James Barnard

Low dose (renal dose) dopamine in the critically ill patient

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether low dose (renal dose) dopamine in the critically ill patient prevents acute renal failure. Altogether 141 papers were found using the reported search, of which three presented the best evidence to answer the clinical question. The author, journal, date and country of publication, patient group studied, study type, relevant outcomes, results, and study weaknesses of these papers are tabulated. We conclude that there is no evidence to support the use of low-dose dopamine to treat acute renal failure in critically ill patients.

Pulmonary Valve Replacement Through a Left Thoracotomy Approach

We report here the first case, to our knowledge, of pulmonary valve replacement being performed via a left thoracotomy approach in a patient with pectus excavatum who had 3 previous sternotomies. The merit of this approach and its feasibility are discussed.