ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Cardiovascular homeostasis is in large part mediated by the autonomic nervous system. Blood pressure perturbations are sensed by the baro-receptors and initiate rapid reflex changes in both parasympathetic and sympathetic activity. Autonomic outflow to the heart might play a critical role in cardiac well-being. Recent data are reviewed which suggest that autonomic dysfunction predisposes to malignant arrhythmias and death. Moreover, intact reflexes appear to be importantly involved in terminating myocardial ischemic episodes. It is therefore conceivable that an intact and functional autonomic nervous system might have a significant impact on cardiac morbidity and mortality in patients recovering from anesthesia and surgery.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This review focuses on various types of invasive and non-invasive methods for determining cardiac output, systemic perfusion, cerebral perfusion and arterial blood pressure. There is emphasis on studies that examine the accuracy and reliability of the various techniques. In addition, studies which look at the utility of these techniques are also discussed.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Cardiac arrhythmias are manifestations of altered physiologic states and common during anesthesia. Electrocardiography (ECG) is the principal means for detection and diagnosis of arrhythmias, and altered physiologic states. Knowledge of cardiac electrophysiology is fundamental to effective arrhythmia prevention and management. This article reviews advances concerning mechanisms for arrhythmias, ECG, arrhythmia management, cardiac pacemakers and the automatic implantable cardioverter-defibrillator (AICD).

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Late complications after corrective surgery for congenital heart defects in children and valve replacement in adults occur more frequently than commonly assumed. The incidence and implications of these complications are reviewed as are non-invasive approaches to the treatment of congenital and valvular lesions.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The patient with either overt or silent coronary artery disease undergoing non-cardiac surgery presents a difficult diagnostic dilemma for the anesthesiologist. With improvements in perioperative care, it is rare for the patient to be refused surgery on the basis of co-existing cardiac disease. Several recent articles have demonstrated the importance of postoperative myocardial ischemia and its association with perioperative cardiac morbidity. The accumulating body of evidence suggests that regimens directed at the postoperative period would have the greatest impact on patient care. With the increasing number of high-risk patients presenting for non-cardiac surgery, the goal of the preoperative evaluation is to identify the patient who would benefit most from further interventions. This goal must be tempered by the increasing cost of medical care. The field of preoperative evaluation is an evolving one. Newer modes of preoperative testing are being developed, while those tests which are now generally accepted, such as dipyridamole-thallium imaging, have demonstrated a reduction in the predictive value of a positive test. This most likely reflects improved care in those patients identified as being at highest risk by virtue of a positive test. In addition, the care of the post-myocardial infarction (MI) patient and the increasing use of percutaneous transcoronary angioplasty (PTCA) have had a significant impact on perioperative risk. This review will focus on the recent advances in preoperative testing and risk stratification as well as those changes in the care of the post-MI patient. In addition, recent evidence for the prognostic importance of perioperative myocardial ischemia in the non-cardiac surgery patient will be reviewed.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This review highlights recent advances in our understanding of the pathogenesis of abdominal aortic aneurysm (AAA) formation; preoperative cardiac evaluation strategies for patients undergoing major vascular surgery; large-scale outcome studies, especially following carotid endarterectomy as well as the perioperative management of patients undergoing abdominal aortic reconstruction, peripheral vascular procedures and carotid endarterectomy.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Current data concerning the incidence and mortality from thromboembolic disease are summarized and recent developments in non-invasive diagnosis of deep vein thrombosis (DVT) are reviewed. Thrombolytic therapy of life-threatening PE is possible, with encouraging results even in the perioperative period. In patients with cancer and DVT, placement of a greenfield filter tor the prevention of PE appears to be safer than anticoagulation.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Early in this century, muscle relaxants for facilitating surgery and maintaining adequate airways were a dream of surgeons and anesthesiologists. Early in the 1950s curare and succinylcholine were developed; however, they had significant and undesirable cardiovascular effects. Pancuronium bromide decreased the incidence of histamine release and hypertension. Later it was discovered that tachycardia caused by pancuronium bromide could increase the incidence of ischemia. New muscle relaxants free of cardiovascular effects (vecuronium, doxacurium and pipecuronium) are discussed with the clinical implications of their onset and duration of action, as well as their interaction with calcium-channel and β-blockers. A technique for anesthetic management in cardiac surgery is also discussed.

ISSN:0952-7907    

出版商:OVID    

年代:1992

数据来源: OVID