Operative notes for patients taking tamsulosin at the time of surgery were reviewed. Preoperative dilated pupil diameter; use of prophylactic intracameral lidocaine epinephrine; and presence of billowing iris, iris prolapse, and pupil constriction were recorded. Intraoperative floppy-iris syndrome was defined as the occurrence of any of the 3 phenomena constituting the syndrome.

RESULTS: DMH1 cost Review of 1163 charts identified 59 patients (81 eyes) taking tamsulosin at the time of surgery. The overall incidence of IFIS was 29.6%. Of those who received prophylactic intracameral lidocaine epinephrine, the incidence of IFIS was 38.5%. The incidence of IFIS was 44.8% in eyes with preoperative dilated pupil diameter

smaller than 6.5 mm and 21.7% in eyes with ZD1839 datasheet a preoperative dilated pupil diameter larger than 6.5 mm. A preoperative dilated pupil diameter smaller than 6.5 mm was significantly associated with IFIS (P = .032).

CONCLUSIONS: The incidence of IFIS was lower than previously reported. Use of prophylactic intracameral lidocaine epinephrine did not reduce the incidence of IFIS. A preoperative dilated pupil diameter smaller than 6.5 mm was significantly associated with

an increased incidence of IFIS.”
“BACKGROUND: Used frequently for right ventricular dysfunction (RVD), the clinical benefit of inhaled nitric oxide (iNO) is still unclear. We conducted a randomized, double-blind, controlled trial to determine the effect of iNO on post-operative outcomes in the setting of left ventricular assist device (LVAD) placement.

METHODS: Included were 150 patients undergoing LVAD placement with pulmonary vascular resistance >= 200 dyne/sec/cm(-5). Patients received iNO (40 ppm) or placebo (an equivalent concentration

of nitrogen) until 48 hours after separation from cardiopulmonary bypass, extubation, or upon meeting study-defined RVD. For ethical reasons, crossover to open-label iNO was allowed during the 48-hour treatment period if RVD criteria were met.

RESULTS: RVD criteria were met by 7 of 73 patients (9.6%; 95% confidence interval, 2.8-16.3) in the iNO group compared with 12 of 77 (15.6%; 95% confidence interval, 7.5-23.7) MAPK inhibitor who received placebo (p = 0.330). Time on mechanical ventilation decreased in the iNO group (median days, 2.0 vs 3.0; p = 0.077), and fewer patients in the iNO group required an RVAD (5.6% vs 10%; p = 0.468); however, these trends did not meet statistical boundaries of significance. Hospital stay, intensive care unit stay, and 28-day mortality rates were similar between groups, as were adverse events. Thirty-five patients crossed over to open-label iNO (iNO, n = 15; placebo, n = 20). Eighteen patients (iNO, n = 9; placebo, n = 9) crossed over before RVD criteria were met.

CONCLUSIONS: Use of iNO at 40 ppm in the perioperative phase of LVAD implantation did not achieve significance for the primary end point of reduction in RVD.