Differences in Plasma Extracellular Vesicles of Different Origin in On-Pump Versus Off-Pump Cardiac Surgery.

Coronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB) causes a systemic inflammatory response that can worsen patient outcomes. Off-pump surgery has been associated with a reduced inflammatory response. The precise mechanisms and the role of extracellular vesicles (EVs) in this context are not fully understood.

[Clinical, laboratory and morphological comparisons in cellular alteration under conditions of hypoxia].

Objective: To compare structural changes in tissues with clinical and laboratory parameters and immunohistochemical determination of proteins HIF1α, HIF2α, caspase-3 during cellular alteration under conditions of hypoxia in the liver and kidneys in an experiment on pigs.

Material And Methods: Laboratory parameters related to the state of gas exchange (decrease in partial pressure of arterial blood oxygen (PaO2), arterial blood saturation, lactate level, kidney function (creatinine, urea) and liver (ALT, AST, bilirubin) in 18 animals were analyzed in comparison with the results of a morphological study. Histological examination evaluated alterative and inflammatory tissue changes of varying severity, and also determined the expression of transcription factors HIF1α and HIF2α and a marker of apoptosis - caspase-3.

[Analysis of indocyanine green plasma disappearance rate in clinical practice].

Objective: To justify the optimal method for determining indocyanine green plasma disappearance rate (PDR).

Material And Methods: We analyzed PDR in intensive care units. Indocyanine green was administered intravenously at a dose of 0.

Clinical features and pregnancy outcomes in women with aortopulmonary window defect: case series.

Background: Aortopulmonary window is a rare congenital heart defect that results in severe pulmonary arterial hypertension (PAH), Eisenmenger syndrome, and congestive heart failure in the first months of life. Pregnancy is absolutely contraindicated in the patients with this condition.

Case Summary: This paper describes two clinical cases of pregnancy in patients (28 and 20 years old) with aortopulmonary window defect, severe PAH, and Eisenmenger syndrome that ended in preterm delivery by caesarean section.

NO Addition during Gas Oxygenation Reduces Liver and Kidney Injury during Prolonged Cardiopulmonary Bypass.

. To evaluate the effect of NO added to the sweep gas of the oxygenator during cardiopulmonary bypass (CPB) on the liver and kidneys in pigs. .

Effect of Volatile Anesthetics on Myocardial Infarction After Coronary Artery Surgery: A Post Hoc Analysis of a Randomized Trial.

Objective: To investigate the effect of volatile anesthetics on the rates of postoperative myocardial infarction (MI) and cardiac death after coronary artery bypass graft (CABG).

Design: A post hoc analysis of a randomized trial.

Setting: Cardiac surgical operating rooms.

Effects of ischaemic postconditioning in aortic valve replacement: a multicenter randomized controlled trial.

Objectives: The effect of ischaemic postconditioning (IPost) on postcardioplegic cardiac function is not known. We hypothesized that IPost was cardioprotective in adult patients undergoing elective aortic valve replacement.

Methods: In a multicentre, prospective, randomized trial, patients (n = 209) were randomized to either a standard operation (controls) or postconditioning.

Heart-Protective Mechanical Ventilation in Postoperative Cardiosurgical Patients.

Background: This study compared the hemodynamic effects and gas exchange under several different ventilator settings-with regard to tidal volume, respiratory rate, and end-expiratory pressure-in patients after coronary artery bypass grafting (CABG).

Methods: Prospective interventional cohort study with a controlled group in a single cardiosurgical ICU involving 119 patients following on-pump CABG surgery. During the 1st postoperative hour, the intervention group patients were ventilated with Vt 10 ml × kg, RR 14/min, PEEP 5 cmHO ("conventional ventilation").

Volatile Anesthetics versus Total Intravenous Anesthesia for Cardiac Surgery.

Background: Volatile (inhaled) anesthetic agents have cardioprotective effects, which might improve clinical outcomes in patients undergoing coronary-artery bypass grafting (CABG).

Methods: We conducted a pragmatic, multicenter, single-blind, controlled trial at 36 centers in 13 countries. Patients scheduled to undergo elective CABG were randomly assigned to an intraoperative anesthetic regimen that included a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or to total intravenous anesthesia.

MortalitY in caRdIAc surgery (MYRIAD): A randomizeD controlled trial of volatile anesthetics. Rationale and design.

Objective: There is initial evidence that the use of volatile anesthetics can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalization following coronary artery bypass graft (CABG) surgery. Nevertheless, small randomized controlled trials have failed to demonstrate a survival advantage. Thus, whether volatile anesthetics improve the postoperative outcome of cardiac surgical patients remains uncertain.

ANESTHETIC MANAGEMENT AND INTENSIVE CARE DURING PERIOPERATIVE PERIOD OF ABDOMINAL DELIVERY IN PREGNANT WOMEN WITH PULMONARY ARTERIAL HYPERTENSION.

Unlabelled: Background The presence ofpulmonary arterial hypertension (PAH) in pregnant women increases mortality up to 12- 30% and up to 50% when PAH is associated with Eisenmenger syndrome. Due to low prevalence of PAH in pregnancy many aspects ofperioperative management are still unclear.

