Publications by authors named "Ioanna Apostolidou"

18 Publications

  • Page 1 of 1

Food Traceability: A Consumer-Centric Supply Chain Approach on Sustainable Tomato.

Foods 2021 Mar 5;10(3). Epub 2021 Mar 5.

Deptartment of Agricultural Economics, School of Agriculture, Aristotle University of Thessaloniki, 541-24 Thessaloniki, Greece.

Technological advances result in new traceability configurations that, however, cannot always secure transparency and food safety. Even in cases where a system guarantees transparency, the actual consumer involvement and a real consumer-based perspective cannot always be ensured. The importance of such consumer centricity is vital, since it is strongly associated with effective supply chains that properly fulfil their end-users' needs and requests. Thus, the objective of this paper was to explore the level of consumer centricity in food supply chains under a traceability system. The methodological approach employed a framework of two studies validating subsequently a similar set of variables, using initially consumers data and then supply chain actors data. The supply chain of sustainable tomato was selected to design the studies. The level of agreement between datasets suggested the level of the supply chain consumer centricity. Findings showed health, trust, quality, nutrition, and safety-related values to be significant for the consumers towards accepting a traceability system. The supply chain actors also accepted a traceability system based on the fact that their customers' needs rely on the exact same beliefs, indicating a high level of consumer centricity. The current work underlines the magnitude of consumer centricity in food supply chains and provides an easy and straightforward framework for its exploration. Key implications suggest the design of more effective supply chain and consumer-based strategies for the food industry. Policymakers could also adopt the concept of consumer centricity to further improve the food industry.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/foods10030543DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999538PMC
March 2021

Posttraumatic stress disorder and anesthesia: Respect for the military veteran's mind.

J Clin Anesth 2021 Mar 25;71:110242. Epub 2021 Mar 25.

Department of Anesthesiology, Minneapolis Veterans Affairs Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA; Department of Anesthesiology, University of Minnesota School of Medicine, B515 Mayo Memorial Building, 420 Delaware St SE, Minneapolis, MN 55455, USA. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jclinane.2021.110242DOI Listing
March 2021

Current Practice in FFP Preparation and Use in Greece: A National Survey

Turk J Haematol 2021 02 22;38(1):22-32. Epub 2020 Nov 22.

General Hospital, Department of Blood Transfusion, Korinthos, Greece

Objective: Fresh frozen plasma (FFP) transfusion is widely used in modern clinical settings. Practices regarding its use vary due to lack of guidelines from randomized trials. The aim of this study was to assess both the current practices regarding FFP production, use, and wastage and the implementation of quality control (QC), female donor plasma production policies, and use of pharmaceutical hemostatic agents in Greece.

Materials And Methods: The study was conducted during February-April 2018. For the first part of the study, data including FFP transfusion indication, hospital department, diagnosis, FFP units/transfusion episode, ABO compatibility, blood donor’s sex, and reasons for discarding were collected. For the second part, questionnaire data were analyzed.

Results: According to data from 20 Greek hospitals, 12655 FFP units were transfused to 2700 patients during 5069 transfusion episodes in the studied period of time. Most patients were hospitalized in internal medicine, general surgery, and intensive care unit departments. Each patient received on average 4.69 units (2.5 units/episode). Transfusion requests were in accordance with international guidelines in 63.44% of cases and 99.04% of the units were given to ABO-identical patients. Main reasons for discarding included failure to meet quality requirements (30.06%), female donors (22.17%), and other causes (27.26%). Among 96.9% of all transfusion services across the country, 28.26% perform QC according to the directions of the European Directorate for the Quality of Medicines & Health Care and 68.83% discard plasma from female donors. Pharmaceutic hemostatic agents are used in 37.23% of the hospitals.

