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G Landoni
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Volatile anesthetics to reduce mortality in coronary artery bypass graft surgery

Volatile anesthetics agents have cardioprotective effects in experimental conditions, that may translate in improved survival in patients undergoing coronary artery bypass graft (CABG). Our clinical trial showed that use of volatile anesthetics was not associated with improved 1-year outcome as compared with total intravenous anesthesia.

The article was published by
El artículo fue publicado por
New England Journal of Medicine
Volume / Volumen: 380
Number / Número: 13
First and last pages / Páginas inicial-final: 1214-1225
Year / Año: 2019
Month / Mes: march

This journal, which is covered by SIIC Data Bases,
is part of the bibliographic collections of the Biblioteca Biomédica (BB) SIIC.
Esta revista, clasificada por SIIC Data Bases,
integra el acervo bibliográfico de la Biblioteca Biomédica (BB) SIIC.

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Institución principal de la investigación

Authors' Report

Crónica del Autor

Los anestésicos volátiles para reducir la mortalidad en la cirugía de injerto de derivación de arteria coronaria

Los agentes anestésicos volátiles tienen efectos cardioprotectores en condiciones experimentales, que pueden traducirse en una mejor supervivencia en pacientes sometidos a injerto de derivación de arteria coronaria (CABG, por sus siglas en inglés). Nuestro ensayo clínico demostró que el uso de anestésicos volátiles no se asoció con un mejor resultado a un año en comparación con la anestesia intravenosa total.
Crónica del Autor

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Bibliographic references
Referencias bibliográficas

1. Alexander JH, Smith PK. Coronary-Artery Bypass Grafting. N Engl J Med 374:1954-64, 2016.
2. Benjamin EJ, Virani SS, Callaway CW, et al; American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association. Circulation 137:e67-e492, 2018.
3. Moazzami K, Dolmatova E, Maher J, et al. In-Hospital Outcomes and Complications of Coronary Artery Bypass Grafting in the United States Between 2008 and 2012. J Cardiothorac Vasc Anesth 31:19-25, 2017.
4. Seccareccia F, Perucci CA, D'Errigo P, et al; Research Group of the Italian CABG Outcome Study. The Italian CABG Outcome Study: short-term outcomes in patients with coronary artery bypass graft surgery. Eur J Cardiothorac Surg 29:56-62, 2006.
5. Pagel PS, Crystal GJ. The Discovery of Myocardial Preconditioning Using Volatile Anesthetics: A History and Contemporary Clinical Perspective. J Cardiothorac Vasc Anesth 32:1112-1134, 2018.
6. Kunst G, Klein AA. Peri-operative anaesthetic myocardial preconditioning and protection - cellular mechanisms and clinical relevance in cardiac anaesthesia. Anaesthesia 70:467-82, 2015.
7. Uhlig C, Bluth T, Schwarz K, et al. Effects of Volatile Anesthetics on Mortality and Postoperative Pulmonary and Other Complications in Patients Undergoing Surgery: A Systematic Review and Meta-analysis. Anesthesiology 124:1230-45, 2016.
8. Landoni G, Greco T, Biondi-Zoccai G, et al. Anaesthetic drugs and survival: a Bayesian network meta-analysis of randomized trials in cardiac surgery. Br J Anaesth 111:886-96, 2013.
9. Landoni G, Lomivorotov V, Pisano A, et al. MortalitY in caRdIAc surgery (MYRIAD): A randomizeD controlled trial of volatile anesthetics. Rationale and design. Contemp Clin Trials 59:38-43. 2017.
10. Ovize M, Thibault H, Przyklenk K. Myocardial conditioning: opportunities for clinical translation. Circ Res 113:439-50, 2013.
11. De Hert S, Vlasselaers D, Barbé R, et al. A comparison of volatile and non volatile agents for cardioprotection during on-pump coronary surgery. Anaesthesia 64:953-60, 2009.
12. Landoni G, Guarracino F, Cariello C, et al. Volatile compared with total intravenous anaesthesia in patients undergoing high-risk cardiac surgery: a randomized multicentre study. Br J Anaesth 113:955-63, 2014.

