Cardiovascular Pharmacology in Adult Patients Undergoing Cardiac Surgery

2018 ◽  
pp. 75-142
Author(s):  
Ali Dabbagh ◽  
Ardeshir Tajbakhsh ◽  
Zahra Talebi ◽  
Samira Rajaei
Keyword(s):  
Cardiac Surgery ◽  
Cardiovascular Pharmacology ◽  
Adult Patients

Topical Lidocaine Patch for Postthoracotomy and Poststernotomy Pain in Cardiothoracic Intensive Care Unit Adult Patients

2019 ◽  
Vol 39 (5) ◽  
pp. 51-57 ◽  
Author(s):  
Michael Liu ◽  
Mabel Wai ◽  
James Nunez
Keyword(s):  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Standard Care ◽  
Academic Medical Center ◽  
Adult Patients ◽  
Control Group ◽  
Lidocaine Group ◽  
Lengths Of Stay ◽  
Topical Lidocaine

Background Transdermal lidocaine patches have few systemic toxicities and may be useful analgesics in cardiac surgery patients. However, few studies have evaluated their efficacy in the perioperative setting. Objective To compare the efficacy of topical lidocaine 5% patch plus standard care (opioid and nonopioid analgesics) with standard care alone for postthoracotomy or poststernotomy pain in adult patients in a cardiothoracic intensive care unit. Methods A single-center, retrospective cohort evaluation was conducted from January 2015 through December 2015 in the adult cardiothoracic intensive care unit at a tertiary academic medical center. Cardiac surgery patients with new sternotomies or thoracotomies were included. Patients in the lidocaine group received 1 to 3 topical lidocaine 5% patches near sternotomy and/or thoracotomy sites daily. Patches remained in place for 12 hours daily. Patients in the control group received standard care alone. Results The primary outcome was numeric pain rating for sternotomy/thoracotomy sites. Secondary outcomes were cardiothoracic intensive care unit and hospital lengths of stay and total doses of analgesics received. Forty-seven patients were included in the lidocaine group; 44 were included in the control group. Mean visual analogue scores for pain did not differ between groups (lidocaine, 2; control, 1.9; P = .58). Lengths of stay were similar for both groups (cardiothoracic intensive care unit: lidocaine, 3.06 days; control, 3.11 days; P = .86; hospital: lidocaine, 8.26 days; control, 7.61 days; P = .47). Conclusions Adjunctive lidocaine 5% patches did not reduce acute pain in postthoracotomy and post-sternotomy patients in the cardiothoracic intensive care unit.

Pharmacokinetics of Propofol in Adult Patients Undergoing Coronary Revascularization

1996 ◽  
Vol 84 (6) ◽  
pp. 1288-1297 ◽  
Author(s):  
James M. Bailey ◽  
Christina T. Mora ◽  
Stephen L. Shafer ◽  
Keyword(s):  
Cardiac Surgery ◽  
Cross Validation ◽  
Predictive Accuracy ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Adult Patients ◽  
Pharmacokinetic Parameters ◽  
Surgery Patient ◽  
Prospective Comparison

Background Propofol is increasingly used for cardiac anesthesia and for perioperative sedation. Because pharmacokinetic parameters vary among distinct patient populations, rational drug dosing in the cardiac surgery patient is dependent on characterization of the drug's pharmacokinetic parameters in patients actually undergoing cardiac procedures and cardiopulmonary bypass (CPB). In this study, the pharmacokinetics of propofol was characterized in adult patients undergoing coronary revascularization. Methods Anesthesia was induced and maintained by computer-controlled infusions of propofol and alfentanil, or sufentanil, in 41 adult patients undergoing coronary artery bypass graft surgery. Blood samples for determination of plasma propofol concentrations were collected during the predefined study periods and assayed by high-pressure liquid chromatography. Three-compartment model pharmacokinetic parameters were determined by nonlinear extended least-squares regression of pooled data from patients receiving propofol throughout the perioperative period. The effect of CPB on propofol pharmacokinetics was modeled by allowing the parameters to change with the institution and completion of extracorporeal circulation and selecting the optimal model on the basis of the logarithm of the likelihood. Predicted propofol concentrations were calculated by convolving the infusion rates with unit disposition functions using the estimated parameters. The predictive accuracy of the parameters was evaluated by cross-validation and by a prospective comparison of predicted and measured levels in a subset of patients. Results Optimal pharmacokinetic parameters were: central compartment volume = 6.0 l; second compartment volume = 49.5 l; third compartment volume = 429.3 l; Cl1 (elimination clearance) = 0.68 l/min; Cl2 (distribution clearance) = 1.97 l/min1; and Cl3 (distribution clearance) = 0.70 l/min. The effects of CPB were optimally modeled by step changes in V1 and Cl1 to values of 15.9 and 1.95, respectively, with the institution of CPB. Median absolute prediction error was 18% in the cross-validation assessment and 19% in the prospective evaluation. There was no evidence for nonlinear kinetics. Previously published propofol pharmacokinetic parameter sets poorly predicted the observed concentrations in cardiac surgical patients. Conclusions The pharmacokinetics of propofol in adult patients undergoing cardiac surgery with CPB are dissimilar from those reported for other adult patient populations. The effect of CPB was best modeled by an increase in V1 and Cl1. Predictive accuracy of the derived pharmacokinetic parameters was excellent as measured by cross-validation and a prospective test.

