ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

With the incremental increase in cardiac surgical procedures and the consequent increase in healthcare resources needed, both diagnostic techniques and treatment modalities are examined with great scrutiny and criticism. Newer techniques should be evaluated, establishing the role of perioperative monitoring technology in determining and improving the outcome after cardiac surgery. In this review I shall focus on the role transoesophageal echocardiography can play in improving outcome after different cardiac surgical procedures.

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

'Fast track' management of the cardiac surgery patient refers to an approach involving early extubation and rapid transit through intensive care. It requires a co-ordinated approach between surgical, anaesthesia, and intensive care teams. The aim is a reduction in the total dose of opioid administered and early physiological stabilization of the patient. There are physiological and perhaps psychological benefits to the patient from early extubation as well as potential economic benefits and better use of resources through decreased length of intensive care unit stay.

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The additional use of thoracic epidural anaesthesia in the perioperative management of patients undergoing coronary artery bypass surgery is still uncommon. However, experimental and clinical studies strongly suggest that thoracic epidural anaesthesia may lead to a reduced frequency of perioperative myocardial ischaemia and infarction and may improve postoperative pulmonary function. Early recovery from anaesthesia may be enhanced. Procedural safeguards to minimize neurological complications must be thoroughly established and observed before the routine use of thoracic epidural anaesthesia.

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The normal anatomy and physiology of the right ventricle is reviewed in order to understand its dysfunction. Right ventricular failure may occur because of pulmonary artery hypertension or right ventricular ischemia. Use of intraoperative transesophageal echocardiographic techniques, myocardial protection, new approaches to coronary artery bypass, new pharmacological treatments, and mechanical assist support may modify the outcome of patients with right ventricular failure.

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Several recent papers have documented the increased risk of adverse neurological outcome associated with age in elderly patients undergoing coronary artery bypass surgery. Further evidence favouring cerebral microemboli as a primary mechanism of cerebral injury after coronary artery bypass surgery has been presented. Improved neurobehavioural outcomes with alpha-stat management during cardiopulmonary bypass have now been shown in several papers. Hypothermic circulatory arrest and the role and limitations of retrograde cerebral perfusion are also evaluated.

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

It has been demonstrated that derangements of gut mucosal perfusion and function commonly occur during cardiac surgery. The exact relationship between these observations and the development of postoperative organ dysfunction are areas of debate. However, therapeutic stratagies aimed at maintaining gut perfusion have been associated with a better outcome.

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Numerous techniques of general anaesthesia for thoracoscopic surgery have been described. One-lung ventilation provides a better surgical field for thoracic procedures but also impairs arterial oxygenation by increasing venous admixture. One of the most important challenges for the anaesthesiologist is the improvement of arterial oxygenation, using mechanical or pharmacological methods, when one-lung ventilation leads to desaturation.

ISSN:0952-7907    

出版商:OVID    

年代:1997

数据来源: OVID