Conclusion: This is the first national survey regarding FFP production and transfusion in Greece. Staff of internal medicine, general surgery, and ICU departments, where most FFP-transfused patients are hospitalized, should be regularly involved in training on contemporary transfusion guidelines. Upcoming centralization of FFP production and inventory management could help in homogenizing practices regarding FFP use and improve product quality. Strengthening the use of pharmaceutic hemostatic agents could improve patients’ management.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4274/tjh.galenos.2020.2020.0241DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7927442PMC
February 2021

Adult Emergence Agitation: A Veteran-Focused Narrative Review.

Anesth Analg 2021 02;132(2):353-364

From the Department of Anesthesiology, Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota.

Emergence agitation (EA) is a self-limited state of psychomotor excitement during awakening from general anesthesia. EA is confined to the emergence period as consciousness is restored, which sharply distinguishes it from other postoperative delirium states. Sporadic episodes of EA may become violent with the potential for harm to both patients and caregivers, but the long-term consequences of such events are not fully understood. Current literature on EA in adults is limited to small-scale studies with inconsistent nomenclature, variable time periods that define emergence, a host of different surgical populations, and conflicting diagnostic criteria. Therefore, true incidence rates and risk factors are unknown. In adult noncardiac surgery, the incidence of EA is approximately 19%. Limited data suggest that young adults undergoing otolaryngology operations with volatile anesthetic maintenance may be at the highest risk for EA. Currently suggested EA mechanisms are theoretical but might reflect underblunted sympathetic activation in response to various internal (eg, flashbacks or anxiety) or external (eg, surgical pain) stimuli as consciousness returns. Supplemental dexmedetomidine and ketamine may be utilized for EA prevention. Compared to the civilian population, military veterans may be more vulnerable to EA due to high rates of posttraumatic stress disorder (PTSD) manifesting as violent flashbacks; however, confirmatory data are limited. Nonetheless, expert military medical providers suggest that use of patient-centered rapport tactics, PTSD trigger identification and avoidance, and grounding measures may alleviate hyperactive emergence phenomena. Future research is needed to better characterize EA in veterans and validate prophylactic measures to optimize care for these patients. This narrative review provides readers with an important framework to distinguish EA from delirium. Furthermore, we summarize current knowledge of EA risk factors, mechanisms, and adult management strategies and specifically revisit them in the context of veteran perioperative health. The anesthesiology care team is ideally positioned to further explore EA and develop effective prevention and treatment protocols.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1213/ANE.0000000000005211DOI Listing
February 2021

Mapping Sustainable Tomato Supply Chain in Greece: A Framework for Research.

Foods 2020 Apr 26;9(5). Epub 2020 Apr 26.

Department of Agricultural Economics, School of Agriculture, Aristotle University of Thessaloniki, 541-24 Thessaloniki, Greece.

Sustainable food supply chains are complex systems involving several stakeholders, processes, flow of goods/materials and information. The value generated in combination with the contradictory agendas among actors makes any groundwork for future research a challenging endeavor. Hence, an end-to-end mapping of the food supply chain under examination is a vital prerequisite for the design of a comprehensive research framework. This study exemplified such a mapping approach in the Greek sustainable tomato supply chain, providing significant insights for an impactful research agenda. Data were obtained from secondary sectoral sources and open interviews with key players across the supply chain-covering all its main stages, i.e., production, packaging, storing, transportation, wholesaling, and retailing. The findings are summarized in three supply chain maps that illustrate the areas concerning sustainability, value chain and stakeholders. These maps synthesize a bigger picture of the supply chain that reveals the complicated interactions among its actors, the hidden bottlenecks in the flow of information and the areas that need deeper exploration. Its fundamental implication is the design of a targeted research framework, underlying the main priorities of the Greek tomato supply chain and eventually the Greek agri-food sector.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/foods9050539DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278838PMC
April 2020

Survival of intraoperative massive pulmonary embolism using alteplase and VA-ECMO.

J Clin Anesth 2019 Nov 6;57:112. Epub 2019 Apr 6.