scholarly journals Pulmonary artery catheter use in adult patients undergoing cardiac surgery: a retrospective, cohort study

2018 ◽  
Vol 7 (1) ◽  
Author(s):  
Andrew D. Shaw ◽  
Michael G. Mythen ◽  
Douglas Shook ◽  
David K. Hayashida ◽  
Xuan Zhang ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cohort Study ◽  
Pulmonary Artery ◽  
Pulmonary Artery Catheter ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Adult Patients

scholarly journals Predictors of postoperative cognitive dysfunction in adult patients undergoing elective cardiac surgery

2014 ◽  
Vol 58 (3) ◽  
pp. 334 ◽  
Author(s):  
Madanmohan Shiraboina ◽  
Syamasundara Ayya ◽  
RV Kumar ◽  
Padmaja Durga ◽  
Ramachandran Gopinath ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cognitive Dysfunction ◽  
Postoperative Cognitive Dysfunction ◽  
Adult Patients ◽  
Elective Cardiac Surgery

Mediastinitis and Cardiac Surgery - an Updated Risk Factor Analysis in 10,373 Consecutive Adult Patients

2002 ◽  
Vol 50 (2) ◽  
pp. 87-91 ◽  
Author(s):  
J. F. Gummert ◽  
M. J. Barten ◽  
C. Hans ◽  
M. Kluge ◽  
N. Doll ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Cardiac Surgery ◽  
Risk Factor ◽  
Adult Patients ◽  
Risk Factor Analysis

A prospective randomized comparative study between Macintosh and GlideScope in adult patients undergoing cardiac surgery

2015 ◽  
Vol 9 (1) ◽  
pp. 8 ◽  
Author(s):  
Rabie Soliman ◽  
Osama Alamoudy ◽  
Abeer Farouk ◽  
Mohammed Mofeed
Keyword(s):  
Cardiac Surgery ◽  
Comparative Study ◽  
Adult Patients

Cerebral perfusion monitoring in adult patients following cardiac surgery: an observational study

2017 ◽  
Vol 53 (6) ◽  
pp. 669-680
Author(s):  
Tammy Slater ◽  
Julie Stanik-Hutt ◽  
Patricia Davidson
Keyword(s):  
Cardiac Surgery ◽  
Observational Study ◽  
Cerebral Perfusion ◽  
Adult Patients

Toward a new approach for the detection of pain in adult patients undergoing cardiac surgery: Near-infrared spectroscopy—A pilot study

Heart & Lung ◽  
2010 ◽  
Vol 39 (6) ◽  
pp. 485-493 ◽  
Author(s):  
Céline Gélinas ◽  
Manon Choinière ◽  
Manon Ranger ◽  
André Denault ◽  
Alain Deschamps ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Infrared Spectroscopy ◽  
Pilot Study ◽  
Near Infrared Spectroscopy ◽  
Near Infrared ◽  
Adult Patients ◽  
New Approach

602 Effect of Pulmonary Hypertension on Adult Patients Undergoing Non-Cardiac Surgery

2010 ◽  
Vol 138 (5) ◽  
pp. S-857
Author(s):  
I. Michael Leitman ◽  
Andrew D. Yu ◽  
Joseph Park ◽  
Martin S. Karpeh
Keyword(s):  
Pulmonary Hypertension ◽  
Cardiac Surgery ◽  
Adult Patients
Sign in / Sign up

Export Citation Format

Share Document