The prophylactic use of fibrinogen concentrate in high-risk cardiac surgery.

Background: Perioperative blood loss is a major contributor to morbidity and mortality in cardiac surgery. Plasma fibrinogen levels play an essential role in hemostasis and deplete quickly during hemorrhage. The objective of this study was to determine whether prophylactic fibrinogen concentrate administration lowers overall blood product transfusion requirements in high-risk cardiac surgery in patients with low fibrinogen plasma levels.

Hemodynamic effects of dobutamine and dopexamine after cardiopulmonary bypass in pediatric cardiac surgery.

Background: After surgical repair of congenital heart disease, inotropic support is sometimes necessary to wean from cardiopulmonary bypass. In pediatric cardiac surgery, dobutamine and dopamine are often used as inotropic support. Dopexamine is a synthetic catecholamine, which has positive inotropic and vasodilating properties.

Effect of isoflurane on echocardiographic left-ventricular relaxation indices in patients with diastolic dysfunction due to concentric hypertrophy and ischemic heart disease.

Objective: The purpose of this study was to investigate whether isoflurane, a known negative lusitropic agent, exacerbates diastolic dysfunction in patients with preexisting impaired relaxation.

Design: Prospective, experimental study.

Setting: Single-institution, university hospital.

Transesophageal echocardiography as a guide for patient positioning before neurosurgical procedures in semi-sitting position.

With an incidence of a patent foramen ovale in nearly one fourth of the normal population, neurosurgical procedures in the semi-sitting position are associated with the risk of paradoxical air embolism. The present study was undertaken to evaluate an anesthetic concept to detect a patent foramen ovale with the help of transesophageal echocardiography in anesthetized patients before neurosurgical procedures in the semi-sitting position. Transesophageal echocardiography was performed after induction of anesthesia before surgery to avoid additional physical and psychologic stress for the patients.

The effect of intravenous quinaprilat on plasma cytokines and hemodynamic variables during cardiac surgery.

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 have beneficial effects with respect to the development of the systemic inflammatory response syndrome.