Department of Anesthesiology, University of Minnesota, Minneapolis, MN, United States of America; VA Health Care System Minneapolis, MN, United States of America.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jclinane.2019.03.007DOI Listing
November 2019

Decreased mortality with local versus general anesthesia in endovascular aneurysm repair for ruptured abdominal aortic aneurysm in the Vascular Quality Initiative database.

J Vasc Surg 2019 07 2;70(1):92-101.e1. Epub 2019 Jan 2.

Division of Cardiovascular Medicine, University of Minnesota, Minneapolis, Minn.

Background: Endovascular aneurysm repair (EVAR) is an accepted approach for patients presenting with ruptured abdominal aortic aneurysm (rAAA) and suitable anatomy. The effect of anesthesia modality on mortality outcomes in rAAA has not been well described. Using the Vascular Quality Initiative database, this study compares local anesthesia (LA) vs general anesthesia (GA) in EVAR for rAAA.

Methods: The Vascular Quality Initiative database was queried for patients presenting with rAAA managed with open surgical repair, EVAR under LA (rEVAR-LA), and EVAR under GA (rEVAR-GA) between 2003 and 2017. Patients were observed until the earlier end point of either death or 1-year follow-up. Kaplan-Meier event rates are presented at 30 days and 1 year. Cox proportional hazards regression was used to model risk of death, with adjustment for demographic and clinical factors. Additional multivariate Cox hazards analyses were used to assess effect modifiers for 1-year mortality for the different repair methods.

Results: A total of 3330 patients (77.4% male) met the inclusion criteria (1594 [47.9%] open surgical repair, 226 [6.8%] rEVAR-LA, and 1510 [45.3%] rEVAR-GA). Patients treated with rEVAR-LA compared with rEVAR-GA had decreased intraoperative time, number of intraoperative blood transfusions, intraoperative crystalloid administration, intensive care unit length of stay, and postoperative pulmonary complications. Mortality rates with rEVAR-LA were lower compared with rEVAR-GA at 30 days (15.5% vs 23.3%; adjusted hazard ratio [AHR], 0.70; 95% confidence interval [CI], 0.49-0.99; P = .04) and at 1 year (22.5% vs 32.3%; AHR, 0.71; 95% CI, 0.53-0.96; P = .02). Patients undergoing EVAR who were <75 years old and those without preoperative hypotension had the greatest survival benefit from LA compared with GA (both factors: AHR, 0.14 [95% CI, 0.03-0.57]; single factor: AHR, 0.57 [95% CI, 0.36-0.91]).

Conclusions: This study demonstrates that rEVAR-LA for rAAA may be a safe alternative to rEVAR-GA for certain patients, with lower morbidity and improved mortality. Further prospective study is warranted to confirm mortality benefit in rEVAR-LA for rAAA.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jvs.2018.10.090DOI Listing
July 2019

Two Minutes to Improve Cardiac Surgery Outcomes.

Anesth Analg 2017 08;125(2):380-382

From the Department of Anesthesiology, University of Minnesota Medical School, Minneapolis, Minnesota.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1213/ANE.0000000000002265DOI Listing
August 2017

Identifying Variability in Mental Models Within and Between Disciplines Caring for the Cardiac Surgical Patient.

Anesth Analg 2017 07;125(1):29-37

From the *University of Minnesota Medical School, Minneapolis, Minnesota; †Center for Design in Health, College of Design and ‡Department of Anesthesiology, University of Minnesota, Minneapolis, Minnesota; §Department of Anesthesiology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts; and ‖Department of Cardiac Surgery and ¶Department of Anesthesiology, Anesthesiology American Anesthesia of Minnesota, Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota.

Background: The cardiac operating room is a complex environment requiring efficient and effective communication between multiple disciplines. The objectives of this study were to identify and rank critical time points during the perioperative care of cardiac surgical patients, and to assess variability in responses, as a correlate of a shared mental model, regarding the importance of these time points between and within disciplines.

