ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

This review focuses on the important role played by the various types of remedial therapy in the prevention and treatment of perioperative cardiac arrhythmias. It discusses the new concepts of arrhythmogenesis and proarrhythmia; the long QT interval syndrome; newer, more selective class 3 antiarrhythmic drugs; cardiac rhythm management devices; drugs or devices used as prophylaxis for postoperative atrial arrhythmias; intravenous amiodarone for destabilizing ventricular arrhythmias; and preoperative potassium imbalance.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Investigations into cardiopulmonary bypass continue to refine knowledge and clinical practice. Recent investigations have emphasized neurological complications, introducing the possibility of genetic predisposition as a risk factor. Appropriate flows, pressures, and hematocrit levels during cardiopulmonary bypass continue to create controversy. Whereas previous debate has centered around appropriate temperature management, recent discussions consider the possibility that mild hypothermia after cardiopulmonary bypass might be neuroprotective. Meta-analyses and prospective investigations continue to suggest the virtual equivalence of aprotinin and lysine analogues in reducing bleeding and transfusion after cardiopulmonary bypass. Several recent studies identified the mechanisms and severity of the inflammatory response to cardiopulmonary bypass, as well as possible techniques for attenuating inflammation.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

This review presents a brief overview about the role of regional anaesthesia in patients at risk for myocardial ischemia and/or infarction after cardiac and noncardiac surgical procedures. It includes pathophysiological insights in the problems of plaque rupture and the possible interactions by the use of regional anaesthesia. Special emphasis is put on the subject of thoracic epidural anaesthesia with newer studies showing improvement in relief of angina and improvement of global systolic and diastolic function in patients with coronary artery disease.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The monitoring of cardiovascular function is an indispensable element in anaesthesia. A thorough understanding of pathophysiology in various disease states allows optimal balancing of the invasiveness and completeness of haemodynamic monitoring. The prevention of both intraoperative and postoperative complications is therefore a primary goal.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Circulatory stability is one of the main objectives of the perioperative management of high-risk patients. Most of these patients are chronically treated with cardiovascular treatments, which interfere with the functioning of several physiological systems aimed at maintaining the circulatory status when the loading conditions of the heart deteriorate, or limit the compensatory mechanisms used when metabolic needs increase. Taking into account the pharmacology of these medications, their repercussions on perioperative haemodynamics and their potential beneficial effects on regional circulations, it has become possible to determine whether or not they must be given or withdrawn perioperatively.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Postoperative intensive care in cardiac surgery is a growing area, fuelled by the increase in the number of cardiac surgical procedures performed. An increase in the number of patients has resulted in increased resource utilization. Much of the recent research in this field is concerned with the early extubation of cardiac surgical patients, reducing the length of stay in the intensive care unit and predicting which patients will have delayed extubation and a prolonged length of stay. A number of recent studies have been published advocating ‘off pump’ cardiac surgery as a way of reducing the physiological insult of cardiopulmonary bypass and thereby improving the postoperative course. There is still insufficient evidence that this approach reduces morbidity and intensive care unit length of stay in multi-vessel off-pump coronary artery bypass surgery. The traditional design of post-cardiac surgical intensive care units and high dependancy units has also recently been challenged. More flexible integrated units improve cost control and are more suited to modern cardiac surgery.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Regional pulmonary perfusion is spatially heterogeneous. The classic assumption has been that this is due to the influence of gravity. In the past decade, a new concept has emerged, stressing the fractal geometric properties of the pulmonary vascular tree. Studies that support the gravitational concept tend to have been elaborated using a lower resolution of measurement whereas experiments with high resolution measurements often yield results that contradict the gravitational hypothesis.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

This review summarizes recent reports on preoperative pulmonary evaluation focusing on the impact on outcome in thoracic and non-thoracic surgery. Data suggest that hitherto widely accepted pulmonary function tests do not predict perioperative complications. Therefore, they may not be considered alone to decide on the patient's operability. So-called prohibitive lung function parameters should no longer be used to deny a potentially curative lung resection. A more clinically oriented, interdisciplinary approach to severely compromised patients may be best suited to discuss and solve their problems.

ISSN:0952-7907    

出版商:OVID    

年代:2001

数据来源: OVID