Other articles written by the author G Landoni
Otros artículos de G Landoni

Landoni G, Lomivorotov VV, Alvaro G, Lobreglio R, Pisano A, Guarracino F, Calabrò MG, Grigoryev EV, Likhvantsev VV, Salgado-Filho MF, Bianchi A, Pasyuga VV, Baiocchi M, Pappalardo F, Monaco F, Boboshko VA, Abubakirov MN, Amantea B, Lembo R, Brazzi L, Verniero L, Bertini P, Scandroglio AM, Bove T, Belletti A, Michienzi MG, Shukevich DL, Zabelina TS, Bellomo R, Zangrillo A; CHEETAH Study Group. (2017). Levosimendan for Hemodynamic Support after Cardiac Surgery. N Engl J Med. DOI: 10.1056/NEJMoa1616325. [Epub ahead of print] PMID: 28320259
Myles PS, Smith JA, Forbes A, Silbert B, Jayarajah M, Painter T, Cooper DJ, Marasco S, McNeil J, Bussières JS, McGuinness S, Byrne K, Chan MT, Landoni G, Wallace S; ATACAS Investigators of the ANZCA Clinical Trials Network. (2017). Tranexamic Acid in Patients Undergoing Coronary-Artery Surgery. N Engl J Med. vol. 376(2):136-148. DOI: 10.1056/NEJMoa1606424. PMID: 27774838
Bove T, Zangrillo A, Guarracino F, Alvaro G, Persi B, Maglioni E, Galdieri N, Comis M, Caramelli F, Pasero DC, Pala G, Renzini M, Conte M, Paternoster G, Martinez B, Pinelli F, Frontini M, Zucchetti MC, Pappalardo F, Amantea B, Camata A, Pisano A, Verdecchia C, Dal Checco E, Cariello C, Faita L, Baldassarri R, Scandroglio AM, Saleh O, Lembo R, Calabrò MG, Bellomo R, Landoni G. Effect of fenoldopam on use of renal replacement therapy among patients with acute kidney injury after cardiac surgery: a randomized clinical trial. JAMA 312(21):2244-53, 2014.
Crescenti A, Borghi G, Bignami E, Bertarelli G, Landoni G, Casiraghi GM, Briganti A, Montorsi F, Rigatti P, Zangrillo A. Intraoperative use of tranexamic acid to reduce transfusion rate in patients undergoing radical retropubic prostatectomy: double blind, randomised, placebo controlled trial. BMJ 343:d5701, 2011.
Bove T, Landoni G, Calabrò MG, Aletti G, Marino G, Cerchierini E, Crescenzi G, Zangrillo A. Renoprotective action of fenoldopam in high-risk patients undergoing cardiac surgery: a prospective, double-blind, randomized clinical trial. Circulation 111(24):3230-5, 2005.
Sartini C, Lomivorotov V, Pieri M, Delgado JCL, Baiardo Redaelli M, Hajjar L, Pisano A, Likhvantsev V, Fominskiy E, Bradic N, Cabrini L, Novikov M, Avancini D, Riha H, Lembo R, Gazivoda G, Paternoster G, Wang C, Tamà S, Alvaro G, Wang CY, Roasio A, Ruggeri L, Yong CY, Pasero D, Severi L, Pasin L, Mancino G, Mura P, Musu M, Spadaro S, Conte M, Lobreglio R, Silvetti S, Votta CD, Belletti A, Di Fraja D, Corradi F, Brusasco C, Saporito E, D'Amico A, Sardo S, Ortalda A, Riefolo C, Fabrizio M, Zangrillo A, Bellomo R, Landoni G. A Systematic Review and International Web-Based Survey of Randomized Controlled Trials in the Perioperative and Critical Care Setting: Interventions Reducing Mortality. J Cardiothorac Vasc Anesth pii: S1053-0770(18)31044-9, 2018.
Sousa-Uva M, Head SJ, Milojevic M, Collet JP, Landoni G, Castella M, Dunning J, Gudbjartsson T, Linker NJ, Sandoval E, Thielmann M, Jeppsson A, Landmesser U. 2017 EACTS Guidelines on perioperative medication in adult cardiac surgery. Eur J Cardiothorac Surg 53(1):5-33, 2018.
Hajjar LA, Zambolim C, Belletti A, de Almeida JP, Gordon AC, Oliveira G, Park CHL, Fukushima JT, Rizk SI, Szeles TF, Dos Santos Neto NC, Filho RK, Galas FRBG, Landoni G. Vasopressin Versus Norepinephrine for the Management of Septic Shock in Cancer Patients: The VANCS II Randomized Clinical Trial. Crit Care Med 47(12):1743-1750. doi: 10.1097/CCM.0000000000004023, 2019.
Hajjar LA, Vincent JL, Barbosa Gomes Galas FR, Rhodes A, Landoni G, Osawa EA, Melo RR, Sundin MR, Grande SM, Gaiotto FA, Pomerantzeff PM, Dallan LO, Franco RA, Nakamura RE, Lisboa LA, de Almeida JP, Gerent AM, Souza DH, Gaiane MA, Fukushima JT, Park CL, Zambolim C, Rocha Ferreira GS, Strabelli TM, Fernandes FL, Camara L, Zeferino S, Santos VG, Piccioni MA, Jatene FB, Costa Auler JO Jr, Filho RK. Vasopressin versus Norepinephrine in Patients with Vasoplegic Shock after Cardiac Surgery: The VANCS Randomized Controlled Trial. Anesthesiology 126(1):85-93, 2017 .

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G Landoni was invited by SIIC on
G Landoni fue invitado por SIIC el
2021, february 23
  The authors' report was accepted on
La crónica del autor fue aprobada el
2021, march 17
The authors' report was accepted on
La crónica del autor fue aprobada el
2021, march 17
Published in siicsalud
Publicado en siicsalud
2021, june 15

The article is strictly related to the following sections of siicsalud
El artículo se relaciona estrictamente con las siguientes secciones de siicsalud

/ Anestesiología
/ Farmacología

and secondarily related to the following sections

y secundariamente con las siguientes secciones

Surgical Anesthesiology
Anestesiología Quirúrgica

Cardiac Anesthesiology

Clinical Cardiology
Cardiología Clínica


Cardiovascular surgery
Cirugía Cardiovascular

Coronary Unit
Unidad Coronaria

Intensive Care
Cuidados Intensivos





Pharmaceutical Medicine
Medicina Farmacéutica

Internal Medicine
Medicina Interna

Public Health
Salud Pública

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Volatile Anesthetics versus Total Intravenous Anesthesia for Cardiac Surgery

Author / Autor
VV Lomivorotov1, CN Neto2, A Zangrillo3

3, Università-Vita Salute San Raffaele, Milán, Italia

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