摘要:

Controversy has arisen over the influence of normothermic bypass on stroke rate. Two major prospective trials have produced strikingly disparate results and are discussed. The significance of symptomatic versus asymptomatic carotid stenosis as a risk for postoperative stroke is also reviewed. Evidence is presented that low-flow bypass produces better outcome than total circulatory arrest during procedures conducted with deep hypothermia. Additionally, profound hypothermia may confer additional protection. Selective cerebral perfusion is now receiving increasing attention with several studies outlining its efficacy during circulatory arrest. Newer modalities of pharmacological cerebral protection are also reviewed.

ISSN:0952-7907    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The ability to correct complex congenital heart defects surgically has improved considerably. However, several factors can adversely affect outcome in neonates, infants, and children undergoing cardiac surgery. The purpose of this review is to discuss important advances in coagulation, cardiopulmonary bypass, echocardiography, and cardiac catheterization. The effects of aprotinin, a proteinase inhibitor, on platelet preservation, aggregation, and postoperative blood loss is described. The physiology and effects of deep hypothermic circulatory arrest are compared with low-flow cardiopulmonary bypass. The value and feasibility of echocardiography with an update on interventional cardiology is discussed.

ISSN:0952-7907    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Clinical outcome studies of the treatment of congestive heart failure have been published during the past 2 years which substantiate the use of one old drug, digoxin, and angiotensin-converting enzyme inhibitors. The positive inotropic drugs such as the phosphodiesterase inhibitor, milrinone, and the β agonist, xamoterol, and pure vasodilators have proved ineffective if not dangerous. However, three new drugs have been tested with preliminary beneficial results: the vasodilator and inotropic drug, flosequinan; the phosphodiesterase inhibitor and calcium channel sensitizer, pimobendan; and the positive inotrope and cytokine inhibitor, vesnarinone. Further long-term studies are necessary before these drugs become established modes of therapy.

ISSN:0952-7907    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The rein angiotensin system (RAS) blood pressure as its main endocrine activity. However, other systems (sympathetic nervous system, vasopressin) are also involved in blood pressure regulation and can compensate for a depressed RAS. Angiotensin-converting enzyme (ACE) inhibition impedes angiotensin II production and interferes with circulating and regional RAS activities; however, ACE inhibiiton exceeds simple RAS blockade. Consistent beneficial effects of these actions have already been demonstrated in heart failure and hypertension, and are under investigation in myocardial ischaemia. By contrast, very few studies on ACE inhibition have been conducted during anaesthesia and surgery.

ISSN:0952-7907    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Our understanding of the vital function of the vascular endothelium in circulatory physiology is rapidly expanding. Endothelium-derived vasoactive substances influence vascular tone, growth, inflammation, and haemostasis. Endothelial dysfunction is implicated in the pathophysiology of cardiovascular diseases such as atherosclerosis, ischaemia-reperfusion injury, hypertension, and congestive heart failure. New pharmacological therapies are evolving from our understanding of the role of the endothelium.

ISSN:0952-7907    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Alpha2-adrenergic agonists and the mechanisms by which they act continue to be a major stimulus to basic and clinical research. New advances in molecular biology and knowledge of the anatomical distribution of the α2-adrenoceptor subtypes may lead to the development of new agents of interest to clinical anaesthesiologists. Improved understanding and functional recognition of the β3-adrenoceptor subtype has accompanied isolation of the gene coding the third β-receptor subtype.

ISSN:0952-7907    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The cardiovascular effects of newly developed inhalational anaesthetic sevoflurane and desflurane, and intravenous anaesthetics propofol and pregnanolone have received considerable attention in order to ensure their administration will be appropriate and safe. Recent investigations of the effects of these novel anaesthetic agents on cardiovascular systems are reviewed.

ISSN:0952-7907    

出版商:OVID    

年代:1995

数据来源: OVID