Epidural sufentanil during paediatric cardiac surgery: effects on metabolic response and postoperative outcome.

The metabolic and neuroendocrine effects of caudal epidural analgesia were studied during paediatric cardiac surgery. Combined epidural and general anaesthesia (EPI group; n=12) was compared with deep opioid anaesthesia (DOA group; n=12). During anaesthesia and surgery, haemodynamic stability was similar in the two groups.

Hemodynamic effects of synchronized high-frequency jet ventilation compared with low-frequency intermittent positive-pressure ventilation after myocardial revascularization.

Background: The purpose of this prospective study was to examine the effect on cardiac performance of selective increases in airway pressure at specific points of the cardiac cycle using synchronized high-frequency jet ventilation (sync-HFJV) delivered concomitantly with each single heart beat compared with controlled mechanical ventilation in 20 hemodynamically stable, deeply sedated patients immediately after coronary artery bypass graft.

Methods: Five 30-min sequential ventilation periods were used interspersing controlled mechanical ventilation with sync-HFJV twice to control for time and sequencing effects. Sync-HFJV was applied using a driving pressure, which generated a tidal volume resulting in gas exchanges close to those obtained on controlled mechanical ventilation and associated with the maximal mixed venous oxygen saturation.

Aortic valve repair by cusp extension with the use of fresh autologous pericardium in children with rheumatic aortic insufficiency.

Objectives: Our goal was to evaluate the midterm results of aortic valve repair by a more sophisticated tailoring of cusp extension-taking into account the dimensions of the native aortic cusps-with the use of fresh autologous pericardium.

Patients And Methods: Forty-one children who had severe rheumatic aortic insufficiency (mean age 11.5 +/- 2.

Can gastric intramucosal pH (pHi) predict outcome of paediatric cardiac surgery?

In forty-two children undergoing cardiac surgery using hypothermic cardiopulmonary bypass (CPB), a gastric tonometer was used intraoperatively to estimate pHi, reflection of splanchnic perfusion. PHi monitoring was used to predict early postoperative complications. Intramucosal acidosis appeared after removal of the aortic clamp and remained after weaning of CPB.

[Coronary surgery without extracorporeal circulation. Indications, methods and results. Apropos of 224 cases].

Coronary revascularization without cardiopulmonary bypass is evolving as an important technique. From January 1988 to September 1997, 224 patients underwent consecutively coronary artery bypass grafting without cardiopulmonary bypass in our institution. Indications for this type of revascularization were essentially: patients with a single coronary lesion and patients which presented an increased risk for extra-corporeal circulation.