive of increased symptoms of wheeze (OR 0.005; p = 0.015; 95% CI 0.0060, 0.775). CONCLUSIONS:Postoperative changes in respiratory muscle strength and spirometry can persist up to at least 8 weeks postoperatively. Many patients report a change in respiratory symptoms of cough, phlegm, dyspnea, or wheeze. The change in respiratory symptoms at 8 weeks is correlated with residual respiratory muscle weakness, decrease in spirometry, and residual atelectasis.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Johnson D,Hurst T,Thomson D,Mycyk T,Burbridge B,To T,Mayers Idoi
10.1016/s1053-0770(96)80130-3subject
Has Abstractpub_date
1996-08-01 00:00:00pages
571-7issue
5eissn
1053-0770issn
1532-8422pii
S1053-0770(96)80130-3journal_volume
10pub_type
杂志文章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:OBJECTIVES:To test the hypothesis that the hemodynamic and left ventricular functional actions of levosimendan (Orion Pharmaceutica, Espoo, Finland), a new myofilament calcium sensitizer with phosphodiesterase-inhibiting properties, in conscious dogs are correlated with plasma concentrations of the drug measured with r...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(97)90252-4
更新日期:1997-02-01 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:OBJECTIVES:To determine the effect of the introduction of a specialty-specific progressive care unit (PCU) on the intensive care unit (ICU) to which relatively low-acuity patients had previously been admitted. DESIGN:Retrospective cohort study. SETTING:The thoracic (noncardiac) surgical ICU of a tertiary referral ins...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2007.12.015
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVES:To determine whether amrinone is bound to cardiopulmonary bypass circuits. When amrinone is administered to children during cardiopulmonary bypass, determine whether measured amrinone concentrations differ from those predicted based on a reported volume of distribution of 1.6 L/kg. DESIGN:In vitro study: Up...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(05)80321-0
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to compare the anesthetic efficacy of prilocaine infiltration and a eutectic mixture of local anesthetics (EMLA) in cream for femoral vessel catheterization during pediatric cardiac catheterization and to evaluate whether EMLA cream application improves cannulation success. DESIGN:P...
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.2004.10.007
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:The objective of this retrospective review was to evaluate the perioperative and procedural management of patients with pulmonary alveolar proteinosis (PAP) who presented for whole-lung lavage (WLL). DESIGN:The records of all adult patients with PAP who underwent WLL between January 1, 1988 and August 20, 20...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.03.047
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVE:To determine whether preoperative regional cerebral oxygen saturation (rSO2) and the decrease in rSO2 during carotid clamping were predictive of the risk for neurologic complications in carotid endarterectomy and to determine the cutoff values of the studied parameters. DESIGN:Cohort, prospective, nonrandomi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章
doi:10.1053/j.jvca.2016.10.017
更新日期:2017-06-01 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:OBJECTIVES:To implement a statistical model for protamine titration. DESIGN:Prospective randomized trial. SETTING:University hospital. PARTICIPANTS:Sixty (n = 30+30) patients scheduled for elective coronary artery bypass surgery were randomly assigned to 2 groups. INTERVENTIONS:Protamine dose calculated according t...
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.2016.07.018
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the effect of magnesium sulfate on pain management for post-thoracotomy patients. DESIGN:A prospective, randomized, controlled clinical study. SETTING:University hospital. PARTICIPANTS:Twenty-four patients undergoing thoracotomy. INTERVENTIONS:After thoracotomy...
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.2006.11.013
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVE:To compare dexmedetomidine-based to propofol-based sedation after coronary artery bypass graft (CABG) surgery in the intensive care unit (ICU). DESIGN:Randomized, open label. SETTING:Twenty-five centers in the United States and Canada. PARTICIPANTS:Two hundred ninety-five adults undergoing CABG surgery. I...
journal_title:Journal of cardiothoracic and vascular anesthesia
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
abstract:OBJECTIVE:The long-term use of milrinone is associated with increased mortality in chronic heart failure. A recent meta-analysis suggested that it might increase mortality in patients undergoing cardiac surgery. The authors conducted an updated meta-analysis of randomized trials in patients undergoing cardiac surgery t...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1053/j.jvca.2012.08.005
更新日期:2013-04-01 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
abstract:OBJECTIVE:The aim of this study was to test the hypothesis that normothermic cardiopulmonary bypass (CPB) is as effective as hypothermic CPB in terms of cardiac protection (cTnI level) and outcome in patients with valvular heart disease. DESIGN:Prospective randomized study. SETTING:A tertiary cardiothoracic referral ...
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.2013.03.009
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:It has been demonstrated that new regional wall motion abnormalities (RWMAs) are infrequently associated with electrocardiographic (ECG) ischemic changes during coronary artery bypass graft (CABG) surgery. The evaluation of apical or basal areas by biplane transesophageal echocardiography (TEE) may clarify t...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/S1053-0770(96)80196-0
更新日期:1996-10-01 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: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: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: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::Tricuspid regurgitation is a notable aspect of congestive heart failure and is linked with worse outcomes if untreated. Functional tricuspid regurgitation commonly is seen in patients with heart failure, particularly in patients presenting for surgical management, such as those for mechanical cardiac assist device imp...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2020.06.022
更新日期:2020-06-12 00:00:00
abstract:OBJECTIVES:Cardiopulmonary bypass (CPB) provides a unique circumstance to study the effects of drugs on the systemic vasculature. Thus, this study was designed to evaluate the effects of sodium bicarbonate on the systemic circulation during CPB in humans. DESIGN:Randomized, double-blind study. SETTING:Tertiary care u...
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.2007.06.001
更新日期:2008-04-01 00:00:00
abstract::The clinical competency committee offers a fellowship program a structured approach to assess the clinical performance of each trainee in a comprehensive fashion This special article examines the structure and function of this important committee in detail. Furthermore, the strategies for the optimal functioning of th...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.01.001
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:To investigate the prognostic impact of red blood cell (RBC) transfusion on the outcome after transfemoral transcatheter aortic valve replacement (TAVR). DESIGN:Nationwide, retrospective multicenter study. SETTING:Five University Hospitals. PARTICIPANTS:The nationwide FinnValve registry included data from ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,多中心研究
doi:10.1053/j.jvca.2019.06.038
更新日期:2019-11-01 00:00:00
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 au...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2014.09.006
更新日期:2015-01-01 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::Surgical excellence in pulmonary thromboendarterectomy (PTE) for chronic thromboembolic pulmonary hypertension (CTEPH) has begun to spread around the world. The perioperative mortality for this procedure is typically under 10%. The maximal benefit from PTE is derived in those patients who have a high proximal clot bur...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2011.03.182
更新日期:2011-08-01 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: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::Since DeBakey's replacement of an aortic arch aneurysm using cardiopulmonary bypass and individual perfusion of the brachiocephalic and carotid arteries, selective cerebral perfusion has been used as an effective method of cerebral protection. Although interest in this technique waned with the evolution of hypothermic...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s1053-0770(96)80181-9
更新日期:1996-01-01 00:00:00