Controversies in Cardiovascular Anesthesia

201 Pages·1988·4.51 MB·English

by  Jan L. Kramer

CONTROVERSIES IN CARDIOVASCULAR ANESTHESIA
CONTROVERSIES IN CARDIOVASCULAR
ANESTHESIA
edited by
PHILLIP N. FYMAN
ALEXANDER W. GOTTA
~.
"
KLUWER ACADEMIC PUBLISHERS
Boston Dordrecht London
Distributors
for the United States and Canada: Kluwer Academic Publishers, 101 Philip Drive, Assinippi Park,
Norwell, MA, 02061, USA
for the UK and Ireland: Kluwer Academic Publishers, Falcon House, Queen Square, Lancaster
LAllRN, UK
for all other countries: Kluwer Academic Publishers Group, Distribution Centre, P. O. Box 322,
3300 AH Dordrecht, THE NETHERLANDS
Library of Congress Cataloging-in-Publication Data
Controversies in cardiovascular anesthesia.
Includes bibliographies and index.
1. Cardiovascular system-Surgery. 2. Anesthesia. I. Fyman,
Phillip. II. Gotta, Alexander W. [DNLM: 1. Anesthesia.
2. Cardiovascular System-surgery. WG 168 C764]
RD597.C67 1988 617'.96741 87-24774
[SBN-13: 978-1-4612-8993-7 e-[SBN-13: 978-1-4613-1771-5
00[: [0.1007/978-[-4613-1771-5
Copyright
© 1988 by Kluwer Academic Publishers, Boston.
Softcover reprint of the hardcover 1st edition 1988
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or
transmitted in any form or by any means, mechanical, photocopying, recording, or otherwise,
without the prior written permission of the publisher, Kluwer Academic Publishers, 101 Philip
Drive, Assinippi Park, Norwell, MA 02061.
We would like to acknowledge the encouragement of James Cottrell, M.D.
and the support of our families, that was necessary to write this book.
Phillip N. Fyman, M.D.
Alexander W. Gotta, M.D.
CONTENTS
Contributing Authors IX
Preface X111
1. An inhalation anesthetic technique is preferable for patients
undergoing coronary artery bypass grafting
JAN L. KRAMER, DAVID J. WAGNER, AND STEPHEN J. THOMAS
2. An intravenous technique is preferable for patients undergoing coronary 13
artery bypass grafting
JAMES B. STREISAND, THEODORE H. STANLEY, AND PAUL S. NELSON
3. Blood gas values should be corrected for body temperature during 35
hypothermia
ENRICO M. CAMPORESI AND RICHARD E. MOON
4. Blood gases should not be temperature corrected during hypothermia 55
PAUL L. GOLDINER, YASU OKA, AND EDWARD SVADJIAN
5. High pump flows and pressure are desirable during cardiopulmonary 83
bypass
KETAN SHEVDE AND SARADA MYLAVARAPU
6. Low pressure during cardiopulmonary bypass is preferable 99
J.G. REVES, ANN GOVIER, AND NARDA CROUGHWELL
7. Pulmonary artery catheters should be used routinely in all patients 115
undergoing coronary artery bypass grafting
MARTIN J. LONDON AND DENNIS T. MANGANO
vii
viii Contents
8. Routine insertion of pulmonary artery catheters is not necessary in all 129
patients undergoing coronary artery bypass grafting
PHILLIP N. FYMAN AND LAWRENCE KUSHINS
9. General anesthesia is preferable for patients undergoing carotid 143
endarterectomy
CAROL L. LAKE
10. Regional anesthesia is preferable for patients undergoing carotid 169
endarterectomy
PIERRE CASTHELY AND JOHN DLUZNESKI
Index 185
CONTRIBUTING AUTHORS
Enrico M. Camporesi, M.D.
Professor of Anesthesiology
Duke Unviersity Medical Center
Durham, North Carolina 27710
Pierre Casthcly, M.D.
Associate Professor of Anesthesiology
State University of New York
Health Science Center at Brooklyn
Brooklyn, New York
Narda Croughwell, CRNA
Research coordinator
Division of Cardiothoracic Anesthesia
Duke University Medical Center
Durham, North Carolina
John Dluzneski, M.D.
Fellow in Cardiac Anesthesia
State University of New York
Health Science Center at Brooklyn
Brooklyn, New York
ix
x Contributing Authors
Phillip N. Fyman, M.D.
Attending Anesthesiologist
Long IslandJewish Medical Center
New Hyde Park, New York 10042
Paul L. Goldiner, M.D.
Professor and Chairman
Department of Anesthesiology
Albert Einstein College of Medicine
Bronx, New York
Alexander W. Gotta, M.D.
Professor of Clinical Anesthesiology
State University of New York
Health Science Center at Brooklyn
Brooklyn, New York
Ann Govier, M.D.
Staff Anesthesiologist
Department of Cardiothoracic Anesthesia
Cleveland Clinic
Cleveland, Ohio
Jan L. Kramer, M.D.
Fellow in Cardiac Anesthesia
New York University Medical Center
New York, New York 10016
Lawrence Kushins, M.D.
Director, Cardiac Anesthesia
Long IslandJewish Medical Center
New Hyde Park, New York
and
Clinical Assistant Professor of Anesthesiology
State University of New York
School of Medicine at Stony Brook
Stony Brook, New York
Carol L. Lake, M.D.
Associate Professor of Anesthesiology
University of Virginia School of Medicine
Charlottesville, Virginia
xi
Martin]. London, M.D.
Assistant Professor of Anesthesiology
University of California, San Francisco
San Francisco, California
Dennis T. Mangano, Ph.D., M.D.
Professor of Anesthesiology
University of California, San Francisco
San Francisco, California
Richard E. Moon, M.D.
Assistant Professor of Anesthesiology
Duke University Medical Center
Durham, North Carolina 27710
Sarada Mylavarapu, M.D.
Fellow in Cardiac Anesthesia
Maimonides Medical Center
Brooklyn, New York 11219
Paul S. Nelson, M.D.
Fellow in Anesthesiology
University of Utah School of Medicine
Salt Lake City, Utah 84132
Yasu Oka, M.D.
Professor of Anesthesiology
Albert Einstein College of Medicine
Bronx, New York
J. G. Reves, M.D.
Professor of Anesthesiology
Director, Cardiothoracic Anesthesia
Duke University Medical Center
Durham, North Carolina
Ketan Shevde, M.D.
Director, Cardiac Anesthesia
and
Acting Director
Department of Anesthesiology
Maimonides Medical Center
Brooklyn, New York 11219
xii Contributing Authors
Theodore H. Stanley, M.D.
Professor of Anesthesiology
and
Research Professor of Surgery
University of Utah School of Medicine
Salt Lake City, Utah 84132
James B. Streisand, M.D.
Assistant Professor of Anesthesiology
University of Utah School of Medicine
Salt Lake City, Utah 84132
Edward Svadjian, M.D.
Assistant Professor of Anesthesiology
Albert Einstein College of Medicine
Bronx, New York
Stephen]. Thomas, M.D.
Associate Professor of Anesthesiology
Director of Cardiothoracic Anesthesia
New York University Medical Center
New York, New York 10016
David]. Wagner, M.D.
Fellow in Cardiac Anesthesia
New York University Medical Center
New York, New York 10016