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Accurate measurements of arterial P(CO(2)) (P(a,CO(2))) currently require blood sampling because the end-tidal P(CO(2)) (P(ET,CO(2))) of the expired gas often does not accurately reflect the mean alveolar P(CO(2)) and P(a,CO(2)). Differences between P(ET,CO(2)) and P(a,CO(2)) result from regional inhomogeneities in perfusion and gas exchange. We(More)
Both hypoxia and carbon dioxide increase cerebral blood flow (CBF), and their effective interaction is currently thought to be additive. Our objective was to test this hypothesis. Eight healthy subjects breathed a series of progressively hypoxic gases at three levels of carbon dioxide. Middle cerebral artery velocity, as an index of CBF; partial pressures(More)
PURPOSE Recombinant factor VIIa (rFVIIa) is being used for refractory, excessive blood loss (EBL) after cardiac surgery, but its safety for this indication is not known. METHODS The unadjusted and risk-adjusted adverse event (AE) rates were compared between 114 consecutive cardiac surgical patients who received rFVIIa for refractory EBL and 541 concurrent(More)
Right ventricular failure (RVF) complicates 20-50% of left ventricular assist device (LVAD) implantation cases and contributes to increased postoperative morbidity and mortality. Normal LVAD function alters the highly compliant right ventricular (RV) physiology, which may unmask RVF. Risk scores for predicting RVF post-LVAD incorporate multiple risk factors(More)
BACKGROUND A volatile anaesthetic (VA) reflector can reduce VA consumption (VAC) at the cost of fine control of its delivery and CO2 accumulation. A digital in-line vaporizer and a second CO2 absorber circumvent both of these limitations. We hypothesized that the combination of a VA reflector with an in-line vaporizer would yield substantial VA(More)
OBJECTIVE To overcome a challenge in transesophageal echocardiographic (TEE) training, an online virtual TEE simulation was developed that allows the user to navigate among the 20 standard views. The TEE probe position and ultrasound plane movements on a 3-dimensional heart model were displayed with the corresponding TEE video recording as the probe was(More)
In recent years, the use of transoesophageal echocardiography has increased in anaesthesia and intensive care. We explored the impact of two different teaching methods on the ability of echocardiography-naïve subjects to identify cardiac anatomy associated with the 20 standard transoesophageal echocardiography imaging planes, and assessed trainees'(More)
Echocardiography is a key assessment tool for the evaluation of cardiac structure and function. The ability to image cardiac structures using 3-dimensional (3D) echocardiography is evolving. In this article, we present some of the key features of the emerging 3D technology and review its applications with an emphasis on real-time 3D transesophageal(More)
PURPOSE Transesophageal echocardiography (TEE) is becoming a standard imaging tool during cardiac surgery as well as an important diagnostic tool in cardiology and in intensive care, resulting in an increasing demand for TEE training. To address the problem of limited time for learning during TEE studies, we have developed a novel online application that(More)
PURPOSE To determine the independent relationship between leukoreduced platelet transfusions and adverse events in cardiac surgery. METHODS In this observational study, detailed baseline and perioperative data were prospectively collected on consecutive patients who underwent cardiac surgery at a single institution from 1999 to 2004. The independent(More)