296 LITERATURE REVIEW

Observation that palpation of the carotid artery reduces IJV size suggests that if the carotid artery impulse is to be used as a landmark to guide needle direction, the location of carotid impulse should be noted and the palpating hand should be removed before cannulation is attempted.

Grobbee DE, Rimm EB, Giovannucci E, et al: Coffee, caffeine, and cardiovascular disease in men. N Engl J Med 323:1026-1032,199O

This is a prospective evaluation of the relation of coffee consumption to risk of myocardial infarction, need for coronary artery bypass surgery or angioplasty, and risk of stroke in more than 45,000 American men, aged 40 to 75. Total coffee consumption was not associated with an increased risk of coronary heart disease or a stroke (the age-adjusted relative risk for all cardiovascular disease among participants drinking 4 or more cups of coffee daily was 1.04). However, higher consumption of decaffeinated coffee was associated with a marginally significant increase in coronary heart disease risk (relative risk, 1.63). Drink up!

REVIEW ARTICLES

Goodnough LT, Johnston MFM, Ramsey G, et al: Guidelines for transfusion support in patients under- going coronary artery bypass grafting. Ann Thorac Surg So:675683,199O

This current review article represents the blood banker’s view on blood use during coronary artery surgery. The authors are mem- bers of the Transfusion Practices Committee of the American Association of Blood Banks. This review covers preoperative evaluation of the hemostatic system, red blood cell utilization, management of operative bleeding complications, and provides guidelines for blood component therapy. Recommendations made by the authors include (1) use of a combination of interventions designed to minimize homologous blood exposure; (2) elimination of the practice of prophylactic plasma or platelet transfusion; (3) avoidance of designated blood donation from first-degree relatives because of transfusion-associated graft-versus-host disease risks;

and (4) use of crystalloid or colloid solutions for volume replace- ment therapy.

Scott WJ, Kessler R, Wernly JA: Blood conserva- tion in cardiac surgery. Ann Thorac Surg S&843-851, 1990

Blood conservation techniques for use in cardiac surgery. categorized as preoperative, intraoperative, postoperative, or phar- macological, are reviewed in this article. The clinical efficacy of many strategies is discussed and based on a review of literature. The authors conclude that an effective blood conservation program includes avoidance of aspirin preoperatively, autologous predona- tion when permitted prior to elective operation, intraoperative autologous blood harvesting, intraoperative and postoperative blood scavenging and autotransfusion, and future use of aprotinin. This article presents an informative, succinct overview, although the bibliography (73 references) does not represent a complete literature review for all strategies discussed.

Shook JE, Watkins WD, Camporesi EM: Differen- tial roles of opioid receptors in respiration respira- tory disease, and opioid-induced respiratory depres- sion. Am Rev Respir Dis 142:895-909,199O

This “state-of-the-art” review article describes the respiratory actions of endogenous opioids, the pathophysiological alterations in cerebrospinal fluid endogenous opioid concentrations in certain conditions, and the effects of antagonist administration on normal and abnormal ventilatory states. The effects of specific opioid receptors on ventilatoty function are characterized. Receptor selectivity and ventilatory effects of clinically used opioid com- pounds are reviewed.

ACKNOWLEDGMENT

Articles reviewed in this issue were selected from those pub- lished in the following journals: American Heari Journal, American Journal of Cardiology, American Review of Respiratory Disease. Annals of Internal Medicine, Annals of Surgery, Annals of Thoracic Surgery, Circulation, Critical Care Medicine, Journal of Thoracic and Cardiovascular Surgey, and New England Journal of Medicine.