Abstract:
OBJECTIVES:Although volatile anesthetics have been shown to have spasmolytic effects on constricted airways, most previous studies were performed to assess bronchodilation with indirect methods such as measurement of airway resistance, whose reliability is controversial. As the authors have developed a new direct method using a superfine fiberoptic bronchoscope (SFB) and confirmed the accuracy of this method, this study assessed the spasmolytic effect of sevoflurane (S) as compared with enflurane (E) and halothane (H). DESIGN:Open-labeled, randomized study. SETTING:The study protocol was approved by the Animal Care Committee in a school of medicine. PARTICIPANTS:Twenty-two mongrel dogs. INTERVENTIONS:The dogs were anesthetized with pentobarbital, IV, paralyzed with pancuronium, and the lungs were mechanically ventilated. The endotracheal tube had an additional lumen to insert the SFB (outer diameter 2.2 mm). The tip of the SFB was located between a second and third bronchial bifurcation to continuously monitor the bronchial cross-sectional area (BCA) of third or fourth generation bronchi. The BCA was printed out by videoprinter at the end of expiration and was calculated on a Macintosh IIci computer using an NIH (National Institutes of Health) image program. Bronchoconstriction was produced with histamine (HA: 10 micrograms/kg + 500 micrograms/kg/hr). In the first protocol, 4 mongrel dogs were used to assess the accuracy of the new method. BCA was measured 30 and 60 minutes after the placement of the SFB and also 30 and 60 minutes after the start of the histamine (HA) infusion. Arterial blood (4 mL) was collected at 30 and 60 minutes after placement of the SFB to measure the plasma concentration of catecholamines with gas chromatographic mass spectrometry. In the second protocol, 18 dogs were randomly allocated to 3 groups of 6 each: group S, group E, and group H. Thirty minutes after the start of the HA infusion, the dogs subsequently inhaled the following concentrations of S, E, or H for 15 minutes: 0.2, 0.4, 0.8, and 1.6 minimum alveolar concentrations. The BCA was assessed before and 30 minutes after the start of HA and at the end of the inhalation period of each concentration. MEASUREMENTS AND MAIN RESULTS:In the first study, no significant differences in the BCA were found between 30 and 60 minutes after the placement of the SFB and between 30 and 60 minutes after the start of HA. The plasma concentrations of norepinephrine and epinephrine changed from 138 +/- 45 and 162 +/- 18 to 188 +/- 48 and 136 +/- 18 pg/mL, respectively. In the second study, all volatile anesthetics significantly increased the BCA in a dose-dependent manner. There was no significant difference among the three groups. CONCLUSION:As the BCA did not change in the first study, the tip of the SBF could be well fixed, and the 30-minute interval is long enough for the HA infusion to produce stable bronchoconstriction. The plasma catecholamine concentrations suggest that the pentobarbital anesthesia was deep enough to inhibit the direct irritant effect of the endotracheal tube and the SFB on the airway. This new direct method indicates that S dilates HA-constricted proximal airway with the same potency as E and H.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Hashimoto Y,Hirota K,Ohtomo N,Ishihara H,Matsuki Adoi
10.1016/s1053-0770(96)80240-0subject
Has Abstractpub_date
1996-02-01 00:00:00pages
213-6issue
2eissn
1053-0770issn
1532-8422pii
S1053-0770(96)80240-0journal_volume
10pub_type
杂志文章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:OBJECTIVE:To examine the effects of gender on time to extubation after coronary artery bypass graft (CABG) surgery and intensive care unit and hospital length of stay. DESIGN:Retrospective study comparing outcomes as related to gender. SETTING:Tertiary care university teaching hospital. PARTICIPANTS:Consecutive pati...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2001.21933
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:Whereas it is established that endothelin-1 elicits sustained deleterious effects on the cardiovascular system during cardiopulmonary bypass (CPB), presently it remains unknown whether the inhaled administration of the dual ETA and ETB antagonist tezosentan prevents the development of pulmonary endothelial dy...
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.2013.12.013
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVES:Perioperative treatment with angiotensin-converting enzyme (ACE) inhibitors in cardiac surgery with cardiopulmonary bypass is still controversial. Using ACE inhibitors during cardiac surgery might be associated with an increased risk of critical hypotensive episodes. On the other hand, ACE inhibitors could h...
