Abstract:
BACKGROUND:Few data support an association between blood pressure variability and clinical outcomes during cardiac surgery. We tested the hypothesis that intraoperative systolic blood pressure variability outside a targeted blood pressure range predicts 30-day mortality in patients undergoing cardiac surgery. METHODS:Electronically captured blood pressure data from 7,504 consecutive coronary bypass surgery procedures between September 1, 1996, and December 31, 2005, were divided into development and validation cohorts. Systolic blood pressure variability episodes outside a blood pressure range (e.g., higher than 135 or lower than 95 mmHg) were characterized by number of episodes, magnitude of episode, duration of episode, and magnitude x duration of excursion (i.e., area under the curve). Multiple logistic regression analysis was used to assess 30-day mortality association. The most predictive mortality risk characteristic and blood pressure range was tested in the validation cohort. RESULTS:A total of 3.1 million intraoperative blood pressure evaluations were analyzed. Systolic blood pressure variability was derived in 5,038 patients and validated in 2,466 patients (8% without cardiopulmonary bypass and 6% with valve procedure). Among all tested indices of blood pressure variability, mean duration of systolic excursion (outside a range of 105-130 mmHg) was most predictive of 30-day mortality (odds ratio = 1.03 per minute, 95% CI 1.02-1.39, P < 0.0001). CONCLUSIONS:Intraoperative blood pressure variability is associated with 30-day postoperative mortality in patients undergoing aortocoronary bypass surgery.
journal_name
Anesthesiologyjournal_title
Anesthesiologyauthors
Aronson S,Stafford-Smith M,Phillips-Bute B,Shaw A,Gaca J,Newman M,Cardiothoracic Anesthesiology Research Endeavors.doi
10.1097/ALN.0b013e3181e07ee9subject
Has Abstractpub_date
2010-08-01 00:00:00pages
305-12issue
2eissn
0003-3022issn
1528-1175journal_volume
113pub_type
杂志文章,随机对照试验相关文献
ANESTHESIOLOGY文献大全abstract::In order to elucidate the possible mechanism(s) by which opiates may affect cerebral and spinal circulation, and cerebral metabolism, cerebral blood flow (CBF) and spinal cord blood flow (SCBF) were measured simultaneously following intravenous or subarachnoid administration of morphine in dogs lightly anesthetized wi...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:
更新日期:1983-09-01 00:00:00
abstract:BACKGROUND:Basal cytotoxic activity of NK cells, a subtype of lymphocytes involved in the nonspecific immune response to viruses, tumors, and some bacteria, is altered in the postoperative period. The current study examines the effects of halothane and isoflurane on interferon-induced stimulation of NK cell cytotoxicit...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199304000-00013
更新日期:1993-04-01 00:00:00
abstract:BACKGROUND:Ketamine is often administered to patients in whom hemodynamic instability is suspected. This study was designed to investigate the effect and possible site of action of ketamine on baroreflex response in rats. The site focused upon was the N-methyl-D-aspartate (NMDA) receptor of the nucleus tractus solitari...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199301000-00022
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:In previous studies, the authors showed that anesthetics affect the expression ratios of many genes in rat liver. microRNAs (miRNA) negatively regulate more than 30% of genes in cells, and control cell proliferation, inflammation, and metabolism. The authors hypothesized that anesthetics influence miRNA expr...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3182746676
更新日期:2012-12-01 00:00:00
abstract::Fourteen cases of sudden cardiac arrest in healthy patients who received spinal anesthesia were discovered in a preliminary review of 900 closed insurance claims for major anesthetic mishaps. All patients were resuscitated from the intraoperative cardiac arrest, but six suffered such severe neurologic injury that they...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198801000-00003
更新日期:1988-01-01 00:00:00
abstract::This study was designed to assess the relationship between MAC and hypertension. To this purpose, MAC of halothane was determined in fully inbred spontaneously hypertensive rats (SHR) and Wistar Kyoto rats (WKY). Because MAC determination was performed in animals whose lungs were mechanically ventilated, the adequacy ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199005000-00013
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Recent advances have indicated a complex interplay between the autonomic nervous system and the innate immune system. Targeting neural networks for the treatment of sepsis is being developed as a therapeutic strategy. Because electroacupuncture at select acupoints can modulate activities of the autonomic ner...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3182426ebd
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:The hanging drop technique is used for identifying the cervical epidural space, using its negative pressure. However, it is doubtful whether the epidural space intrinsically exhibits a negative pressure. We designed this study to test the hypothesis that the cervical epidural pressure (CEP) is significantly ...
