Document Detail

Myocardial ischemia following surgery: preliminary findings. Study of Perioperative Ischemia (SPI) Research Group.
MedLine Citation:
PMID:  2133859     Owner:  NLM     Status:  MEDLINE    
Humoral changes, changes in hemodynamics, and the incidence of ischemia appear to be highest during the postbypass-postoperative period. Preliminary data also suggest that postbypass ischemia detected by transesophageal echocardiography may be predictive of outcome. Our previous experience with postoperative hypertension following coronary artery surgery has led us to increase analgesic medication of patients during and following anesthetic emergence. Patterns of postoperative ischemia observed in patients undergoing noncardiac and cardiac surgery suggest that extension of anesthesia to the postoperative period may be beneficial with respect to suppression of ischemia. It appears that by maintaining a continuous infusion of a high dose of narcotic, postoperative myocardial ischemia can be modified. The implication is that by blunting activation of the sympathetic nervous system in the postoperative period, and preventing the resultant endocrine, metabolic, and hemodynamic changes, the imbalance of myocardial oxygen supply and demand can be shifted away from ischemia. Further investigation is needed to confirm these data, and to address the effects of modification of postoperative myocardial ischemia on eventual postoperative cardiac outcomes.
D T Mangano
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.; Review    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  5     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:  1990 Sep 
Date Detail:
Created Date:  1992-04-09     Completed Date:  1992-04-09     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  288-93     Citation Subset:  IM    
Department of Anesthesia, University of California, San Francisco.
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MeSH Terms
Cardiac Surgical Procedures / adverse effects*
Coronary Disease / etiology*,  metabolism,  physiopathology
Heart Conduction System / physiopathology
Myocardium / metabolism
Postoperative Complications
Grant Support

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