Methods: Using Delphi technique methodology, panelists from 3 institutions were tasked with developing a list of critical time points, which were subsequently assigned to pause point (PP) categories. Panelists then rated these PPs on a 100-point visual analog scale. Descriptive statistics were expressed as percentages, medians, and interquartile ranges (IQRs). We defined low response variability between panelists as an IQR ≤ 20, moderate response variability as an IQR > 20 and ≤ 40, and high response variability as an IQR > 40.

Results: Panelists identified a total of 12 PPs. The PPs identified by the highest number of panelists were (1) before surgical incision, (2) before aortic cannulation, (3) before cardiopulmonary bypass (CPB) initiation, (4) before CPB separation, and (5) at time of transfer of care from operating room (OR) to intensive care unit (ICU) staff. There was low variability among panelists' ratings of the PP "before surgical incision," moderate response variability for the PPs "before separation from CPB," "before transfer from OR table to bed," and "at time of transfer of care from OR to ICU staff," and high response variability for the remaining 8 PPs. In addition, the perceived importance of each of these PPs varies between disciplines and between institutions.

Conclusions: Cardiac surgical providers recognize distinct critical time points during cardiac surgery. However, there is a high degree of variability within and between disciplines as to the importance of these times, suggesting an absence of a shared mental model among disciplines caring for cardiac surgical patients during the perioperative period. A lack of a shared mental model could be one of the factors contributing to preventable errors in cardiac operating rooms.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1213/ANE.0000000000002087DOI Listing
July 2017

Paravertebral Catheter Use for Postoperative Pain Control in Patients After Lung Transplant Surgery: A Prospective Observational Study.

J Cardiothorac Vasc Anesth 2017 Feb 4;31(1):142-146. Epub 2016 May 4.

Department of Surgery, University of Minnesota, Minneapolis, MN.

Objective: Effective postoperative pain management has been shown to be a positive predictive factor for postoperative recovery following a thoracotomy. The primary objective of this study was to examine the efficacy and safety of continuous paravertebral blockade in managing acute postsurgical pain following unilateral and bilateral single-lung transplantation.

Design: The authors conducted a prospective observational trial of patients.

Setting: The study was conducted in an academic university hospital.

Participants: Patients (≥18 years of age) who underwent either unilateral or bilateral single-lung transplantation and received a postoperative paravertebral catheter.

Interventions: Paravertebral catheters were placed via an ultrasound-guided technique on either postoperative day 1 or 2. After placement, a continuous infusion of 0.2% ropivacaine was run at 0.2 to 0.25 mL/kg/h with maximum dose of 7 mL/h per side in bilateral lung transplant patients, and 14 mL/h in unilateral lung transplant patients.

Measurements And Main Results: Patients were followed up to 120 hours after placement of catheters, and pain scores, opioid use, and adverse events were recorded. There were 35 patients who completed the study from October 2013 to December 2014 (21 bilateral transplants and 14 unilateral transplants). The mean time to paravertebral catheter placement was 1.14 days in the overall group, with median time to extubation occurring 543 minutes after placement (range, 23-2,985 minutes). Catheters remained in place for a mean of 7.18 days. The mean maximal pain scores for both groups was 5.94 (day 1), 6.26 (day 2), 6.20 (day 3), 5.12 (day 4), and 5.60 (day 5). There were no adverse events related to the paravertebral catheters in either group.

Conclusions: Paravertebral catheters provide a feasible option for postoperative pain control following unilateral or bilateral single-lung transplant in adult patients. Future research should focus on randomized trials of thoracic epidurals compared to paravertebral catheters.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1053/j.jvca.2016.05.006DOI Listing
February 2017

Thermal burn associated with intraoperative convective forced-air warming blanket (bair paws™ flex gown system).

A A Case Rep 2014 Oct;3(7):81-3

From the *Department of Anesthesiology, University of Minnesota Medical School; and †University of Minnesota Medical Center, Fairview Health System, Minneapolis, Minnesota.