journal_title:Anesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/ALN.0b013e3181e898e8
更新日期:2010-09-01 00:00:00
abstract::Using the technique of ventriculocisternal perfusion, resistance to reabsorption of cerebrospinal fluid (Ra) was calculated from determinations of the rate of reabsorption of cerebrospinal fluid (Va) at differing cerebrospinal fluid pressures in dogs. Ra was examined during prolonged anesthesia (5.0-6.0 h) with enflur...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198411000-00009
更新日期:1984-11-01 00:00:00
abstract:BACKGROUND:Pneumocephalus occurs in a variety of clinical settings and has important anesthetic implications, particularly if N2O is used. One common cause of pneumocephalus is a craniotomy or craniectomy, and therefore, patients undergoing these neurosurgical procedures may be at increased risk for the development of ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199405000-00009
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:Recent evidence implicates nitric oxide (*NO) in the pathogenesis of preeclampsia. The authors tested the hypothesis that administration of low-dose endotoxin to pregnant rats mimics the signs of preeclampsia in humans and that *NO and *NO-derived species play a role in that animal model. METHODS:Endotoxin ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200012000-00017
更新日期:2000-12-01 00:00:00
abstract::Perioperative myocardial ischemia is associated with an increased risk of perioperative myocardial infarction (PMI). Several attempts have been made to define intraoperative hemodynamic predictors of myocardial ischemia. In a canine preparation with coronary stenosis, a pressure rate quotient (PRQ = mean arterial pres...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199105000-00008
更新日期:1991-05-01 00:00:00
abstract:WHAT WE ALREADY KNOW ABOUT THIS TOPIC:Cardiac surgery is associated with cognitive decline and postoperative delirium. The relationship between postoperative delirium and cognitive decline after cardiac surgery is unclear WHAT THIS ARTICLE TELLS US THAT IS NEW:The development of postoperative delirium is associated wi...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0000000000002253
更新日期:2018-09-01 00:00:00
abstract::Some previous reports indicate that the excitability of the brain may be increased for days following enflurane anesthesia. The authors investigated this possibility in cats by determining whether or not pentylenetetrazol- (Metrazol) or lidocaine-seizure thresholds decreased after repeated enflurane exposure. The lido...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198105000-00010
更新日期:1981-05-01 00:00:00
abstract:BACKGROUND:Pain behavior in response to skin incision is developmentally regulated, but little is known about the underlying neuronal mechanisms. The authors hypothesize that the spatial activation and intensity of dorsal horn neuron responses to skin incision differ in immature and adult spinal cord. METHODS:Single w...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e3181870a32
更新日期:2008-10-01 00:00:00
abstract::The cerebral and systemic hemodynamic and metabolic effects of hypotension induced with desflurane were examined in 11 dogs. During a steady-state baseline period under 1 MAC desflurane (7.2%), the following were measured or derived: arterial, pulmonary artery, and pulmonary artery occlusion pressures; arterial, mixed...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199103000-00021
更新日期:1991-03-01 00:00:00
abstract:BACKGROUND:The aim of this study was to investigate the effects of two imidazoline-derived intravenous anesthetics, etomidate and midazolam, on vascular adenosine triphosphate-sensitive potassium (KATP) channel activity. METHODS:In isolated rat aorta, isometric tension was recorded to examine the anesthetic effects on...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200703000-00016
更新日期:2007-03-01 00:00:00
abstract::Interposition of activated carbon between a nitrogen analyzer needle valve and gas mixtures containing halothane, methoxyflurane, enflurane, or isoflurane eliminated the interfering effects of these agents, but added sampling delays. Placement of a carbon-filled Swinney adaptor in the sampling line between the needle ...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-197512000-00014
更新日期:1975-12-01 00:00:00
abstract:BACKGROUND:Antioxidant anesthetics such as propofol (2,6-diisopropylphenol) directly inhibit lipid peroxidation via the generation of reactive oxygen species. Currently, there are no other studies regarding the direct effects of propofol medium chain triglyceride/long chain triglyceride (MCT/LCT) on reactive oxygen spe...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318182a903
