Hypertonic saline (2400 mOsm/L) has been used successfully for fluid resuscitation of dogs subjected to severe hemorrhagic shock. This study compared the effects with hypertonic vs. lactated Ringer's solution on intracranial pressure (ICP) in 30 min sustained hypovolemic Hypotension was produced by rapid withdrawal blood until mean arterial 50 mm Hg, maintained at that level or infusion over next as necessary. Eight animals were resuscitated and nine solution. Both solutions restored...

The prognostic value of preoperative symptoms, left ventricular function, and intraoperative factors as related to postoperative outcome in coronary artery bypass grafting is unclear. This study was performed identify risk that could be used markers predict immediate long-term outcome, knowledge which might allow physicians modify these decrease the likelihood an adverse outcome. We retrospectively evaluated (including age, sex, New York Heart Association [NYHA] classification ejection...

Milrinone can reverse acute postischemic myocardial dysfunction after cardiopulmonary bypass, although neither the appropriate bolus dose nor its pharmacokinetics has been established for cardiac surgical patients.Consenting patients undergoing surgery received milrinone (25, 50, or 75 micro gram/kg) in an openlabel, dose-escalating study if their index was <3 L centered dot min-1 m-2 separation from bypass. Heart rate, mean arterial blood pressure, pulmonary capillary wedge and were...

Patients with anterior mediastinal masses are at increased risk for perioperative complications. Our case demonstrates that airway collapse and inability to ventilate may occur in the asymptomatic adult despite spontaneous ventilation inhaled anesthesia an endotracheal tube. Given sudden profound presentation of cardiopulmonary collapse, rigid bronchoscopy should be immediately available facilitate life-saving ventilation. Though repositioning pediatric patient lateral or prone has been...

Amrinone, a phosphodiesterase inhibitor, and epinephrine, an α β-adrenergic receptor agonist, are inotropic drugs used during cardiac surgery to reverse myocardial depression after cardiopulmonary bypass. However, these have not been compared separately, or in combination, this patient population. We hypothesized that the combination might complementary actions improving function. We, therefore, amrinone, of amrinone epinephrine randomized, blinded, placebo-controlled study patients...

Forty hemodynamically stable patients were randomized to receive an intravenous bolus of either calcium chloride (5 mg/kg) (n = 20) or placebo (phase I). Six minutes later, they received epinephrine (30 ng·kg−1-min−1) infusion II). Hemodynamic and ionized measurements obtained in phase I at baseline 3 6 min after the bolus, II, (study times 9 12 min) initiation infusion. Compared with placebo, did not significantly increase cardiac index but increased mean arterial pressure. Calcium improved...

Left ventricular dysfunction is common after cardiac surgery and often treated with positive inotropic drugs (PIDs).We hypothesized that the use of PIDs valve would have significant associations valvular pathophysiology surgical procedure, unlike case for patients undergoing coronary artery surgery, be unrelated to duration cardiopulmonary bypass (CPB) or aortic clamping. One hundred forty-nine consenting were studied. Patients hepatic renal failure, New York Heart Association class IV...

This study evaluates whether repeated postoperative visits by the anesthesiologist improve patient ability to recall anesthesiologist's name and patient's perception of satisfaction with anesthesia services.In a randomized, prospective trial, 144 patients an anticipated length stay at least three days were enrolled in groups: Group A (n = 48) had one visit, B two visits, C visits. All performed attending on consecutive days. Patients contacted after their last visit complete questionnaire....

Positive-pressure ventilation can increase dead space by trapping gas, especially at high frequencies. Under conditions of airway resistance and pulmonary compliance, gas alveolar pressure without affecting proximal pressure, due to impedance expiratory flow. The difference between end-expiration has been called auto-PEEP. Using a mechanical test lung, we altered compliance under variety high-frequency jet ventilator settings evaluate the generation High driving pressures prolonged...

Amrinone and milrinone are phosphodiesterase inhibitors with positive inotropic effects useful for the treatment of ventricular dysfunction after cardiac surgery.Forty-four patients undergoing elective surgery at four centers received either amrinone (n = 22) or in a randomized, blind fashion. Immediately separation from cardiopulmonary bypass (CPB), two bolus doses 0.75 mg/kg 25 [micro sign]g/kg were administered over 30 s, separated by 5 min. Hemodynamic measurements recorded before each...

The activated coagulation time (ACT) is widely used to guide heparin and protamine dosing during cardiac surgery. A common protocol involves establishing a baseline ACT before administering heparin, then using this as target value for assessing the adequacy of neutralization after cardiopulmonary bypass. Results vary in previous comparisons postprotamine ACT, with some showing significantly below values. present study examined ACTs at three possible intervals 68 patients two institutions:...

Left ventricular dysfunction is common after cardiac surgery and often treated with positive inotropic drugs (PIDs).We hypothesized that the use of PIDs valve would have significant associations valvular pathophysiology surgical procedure, unlike case for patients undergoing coronary artery surgery, be unrelated to duration cardiopulmonary bypass (CPB) or aortic clamping. One hundred forty-nine consenting were studied. Patients hepatic renal failure, New York Heart Association class IV...

This study evaluates whether repeated postoperative visits by the anesthesiologist improve patient ability to recall anesthesiologist's name and patient's perception of satisfaction with anesthesia services.In a randomized, prospective trial, 144 patients an anticipated length stay at least three days were enrolled in groups: Group A (n = 48) had one visit, B two visits, C visits. All performed attending on consecutive days. Patients contacted after their last visit complete questionnaire....

Background Patients may receive more than one positive inotropic drug to improve myocardial function and cardiac output, with the assumption that effects of two drugs are additive. The authors hypothesized combinations dobutamine epinephrine would produce additive biochemical hemodynamic effects. Methods study was performed in parts. Phase 1 used human lymphocytes an vitro model cyclic adenosine monophosphate (cAMP) generation response (10(-8) 10(-4) M) or (10(-9) M 10(-5) M), together. 2 a...

Background Triiodothyronine regulates cardiac contractility; however, the mechanisms by which it produces its acute contractile effects remains unknown. We compared of thyroid hormones (triiodothyronine [T3] and thyroxine [T4]) isoproterenol on contractility isolated rat hearts. In addition, we sought to determine whether inotropic were mediated beta-adrenergic receptors or increased production cyclic-3',5'-adenosine monophosphate (cAMP). Methods A Langendorff heart preparation harvested...

To determine whether the calcium-magnesium-parathyroid hormone-calcitriol (vitamin D) axis responds appropriately to hypocalcemia that routinely follows initiation of cardiopulmonary bypass (CPB), we measured blood ionized calcium (CaI), total (CaT), magnesium (MgT), ultrafilterable (MgI), protein, intact parathyroid hormone (PTH), and calcitriol concentrations at eight defined time points in 28 patients undergoing elective cardiac surgery. With onset CPB, CaI decreased from 1.14 +/- 0.02...

To assess the effect of substituting dexmedetomidine for propofol during a nationwide shortage on postoperative time to extubation and opioid requirements in patients who underwent coronary artery bypass graft (CABG) surgery.Retrospective case-control study.Single-center cardiothoracic intensive care unit (ICU) tertiary academic medical center.Seventy adults undergoing isolated, primary, elective CABG received between April 1 June 30, 2010, (35 [cases]) or January March 31, July September...