The Aim: To summarize our approaches to the anesthesia and intensive care in pregnant women with PAH.

[PROTEIN KINASE C EXPRESSION FOLLOWING REMOTE ISCHEMIC PRECONDITIONING IN CARDIAC SURGERY].

Objective: To evaluate cardioprotective effects of remote ischemic preconditioning (RIPC) in cardiac surgery patients undergoing aortic valve replacement depending on the type of anesthesia and investigate the level of myocardial protein kinase C epsilon (PKC-ε) expression after RIPC.

Methods: In prospective randomized trial, forty eight patients aging from 50 to 75 years old (64 (56 ;69)) were included All patients were scheduled for aortic valve replacement using cardiopulmonary bypass (CPB). The patients were randomized into 4 groups: 1) RIPC applied during propofol anesthesia (RIPC prop, n = 12), 2) RIPC applied during sevoflurane anesthesia (RIPC sev, n = 12), 3) propofol anesthesia without RIPC (CONTROL prop, n = 12), 4) sevoflurane anesthesia without RIPC (CONTROL sev, n = 12).

[SPECIFICS OF INHALED ILOPROST PHARMACODYNAMICS IN PATIENTS WITH SEVERE LEFT VENTRICULAR SYSTOLIC DYSFUNCTION].

Purpose: To determine the specifics of inhaled iloprost effect on pulmonary and systemic hemodynamics in patients with pulmonary hypertension (PH) associated with left ventricular systolic dysfunction.

Materials And Methods: 47 vasore- activity tests (VRT) with 20 micrograms inhaled iloprost (Ventavis, Bayer) were performed in 39 candidates on heart transplantation. All patients had heart failure III-IV NYHA and PH with pulmonary vascular resistance (PVR) more than 2.

[Hemodynamic effects of the alveolar recruitment maneuver in cardiosurgical patients with left ventricular systolic dysfunction].

Purpose: To evaluate hemodynamic effects of the ahveolar recruitment maneuver (ARM) in cardiosurgical patients with left ventricular systolic dysfunction.

Materials And Methods: We estimate hemnodynamics data obtained during intraoprative ARM in 16 cardiosuigical patients with left ventricular systolic dysfunction. ARMA were applied due to hypoxemnia with PaO2/FiO2 less than 250 nmm Hg.

[Effects of remote ischemic preconditioning on perioperative period in elective aortic valve replacement].

Purpose Of The Study: To evaluate the effects of remote ischemic preconditioning (RIPC) on the perioperative period in elective aortic valve replacement (AVR) along different anaesthesia techniques.

Materials And Methods: 48 patients aged 50 to 75 years (64 (56;69)) which were scheduled for AVR due to aortic valve stenosis were included into the prospective, randomized study. Four groups were formed after randomization: 1) RIPC applied during propofol anesthesia (RIPCprop, n = 12), 2) RIPC applied during sevoflurane anesthesia (RIPCsevo, n = 12), 3) propofol anesthesia without RIPC (CONTROLprop, n = 12), 4) sevoflurane anesthesia without RIPC (CONTROLsevo, n = 12).

Correlation of cardiac output and sevoflurane required to maintain anesthetic depth targeted with entropy index.

Aims And Objectives: We investigated the correlation of reduced cardiac output on required sevoflurane to maintain targeted anesthesia depth.

Materials And Methods: 36 patients undergoing coronary artery bypass grafting with cardiopulmonary bypass were prospectively included in the study. Inspired sevoflurane concentration was adjusted to ensure state entropy index < 40.

[The first experience with heart transplantation in the Federal Center of the Heart, Blood and Endocrinology named after V. A. Almazov].

At the present time heart transplantation is considered to be the operation of choice in treatment of patients with terminal stage of chronic heart failure. Results of the first 5 heart transplantations made in the Federal Center of the heart, blood and endocrinology named after V. A.

Surfactant therapy for patients with ARDS after cardiac surgery.

This multicenter study investigated the possibility of reducing mortality rate by administering natural lung surfactant additional to standard therapy to treat patients after cardiac surgery who developed an acute respiratory failure (ARDS/ALI).A total of 78 patients (1998-2002) diagnosed with ALI or ARDS were enrolled in the study; patients were considered for study entry only if they developed ALI/ARDS within 72 h after cardiac surgery. A total of 36 patients (2000-2002) received Surfactant-BL via bronchoscope at a dose of 3 mg/kg twice a day, and 42 patients (1998-2000) served as the historical control.

[Transprosthetic aortotomy in reconstruction of the brachiocephalic zone arteries for multiple injury of the opening].

An experience with transprosthetic aortotomy in 8 patients is analyzed. There were no lethal outcomes. The technique of the operation is described.

[The first experience with using a preparation of lung surfactant for prevention and treatment of the acute lung injury syndrome after operations on the heart and aorta].

The authors made an analysis of their experience with using the preparation in 29 patients (22 for treatment and 7 for prophylactics) with acute injury of the lungs. When used for treatment, it gave good results in 16 patients. The prophylactic application of the preparation allowed to avoid acute respiratory insufficiency.