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/j.jvca.2003.10.011
更新日期:2004-02-01 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: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: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: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::Of the 3,231 thoracic procedures performed between July 1, 1994, and June 30, 1996, 8.9% of patients were ventilated postoperatively; 3.1% required an intensive care unit (ICU) stay of a median of 8 days. Of those patients admitted to the ICU, 29% died; 10% of patients requiring postoperative ventilation were subseque...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the safety and efficacy of ketamine in pediatric patients undergoing interventional cardiac procedures. DESIGN:A retrospective clinical study. SETTING:A single, tertiary referral center. PARTICIPANTS:Patients (n = 107) undergoing interventional cardiac procedures between July 1996 and July 1998...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(00)90053-3
更新日期:2000-02-01 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:OBJECTIVE:The present study examined the feasibility and efficacy of continuous bilateral erector spinae blocks for post-sternotomy pain in pediatric cardiac surgery. DESIGN:Prospective cohort study; patients were retrospectively matched 1:2 to control patients. Conditional logistic regression was used to compare dich...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.10.009
更新日期:2020-10-12 00:00:00
abstract:OBJECTIVES:The aim of this study was to evaluate the prognostic impact of cerebral regional oxygen saturation (crSO2) in patients undergoing surgery for Stanford type A aortic dissection (TAAD). DESIGN:Observational, retrospective, institutional study. SETTING:University hospital. PARTICIPANTS:A total of 152 patient...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.10.011
更新日期:2020-10-13 00:00:00
abstract::Cardiopulmonary bypass has been shown to activate various inflammatory cascades in the body, resulting in pathophysiological changes that may affect patient outcome after cardiac surgery. Many of these inflammatory cascades are enzyme mediated, involving serine proteases. This report reviews the mechanisms of bypass-m...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s1053-0770(97)80006-7
更新日期:1997-04-01 00:00:00
abstract::A case of MR progression after single-lung transplant as a significant contributor to postoperative respiratory failure is reported. Pre-existing MR may progress due to the decompressive effects of lung transplantation on RV dimension and consequent alteration of MV geometry. This case highlights the importance of int...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2014.06.017
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:Methicillin-resistant Staphylococcus is a growing problem in intensive care units (ICUs). The aim of this study was to describe the epidemiology of methicillin-resistant Staphylococcus isolates in a cardiac surgical ICU over a 5-year period and to determine the risk factors and outcome of this condition. ME...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2004.12.002
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:To determine the effects of positive-pressure ventilation and experimentally induced pericardial effusion and tamponade on transmitral flow velocities in dogs. DESIGN:Descriptive. SETTING:University laboratory. PARTICIPANTS:Eleven tracheally intubated and mechanically ventilated dogs. INTERVENTIONS:Experi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2003.9
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To evaluate reports from the published literature of all randomized clinical trials (RCT) comparing postoperative sedation with dexmedetomidine versus propofol in adult patients, after open cardiac surgery. DESIGN:A computerized search on Medline, EMBASE, Web of Science, and Agency for Healthcare Research an...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.10.022
更新日期:2020-10-17 00:00:00
abstract:OBJECTIVES:Mesenteric ischemia is still a fatal event after cardiac procedures. No adequate intraoperative methods are available to monitor the gastrointestinal mucosal microcirculation in real-time conditions. The aim of the study was to assess a newly designed microprobe using laser Doppler flowmetry and remission sp...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2014.07.003
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVES:To evaluate the effects of transesophageal echocardiography (TEE) probe insertion on the endotracheal cuff pressure (CP). DESIGN:Prospective observational study. SETTING:Single standing, not-for-profit pediatric hospital. PARTICIPANTS:A total of 80 pediatric patients (aged 6 days to 18.4 years) who underw...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.09.032
更新日期:2017-04-01 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: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:OBJECTIVE:The aim of the present study was to evaluate the correlation, accuracy, and precision of transpulmonary thermodilution cardiac output (CO) measurement. For this purpose, this technique was compared with the clinical gold standard, the CO measurement by pulmonary artery catheter in patients after coronary arte...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(98)90093-3
更新日期:1998-10-01 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 evaluate the success and complication rates of a single center's multidisciplinary approach to transvenous lead extraction. SETTING:One university hospital. PARTICIPANTS:One hundred ninety-five patients scheduled for transvenous lead extraction. INTERVENTIONS:A multidisciplinary approach to transvenous ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2014.11.010
更新日期:2015-04-01 00:00:00
abstract::The aim of this study was to evaluate blood salvage provided by an intraoperative blood recovery system (IBRS) and a mediastinal drainage blood recovery system (MBRS) during and after cardiac surgery. Sixty-six patients undergoing aortocoronary bypass surgery were randomly assigned to three groups of 22 patients each....
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)90119-e
更新日期:1991-10-01 00:00:00
abstract:OBJECTIVES:To identify the prevalence of and risk factors for inadvertent hypothermia after procedures performed with procedural sedation and analgesia in a cardiac catheterization laboratory. DESIGN:A single-center, prospective observational study. SETTING:A tertiary-care private hospital in Australia. PARTICIPANTS...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2015.06.002
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the effect of 0.1 microg/kg/min of fenoldopam mesylate on renal flow and central hemodynamics measured by echocardiography in hemodynamically stable patients with preserved renal function undergoing cardiac surgery. DESIGN:Experimental observational study. SETTING:S...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2009.04.012
更新日期:2010-02-01 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::The Doppler assessment of diastolic dysfunction (DD) is not part of a standard comprehensive intraoperative echocardiographic examination. Although the reasons may be many, the lack of a simplified algorithm for the assessment of DD specific to the perioperative arena, the implications of this diagnosis on clinical ca...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2012.07.012
更新日期:2012-12-01 00:00:00