A 44-year-old man undergoing ambulatory surgery sustained a 5% total body surface first-degree burn on his lower and lateral torso and upper thigh during routine use of a new forced-air warming Bair Paws™ flex gown system. We describe the likely mechanism of injury, intraoperative events suggesting special variation in the warming process, and a brief review of adverse events associated with forced-air warming systems.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1213/XAA.0000000000000047DOI Listing
October 2014

Perioperative stroke arising from the interplay of patent foramen ovale, atrial septal aneurysm, and right diaphragm paralysis during endoscopic surgery.

J Clin Anesth 2013 Sep 2;25(6):516-8. Epub 2013 Sep 2.

Department of Anesthesiology, University of Minnesota Medical Center, Minneapolis, MN 55455, USA. Electronic address:

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jclinane.2013.03.017DOI Listing
September 2013

Catheter ablation of hemodynamically unstable ventricular tachycardia with mechanical circulatory support.

Int J Cardiol 2013 Oct 15;168(4):3859-65. Epub 2013 Jul 15.

University of Minnesota, Minneapolis, MN, USA. Electronic address:

Background: Catheter ablation of hemodynamically unstable ventricular tachycardia (VT) is possible with mechanical circulatory support (MCS), little is known regarding the relative safety and efficacy of different supporting devices for such procedures.

Methods And Results: Sixteen consecutive patients (aged 63 ± 11 years with left ventricular ejection fraction of 20 ± 9%) who underwent ablation of hemodynamically unstable VT were included in this study. Hemodynamic support included percutaneous (Impella® 2.5, n = 5) and implantable left ventricular assist devices (LVADs, n = 6) and peripheral cardiopulmonary bypass (CPB, n = 5). Except for 2 Impella cases, hemodynamic support was adequate (with consistent mean arterial pressure of > 60 mmHg) to permit sufficient activation mapping for ablation. In the Impella and CPB groups, mean time under hemodynamic support was 185 ± 86 min, and time in VT was 78 ± 36 min. Clinical VT could be terminated at least once by ablation in all patients except 1 case with Impella due to hemodynamic instability. Peri-procedural complications included hemolysis in 1 patient with Impella and surgical intervention for percutaneous Impella placement problems in another 2. The median number of appropriately delivered defibrillator therapies was significantly decreased from 6 in the month before VT ablation to 0 in the month following ablation (p = 0.001).

Conclusions: Our data suggest that peripheral CPB and implantable LVAD provide adequate hemodynamic support for successful ablation of unstable VT. Impella® 2.5, on the other hand, was associated with increased risk of complications, and may not provide sufficient hemodynamic support in some cases.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ijcard.2013.06.035DOI Listing
October 2013

Cerebral oximetry during cardiac surgery: the association between cerebral oxygen saturation and perioperative patient variables.

J Cardiothorac Vasc Anesth 2012 Dec 18;26(6):1015-21. Epub 2012 Sep 18.

Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA.

Objective: This "real-world" study was designed to assess the patterns of regional cerebral oxygen saturation (rSO(2)) change during adult cardiac surgery. A secondary objective was to determine any relation between perioperative rSO(2) (baseline and during surgery) and patient characteristics or intraoperative variables.

Design: Prospective, observational, multicenter, nonrandomized clinical study.

Setting: Cardiac operating rooms at 3 academic medical centers.

Participants: Ninety consecutive adult patients presenting for cardiac surgery with or without cardiopulmonary bypass.

Interventions: Patients received standard care at each institution plus bilateral forehead recordings of cerebral oxygen saturation with the 7600 Regional Oximeter System (Nonin Medical, Plymouth, MN).

Measurements And Main Results: The average baseline (before induction) rSO(2) was 63.9 ± 8.8% (range 41%-95%); preoperative hematocrit correlated with baseline rSO(2) (0.48% increase for each 1% increase in hematocrit, p = 0.008). The average nadir (lowest recorded rSO(2) for any given patient) was 54.9 ± 6.6% and was correlated with on-pump surgery, baseline rSO(2), and height. Baseline rSO(2) was found to be an independent predictor of length of stay (hazard ratio 1.044, confidence interval 1.02-1.07, for each percentage of baseline rSO(2)).

