Abstract:
STUDY OBJECTIVES:Strokes and neurocognitive dysfunction have been correlated with cerebral microemboli produced during cardiopulmonary bypass (CPB). The purpose of this study was to determine whether, and to what extent, off-pump coronary artery bypass (OPCAB) reduces the occurrence of cerebral microemboli compared with traditional coronary artery bypass grafting (CABG) with CPB and to compare clinical results. DESIGN AND PATIENTS:A retrospective review of 137 patients undergoing elective CABG was performed, 70 of whom underwent traditional CABG and 67 of whom underwent OPCAB. Using transcranial Doppler ultrasonography, 40 patients (20 CABG, 20 OPCAB) were continuously monitored intraoperatively for the occurrence and pattern of cerebral microemboli. SETTING:Private, university-affiliated tertiary care hospitals. RESULTS:There was no statistical difference in the age, sex, or underlying comorbidities between those patients undergoing CABG and OPCAB. CABG patients did have a slightly lower preoperative ejection fraction (50.9% vs 55.5%, p = 0.03). Despite these similar preoperative characteristics, the OPCAB group experienced significant reductions in cerebral microemboli (27 vs 1,766, p = 0.003), transfusion requirements (29.9% vs 47.1%, p = 0.04), intubation time (3.3 vs 9.5 h, p < 0.001), ICU length of stay (1.5 vs 2.8 days, p = 0.02), and overall hospitalization (4.9 vs 6.6 days, p = 0.01) without an increase in mortality. Fewer strokes and deaths were observed in the OPCAB group, but these trends failed to reach statistical significance. CONCLUSIONS:In similar patient populations, OPCAB was associated with significantly fewer cerebral microemboli and improved clinical results without an increase in mortality. We believe that these early results support OPCAB as a viable and potentially safer alternative to traditional CABG.
journal_name
Chestjournal_title
Chestauthors
Bowles BJ,Lee JD,Dang CR,Taoka SN,Johnson EW,Lau EM,Nekomoto Kdoi
10.1378/chest.119.1.25subject
Has Abstractpub_date
2001-01-01 00:00:00pages
25-30issue
1eissn
0012-3692issn
1931-3543pii
S0012-3692(15)37560-7journal_volume
119pub_type
杂志文章相关文献
CHEST文献大全abstract::Pneumothorax is a rare presentation of congenital cystic adenomatoid malformation (CCAM) in the newborn period and is presumed to be due to resuscitative measures. A previously well three-week-old baby presented with spontaneous tension pneumothorax due to CCAM. In the lung resection specimen, a malformation was seen,...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.99.5.1292
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:Asthma morbidity and mortality are higher in the United States for African-American (AA) children when compared to European-American (EA) children. STUDY OBJECTIVES:To explore racial differences in physiologic factors associated with pediatric asthma severity. DESIGN:Cross-sectional. METHODS:We analyzed d...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.117.5.1336
更新日期:2000-05-01 00:00:00
abstract::We report the cases of two lung transplant recipients (one heart-lung and one single lung) who eventually developed cytomegalovirus (CMV) pneumonitis after documentation of increasing CMV DNA titers in sequential bronchoalveolar lavage (BAL) specimens by polymerase chain reaction (PCR) amplification. To our knowledge,...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.101.1.93
更新日期:1992-01-01 00:00:00
abstract::It is known that smoking affects the development and maintenance of certain types of granulomatous lung diseases. To explore this mechanism(s), we measured tumor necrosis factor (TNF)-alpha concentrations in the culture supernatants of lipopolysaccharide (LPS)-stimulated alveolar macrophages (AMs) in 13 healthy nonsmo...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.103.2.479
更新日期:1993-02-01 00:00:00
abstract:BACKGROUND:Disease-specific patient-reported outcome (PRO) instruments are important in assessing the impact of disease and treatment. The Pulmonary Arterial Hypertension-Symptoms and Impact Questionnaire is the first instrument for quantifying pulmonary arterial hypertension (PAH) symptoms and impacts developed accord...