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Intraspinally administered alpha 2-adrenergic agonists may relieve pain in sympathetically maintained pain (SMP) syndromes, such as reflex sympathetically dystrophy (RSD), by spinal, peripheral, and central nervous system actions. This study examined analgesic efficacy and side effects of epidurally administ...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1993-12-01 00:00:00
abstract:BACKGROUND:Because the nuclear factor-κB (NF-κB) coupled pathway is believed to amplify inflammation prevailing in sepsis, the authors tested the hypotheses that the insertion-deletion polymorphism (-94ins/delATTG) (1) alters nuclear translocation of nuclear factor-κB and activator protein-1 (NF-κB1) in monocytes after...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/ALN.0b013e318277a652
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Nonimmobilizers are agents that lack anesthetic properties, although their chemical structure is very similar to known anesthetics. The primary action site of both agents, whether at the membrane or target protein level, is still a matter of debate. However, increasing evidence points to the distinct modific...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200210000-00016
更新日期:2002-10-01 00:00:00
abstract::Cardiac output and myocardial blood flow decrease dramatically in a dose-dependent pattern in the young lamb during isoflurane anesthesia. This raises important questions about the ability of the young lamb to increase myocardial performance if oxygen delivery were compromised by a decrease in oxygen content during an...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-198911000-00020
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:Recent trials indicate that rapacuronium's pharmacokinetic characteristics are influenced by both renal failure and cirrhosis but the time course of a single bolus dose of 1.5 mg/kg is affected minimally. The authors reassessed these pharmacokinetic findings and examined the time course of the same bolus dos...
journal_title:Anesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/00000542-200012000-00007
更新日期:2000-12-01 00:00:00
abstract::Critically ill patients must often breathe spontaneously through an endotracheal tube that acts as a fixed inspiratory and expiratory tubular airway resistor. Although this practice is common, its effect on the pattern of breathing is not known. The mean breathing patterns of seven normal, healthy male subjects and ei...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-198603000-00009
更新日期:1986-03-01 00:00:00
abstract:BACKGROUND:Tight perioperative control of blood glucose improves the outcome of diabetic patients undergoing cardiac surgery. Because stress response and cardiopulmonary bypass can induce profound hyperglycemia, intraoperative glycemic control may become difficult. The authors undertook a prospective cohort study to de...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200510000-00006
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:In the partial CO(2) rebreathing method, monitored changes in CO(2) elimination and end-tidal CO(2) in response to a brief rebreathing period are used to estimate cardiac output. However, dynamic changes in CO(2) production during ischemia and reperfusion may affect the accuracy of these estimates. This stud...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章
doi:10.1097/00000542-200308000-00009
更新日期:2003-08-01 00:00:00
abstract::Malpractice claims filed against anesthesiologists for care involving obstetric (OB) anesthesia (n = 190) were taken from the American Society of Anesthesiologists' Closed Claims Database and compared to claims not involving OB cases (n = 1351). The most common complications in the OB claims were (percentage of all OB...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-199102000-00009
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:The analgesic efficacy and side effect profile of intravenous parecoxib, a novel cyclooxygenase type-2 (COX-2) inhibitor, was assessed in a double-blinded, placebo-controlled study involving patients undergoing major gynecologic surgical procedures. METHODS:After Institutional Review Board approval, 60 cons...
journal_title:Anesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000542-200206000-00007
更新日期:2002-06-01 00:00:00
abstract:BACKGROUND:Drugs that block spinal excitatory amino acid receptor activation may prevent pain after surgery. The authors previously studied the effect of excitatory amino acid receptor antagonists after incision. In the present study, we examined the role of N-methyl-d-aspartate (NMDA), non-NMDA, and metabotropic gluta...
journal_title:Anesthesiology
pub_type: 杂志文章
doi:10.1097/00000542-200008000-00029
更新日期:2000-08-01 00:00:00