Conclusions: In cardiac surgical patients, lower baseline rSO(2) value, on-pump surgery, and height were significant predictors of nadir rSO(2), whereas only baseline rSO(2) was a predictor of postoperative length of stay. These findings support previous research on the predictive value of baseline rSO(2) on length of stay and emphasize the need for further research regarding the clinical relevance of baseline rSO(2) and intraoperative changes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1053/j.jvca.2012.07.011DOI Listing
December 2012

Contrast echocardiography to differentiate artifact from left atrial thrombus.

Anesth Analg 2012 Apr 7;114(4):742-5. Epub 2012 Feb 7.

Department of Anesthesiology, University of Minnesota, Box 294, B515 Mayo Memorial Building, 420 Delaware St., S.E., Minneapolis, MN 55455, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1213/ANE.0b013e318246dfc2DOI Listing
April 2012

Acute left atrial thrombus after recombinant factor VIIa administration during left ventricular assist device implantation in a patient with heparin-induced thrombocytopenia.

Anesth Analg 2008 Feb;106(2):404-8, table of contents

Department of Anesthesiology, University of Minneapolis, B515 Mayo, MMC 294, 420 Delaware St., S.E., Minneapolis, MN 55455, USA.

We present a patient with end-stage heart failure and heparin-induced thrombocytopenia Type II, who required cardiopulmonary bypass (CPB) during a repeat implantation of a left ventricular assist device for long-term circulatory support. Bivalirudin was selected for anticoagulation during CPB, with concomitant infusion of aprotinin, in an effort to ameliorate blood loss. Nonetheless, profuse bleeding after CPB required massive transfusion of packed red blood cells, multiple coagulation factors, and platelets. Because of persistent bleeding, a single dose of recombinant factor VIIa (rFVIIa, 7.2 mg) was administered as rescue therapy. Within minutes, a large left atrial thrombus was detected by transesophageal echocardiography. We believe this is the first documentation of acute left atrial thrombus formation immediately after a single dose of recombinant factor VIIa administration during a left ventricular assist device implantation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1213/ane.0b013e31815edb52DOI Listing
February 2008

Phenylephrine to increase blood flow in the radial artery used as a coronary bypass conduit.

J Thorac Cardiovasc Surg 2005 Sep;130(3):687-92

Division of Cardiothoracic Anesthesiology, Washington University School of Medicine, St Louis, MO, USA.

Objective: The radial artery has more smooth muscle in its wall than the other arterial conduits and is known to be vasospastic. Because it is frequently necessary to use vasoconstrictors early after coronary bypass surgery we investigated the effects of phenylephrine on conduit flow in this setting.

Methods: Thirty patients undergoing coronary artery bypass with all arterial conduits in which the radial artery was used as a T-graft were randomly assigned to receive intravenous infusions of normal saline (n = 10); nitroglycerin, 0.5 microg x kg x min (n = 11); or nicardipine, 0.5 microg x kg x min (n = 9), beginning early in the operation. After discontinuation of cardiopulmonary bypass and achievement of stable hemodynamics, control measurements were obtained, and this was followed by phenylephrine infusion to achieve a 20% increase in mean arterial pressure, after which the measurements were repeated.

Results: Mean radial artery flow increased similarly in all groups: normal saline, 40% +/- 25%; nicardipine, 37% +/- 27%; nitroglycerin, 48% +/- 36% (P = .533). Comparable changes occurred in arterial pressure and systemic vascular resistance, whereas the cardiac index remained unchanged.

Conclusion: Radial artery blood flow increases when the mean arterial pressure is increased with phenylephrine. There was no evidence of a conduit vasoconstrictive effect, which could limit or reduce conduit flow. Vasoconstriction with phenylephrine is appropriate to provide adequate perfusion pressure for radial artery grafts.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jtcvs.2005.02.066DOI Listing
September 2005