journal_title:Chest
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.chest.2018.04.027
更新日期:2018-10-01 00:00:00
abstract::Granular cell myoblastoma (GCM) is a rare benign neoplasm involving the tracheobronchial tree. It is believed to arise from the Schwann cell. Four cases of tracheobronchial GCM, all of which were multicentric, are presented and a conservative therapeutic approach is suggested. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.98.4.945
更新日期:1990-10-01 00:00:00
abstract::This report describes two patients with multidrug resistant tuberculosis who were successfully treated with the addition of amoxicillin-clavulanic acid to second-line drugs. Mycobacterium tuberculosis possesses a beta-lactamase contributing to its resistance to beta-lactam antibiotics. The combination of clavulanic ac...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.99.4.1025
更新日期:1991-04-01 00:00:00
abstract:BACKGROUND:To address the major methodological issues of reverse causation and selection bias in epidemiologic studies of antibiotic use in early life and the development of asthma, we undertook a cohort study of this association in a complete population of children. METHODS:Using the health-care and prescription data...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.06-3008
更新日期:2007-06-01 00:00:00
abstract::Fenoterol hydrobromide (Berotec; formerly Th 1165a) is a sympathomimetic bronchodilator drug. Twenty subjects with mild to moderate reversible bronchospasm completed a double-blind multiple crossover study of single doses of 5 mg, 7.5 mg, and 10 mg of fenoterol hydrobromide, 24 mg of ephedrine, and placebo. Spirometri...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.72.3.291
更新日期:1977-09-01 00:00:00
abstract:BACKGROUND:National spirometric surveillance data in the United States were last collected during 1988-1994. The objective of this study was to provide current estimates for obstructive and restrictive impairment of lung function and to examine changes since 1988-1994. METHODS:We used data from 14,360 participants age...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.12-1135
更新日期:2013-05-01 00:00:00
abstract::A case of amiodarone pulmonary toxicity (APT) occurring within days of the start of therapy and presenting with hemoptysis is reported. Both the very early onset and the presenting symptom are highly unusual in this entity. Implications in the diagnosis of APT are discussed. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.111.5.1446
更新日期:1997-05-01 00:00:00
abstract::A mechanical model was employed to examine phase and amplitude relationships between simulated pleural and mouth pressures during panting at different frequencies with and without lower airway obstruction and with rigid or flaccid extrathoracic airways. Results confirm the hypothesis that, in the presence of lower air...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.86.4.589
更新日期:1984-10-01 00:00:00
abstract:STUDY OBJECTIVES:(1) To define the incidence and natural history of Aspergillus colonization and infection in lung transplant recipients, and (2) to assess the impact of prophylaxis, surveillance, and therapy on the incidence and outcome of the disease. DESIGN:Retrospective review of 133 consecutive single or bilatera...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.119.1.169
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:D6 is an atypical chemokine receptor involved in chemokine degradation and resolution of acute inflammatory responses in mice. Emerging evidence suggests that D6 might behave differently in human chronic inflammatory conditions. We, therefore, investigated the involvement of D6 in the immune responses in COP...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.11-3220
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To determine the degree to which bioactive penicillin, metronidazole, ceftriaxone, clindamycin, vancomycin, and gentamicin penetrate into empyemic pleural fluid using our new rabbit model of empyema. METHODS:An empyema was created via the intrapleural injection of 10(8)()Pasteurella multocida bacteria into t...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.117.6.1734
更新日期:2000-06-01 00:00:00
abstract:STUDY OBJECTIVES:The aim of this study was to explore the relationship between quality of life and measures of asthma, such as lung function, reversibility to bronchodilation, exhaled nitric oxide (NO), and bronchial responsiveness to direct and indirect stimulus in patients with mild asthma in a primary care setting. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.129.3.624
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:In COPD, a decreased inspiratory capacity to total lung capacity ratio (IC/TLC) is associated with dynamic hyperinflation and poor exercise capacity. The association with upper-extremity force measured by handgrip strength (HGS) and 6-min walk distance (6MWD) has not been previously described. We hypothesize...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.14-2878
更新日期:2015-10-01 00:00:00
abstract:STUDY OBJECTIVES:To describe the prevalence of parental prompting to smoke (eg, parent requests that their child light the parent's cigarette in his/her own mouth) in a sample of families, and to assess the agreement between child and parent reports of the prompting behaviors. DESIGN, SETTING, AND PARTICIPANTS:A total...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.125.2.429
