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Off-Pump Coronary Artery Bypass pp 59–66Cite as

Controversy: Volume Load vs. Vasopressor

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Abstract

Off-pump coronary artery bypass (OPCAB) can cause hypotension during anesthetic management, particularly because of displacement of the heart. While hypotension is mainly treated with fluid volume loading and vasopressors, few studies have investigated which is the more effective of the two treatments. Methods based on volume loading are logical because they aim to replenish the decreased ventricular preload, which is the main cause of the decrease in blood pressure. These methods avoid the damage caused by hypovolemia and the side effects caused by vasopressors, such as increased circulatory dysfunction. In contrast, methods using vasopressors are consistent with recent trends in fluid restriction, which aim to avoid complications caused by fluid overload while also maintaining organ perfusion. Anesthesiologists must have a thorough knowledge of the advantages and disadvantages of each method and employ one or both in accordance with each patient’s needs.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima, 960-1295, Japan

    Shinju Obara & Masahiro Murakawa

Authors
  1. Shinju Obara
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  2. Masahiro Murakawa
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Correspondence to Shinju Obara .

Editor information

Editors and Affiliations

  1. Division of Cardiovascular Surgery, Department of Surgery, Shiga University of Medical Science, Otsu, Shiga, Japan

    Tohru Asai

  2. Department of Cardiovascular Surgery, Nippon Medical School, Bunkyo-ku, Tokyo, Japan

    Masami Ochi

  3. Department of Cardiovascular Surgery, Fukushima Medical University, Fukushima, Fukushima, Japan

    Hitoshi Yokoyama

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Obara, S., Murakawa, M. (2016). Controversy: Volume Load vs. Vasopressor. In: Asai, T., Ochi, M., Yokoyama, H. (eds) Off-Pump Coronary Artery Bypass. Springer, Tokyo. https://doi.org/10.1007/978-4-431-54986-4_7

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  • DOI: https://doi.org/10.1007/978-4-431-54986-4_7

  • Publisher Name: Springer, Tokyo

  • Print ISBN: 978-4-431-54985-7

  • Online ISBN: 978-4-431-54986-4

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