How silent is perioperative myocardial ischemia? a hemodynamic, electrocardiographic, and biochemical study in patients undergoing coronary artery bypass graft surgery

Tupper-Carey, Darryl A.; Newman, David J.; Price, Christopher P.; Walesby, R.K.; Ridout, Deborah; Feneck, R. O.

doi:10.1016/s1053-0770(00)90008-9

Cited by 12 publications

(4 citation statements)

References 18 publications

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“…Although this was a short‐term study, the clinical consequences of SMI have been widely studied [12]. As stated above, SMI is associated with the release of troponin I from myocytes [26]. In addition, the measurement of left ventricular haemodynamics in patients with SMI demonstrated an increase in left ventricular end‐diastolic pressure of > 5 mmHg and an increased oxygen extraction in 63% of the patients studied [23].…”

Section: Discussionmentioning

confidence: 99%

Silent myocardial ischaemia and haemoglobin concentration: a randomized controlled trial of transfusion strategy in lower limb arthroplasty

et al. 2006

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In patients without preoperative evidence of myocardial ischaemia undergoing elective hip and knee replacement surgery, a restrictive transfusion strategy seems unlikely to be associated with an increased incidence of SMI. A proportion of these patients experience moderate SMI, regardless of the transfusion trigger. Use of a restrictive transfusion strategy did not increase length of hospital stay, and use of this strategy would lead to a significant reduction in red cell transfusion in orthopaedic surgery. Our data did not indicate any potential for harm in employing such a strategy in patients with no prior evidence of cardiac ischaemia who were undergoing elective orthopaedic surgery.

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Section: Discussionmentioning

confidence: 99%

Silent myocardial ischaemia and haemoglobin concentration: a randomized controlled trial of transfusion strategy in lower limb arthroplasty

et al. 2006

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“…The level of this release is associated with poor outcome ( 1 Landesberg 2003, Kim 2002, Oscarsson 2004, Howell 2004). During CABG surgery perioperative episodes of myocardial ischemia may occur in 47% of cases before cardiopulmonary bypass (CPB), and in 63% within 8 hours after revascularization (Tupper-Carey 2000). The occurrence of ischemic episodes was associated with increased postoperative levels of troponin I, even in the absence of diagnosed myocardial infarction (Tupper-Carey 2000).…”

Section: Perioperative Myocardial Injurymentioning

confidence: 99%

“…During CABG surgery perioperative episodes of myocardial ischemia may occur in 47% of cases before cardiopulmonary bypass (CPB), and in 63% within 8 hours after revascularization (Tupper-Carey 2000). The occurrence of ischemic episodes was associated with increased postoperative levels of troponin I, even in the absence of diagnosed myocardial infarction (Tupper-Carey 2000). Perioperative myocardial injury after cardiac surgery detected by increased release of cardiac enzymes is also associated with a higher mortality (Steuer 2002, Kathiresan 2004.…”

Section: Perioperative Myocardial Injurymentioning

confidence: 99%

Myocardial ischemia-reperfusion and cardioprotection: a study with microdialysis in a porcine model

Metzsch

2011

Acta Anaesthesiologica Scandinavica

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“…Viele postoperative Myokardinfarkte verlaufen klinisch stumm und sind «Non-q-wave»-Infarkte [66]. Die Mortalitäts-rate eines postoperativen Myokardinfarkts liegt bei 67% [6].…”

Section: Postoperativunclassified

Anästhesiologie des alten Patienten – Besonderheiten und diverse Methoden

Gonano¹,

Zimpfer²

2003

Visc Med

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Anesthesia of Elderly Patients – Peculiarities and Diverse Methods The share of older individuals is the fastest growing sector in our population. It is widely accepted that there are enormous differences between chronological and biological age. The elderly patient is characterized by an ongoing decrease of general and reserve functional capacity of each organ system. These changes might be tolerable and not decreasing quality of daily life, but become obvious during an exceptional situation, e.g. a surgical intervention or an infection. Interacting comorbidities and changes in the cardiovascular, pulmonary, hepatorenal or neuromuscular state require an exact treatment strategy, ranging from the preoperative risk assessment and optimization to optimal intraoperative treatment in view of a decreased reserve functional capability. Tachycardia, excessive changes in blood pressure and blood glucose levels, hypothermia, and of course hypoxia should be avoided in all cases. Postoperative continuation of careful blood and fluid substitution, pain therapy, and above all a careful contact with the elderly patient help to guarantee a perfect result – an early reintegration into their earlier surrounding. The necessity of modern intensive care should be evaluated and organized in advance. Medical progress, short acting, well controllable drugs for general and regional anesthesia as well as modern less invasive monitoring and treatment facilities enable physicians to treat the steadily ageing population. Clinical experience as well as scientific results show clearly that advanced age is associated with an increased perioperative morbidity and mortality risk. Aware of the physiological changes and mastering modern diagnostic and therapeutic facilities, we are proudly to say that advanced chronological age per se is no longer a contraindication for a surgical intervention.

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How silent is perioperative myocardial ischemia? a hemodynamic, electrocardiographic, and biochemical study in patients undergoing coronary artery bypass graft surgery

Cited by 12 publications

References 18 publications

Silent myocardial ischaemia and haemoglobin concentration: a randomized controlled trial of transfusion strategy in lower limb arthroplasty

Silent myocardial ischaemia and haemoglobin concentration: a randomized controlled trial of transfusion strategy in lower limb arthroplasty

Myocardial ischemia-reperfusion and cardioprotection: a study with microdialysis in a porcine model

Anästhesiologie des alten Patienten – Besonderheiten und diverse Methoden

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