更新日期:2004-02-01 00:00:00
abstract::Part 2 of this review of ICU scoring systems examines how scoring system data should be used to assess ICU performance. There often are two different consumers of these data: lCU clinicians and quality leaders who seek to identify opportunities to improve quality of care and operational efficiency, and regulators, pay...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.11-0331
更新日期:2012-02-01 00:00:00
abstract::Of all patients presenting at our level 1 trauma center with multiorgan system injuries, 33 have been identified with acute lesions of the thoracic aorta. Mean severity injury score was 24 +/- 3. Four patients underwent resuscitative thoracotomy upon arrival in the emergency department. One survived and fully recovere...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.101.2.331
更新日期:1992-02-01 00:00:00
abstract::Numerous clinical trials of chemotherapy for tuberculosis conducted throughout the world over the past 4 decades have established 2 basic principles of treatment: effective treatment requires the initial concomitant administration of at least 2 drugs to which the patient's organisms are susceptible; and cure of tuber...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.87.2.117s
更新日期:1985-02-01 00:00:00
abstract:OBJECTIVES:To evaluate the efficacy and complications of noninvasive nasal mask bilevel continuous positive airway pressure ventilation in pediatric patients with hypoxemic respiratory insufficiency. DESIGN:Retrospective chart review. SETTING:Intensive care unit, university affiliated tertiary care children's hospita...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.108.4.1059
更新日期:1995-10-01 00:00:00
abstract:OBJECTIVES:Immunosuppressive pharmacologic agents prescribed to patients with diffuse interstitial and inflammatory lung disease and lung transplant recipients are associated with potential risks for adverse reactions. Strategies for minimizing such risks include administering these drugs according to established, safe...
journal_title:Chest
pub_type: 杂志文章,实务指引
doi:10.1378/chest.12-1044
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:In daily clinical work, we often face delayed or recurrent pneumothorax after radiofrequency (RF) ablation for lung tumors, but a large study on this theme has not been done. Thus, we examined the rate of delayed or recurrent pneumothorax after RF ablation for lung tumors and the risk factors associated with...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-1499
更新日期:2009-04-01 00:00:00
abstract::Exacerbations of sarcoidosis are common. In particular, exacerbations of pulmonary sarcoidosis are reported in more than one-third of patients. Despite their frequent occurrence, there is little medical evidence concerning the definition, diagnosis, and treatment of pulmonary exacerbations of sarcoidosis. In this arti...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.12-1060
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:In response to the Agency for Healthcare Research and Quality statement questioning the usefulness of “screening spirometry,” the National Heart, Lung, and Blood Institute and the COPD Foundation held a consensus conference in June 2008 to establish a procedure to detect cases of COPD in the general populati...
journal_title:Chest
pub_type: 杂志文章,随机对照试验
doi:10.1378/chest.11-1474
更新日期:2012-08-01 00:00:00
abstract::Due to concerns about the efficacy and safety of using pulmonary artery catheterization to evaluate hemodynamic status, noninvasive diagnostic testing has gained increased importance. This article focuses on both the supportive evidence and the limitations of applying the vascular pedicle width (VPW), which is the med...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.121.3.942
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Shared decision-making is an essential element of low-dose CT (LDCT) screening for lung cancer. Understanding patient-level outcomes from the National Lung Screening Trial (NLST) is critical to effectively communicate risks and benefits of screening to patients. METHODS:We performed a secondary analysis of ...
journal_title:Chest
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.chest.2019.06.016
更新日期:2019-11-01 00:00:00
abstract::The significance of dynamic changes of the QS wave magnitude, as demonstrated in the precordial leads, within the natural evolution of acute anterior wall myocardial infarction (AAMI) was assessed in 25 patients within two weeks of their admission to the intensive cardiac care unit. Two sets of tests, including 12-lea...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.94.5.1002
更新日期:1988-11-01 00:00:00
abstract::We describe a new technique for diagnostic fiberoptic bronchoscopic procedures under general anesthesia. The technique of inflation via nasotracheal catheter, which consists of using intermittent high inflating pressure for ventilation by passing a double catheter through the nose to the glottis and into the trachea, ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.72.4.480
更新日期:1977-10-01 00:00:00