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Cardiac anesthesiology

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https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#1
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28629228/use-of-provider-debriefing-to-improve-fast-track-extubation-rates-following-cardiac-surgery-at-an-academic-medical-center
#2
Jordan E Goldhammer, Jillian M Dashiell, Scott Davis, Marc C Torjman, Hitoshi Hirose
When used in appropriate patient populations, fast-track extubation (FTE) anesthetic techniques and intensive care unit (ICU) protocols safely reduce intubation times, ICU length of stay, and resource utilization. The authors hypothesized that perioperative provider debriefing on success or failure of FTE would improve FTE success. This retrospective observational study included consecutive patients undergoing elective coronary artery bypass graft (CABG), valve, or combined CABG/valve surgery between February 2015 and May 2016 (N = 313)...
June 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28537977/perioperative-use-of-focused-transthoracic-cardiac-ultrasound-a-survey-of-current-practice-and-opinion
#3
Frederick Conlin, Neil R Connelly, Michael P Eaton, Patrick J Broderick, Jennifer Friderici, Adam C Adler
BACKGROUND: The advent of portable ultrasound machines in recent years has led to greater availability of focused cardiac ultrasound (FoCUS) in the perioperative and critical care setting. To our knowledge, its use in the perioperative setting among anesthesiologists remains undefined. We sought to assess the use of FoCUS by members of the Society of Cardiovascular Anesthesiologists (SCA) in clinical practice, to identify variations in its application, to outline limits to its use, and to understand the level of training of physicians using this technology...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28489638/current-status-of-cardiovascular-anesthesia-in-china
#4
Jiakai Lu, Weipeng Wang, Weiping Cheng, Lei Chen, Jeffrey Huang, Chris A Ethridge, Jiapeng Huang
High quality and safe cardiac anesthesia is a prerequisite for success in cardiac care. Cardiac surgery has developed rapidly over recent years in China. Because of language barriers, the current status of cardiac anesthesia in China is not well known to Western countries. To assess practice patterns, volume, workforce, and training requirements of Chinese cardiovascular anesthesiologists, we surveyed 92 major cardiovascular centers in China regarding their anesthesia practice, monitoring techniques, resources, staffing, and work hours...
May 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28431420/generative-retrieval-improves-learning-and-retention-of-cardiac-anatomy-using-transesophageal-echocardiography
#5
Amanda M Kleiman, Katherine T Forkin, Allison J Bechtel, Stephen R Collins, Jennie Z Ma, Edward C Nemergut, Julie L Huffmyer
BACKGROUND: Transesophageal echocardiography (TEE) is a valuable monitor for patients undergoing cardiac and noncardiac surgery as it allows for evaluation of cardiovascular compromise in the perioperative period. It is challenging for anesthesiology residents and medical students to learn to use and interpret TEE in the clinical environment. A critical component of learning to use and interpret TEE is a strong grasp of normal cardiovascular ultrasound anatomy. METHODS: Fifteen fourth-year medical students and 15 post-graduate year (PGY) 1 and 2 anesthesiology residents without prior training in cardiac anesthesia or TEE viewed normal cardiovascular anatomy TEE video clips; participants were randomized to learning cardiac anatomy in generative retrieval (GR) and standard practice (SP) groups...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28331172/an-anti-coagulation-conundrum-implantation-of-total-artificial-heart-in-a-patient-with-heparin-induced-thrombocytopenia-type-ii
#6
Theodore J Cios, Yuliana Salamanca-Padilla, Dmitri Guvakov
BACKGROUND Heparin-induced thrombocytopenia (HIT) is a rare but life-threatening complication of heparin administration. It can present a major clinical dilemma for physicians caring for patients requiring life-saving urgent or emergent cardiac surgery. Studies have been published examining the use of alternative anticoagulants for patients undergoing cardiopulmonary bypass (CPB), however, evidence does not clearly support any particular approach. Presently, there are no large-scale, prospective randomized studies examining the impact of alternative anticoagulants on clinical outcomes for HIT-positive patients requiring cardiac surgery...
March 23, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28066904/implementing-point-of-care-ultrasonography-of-the-heart-and-lungs-in-an-anesthesia-department
#7
M T Bøtker, M L Vang, T Grøfte, H Kirkegaard, C A Frederiksen, E Sloth
BACKGROUND: Implementation of point-of-care ultrasonography (POCUS) of the heart and lungs requires image acquisition skills among providers. We aimed to determine the effect of POCUS implementation using a systematic education program on image acquisition skills and subsequent use and barriers in a department of anesthesiology. METHODS: Twenty-five anesthesiologists underwent a systematic education program in POCUS during the fall of 2012. A POCUS expert evaluated images from baseline and evaluation examinations performed on two healthy individuals as useful or not useful for clinical interpretation...
February 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28033081/clinical-databases-and-registries-in-congenital-and-pediatric-cardiac-surgery-cardiology-critical-care-and-anesthesiology-worldwide
#8
David F Vener, Michael Gaies, Jeffrey P Jacobs, Sara K Pasquali
The growth in large-scale data management capabilities and the successful care of patients with congenital heart defects have coincidentally paralleled each other for the last three decades, and participation in multicenter congenital heart disease databases and registries is now a fundamental component of cardiac care. This manuscript attempts for the first time to consolidate in one location all of the relevant databases worldwide, including target populations, specialties, Web sites, and participation information...
January 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/27901331/clinical-indices-and-biomarkers-for-perioperative-cardiac-risk-stratification-an-update
#9
Radmilo J Janković, Danica Z Marković, Dušan T Sokolović, Ivana Zdravković, Massimiliano Sorbello
European Society of Cardiology (ESC)/ European Society of Anesthesiology (ESA) highlighted that anesthesiologist has a leading role in perioperative cardiovascular assessment and management in the year of 2014. During cardiovascular assessment one can rely on cooperation of multidisciplinary specialists like: other anesthesiologists, cardiologists and surgeons. For the purpose of precise systematization and decision making the Lee Score or NSQUIP database can be used besides the traditionally used ASA Score...
April 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27898548/two-cardiac-arrests-because-of-venous-air-embolism-during-endoscopic-retrograde-cholangiopancreatography-a-case-report
#10
Joseph M Sisk, Monica D Choi, Andrew B Casabianca, Ali M Hassan
Venous air embolism is a rare but potentially catastrophic complication of endoscopic retrograde cholangiopancreatography. We report 2 cases of venous air embolism and subsequent cardiac arrests. During resuscitation efforts, a transesophageal echocardiogram was placed, which demonstrated significant air in the right heart. Although gastroenterologists seem to be more aware of this complication, it is underreported in the anesthesiology literature. As anesthesiologists continue to expand coverage to endoscopy suites, anesthesia providers must be aware of predisposing factors and maintain a high index of suspicion to recognize and treat in a timely manner to prevent serious adverse outcomes...
February 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/27765846/noninvasive-assessment-of-cardiac-output-by-brachial-occlusion-cuff-technique-comparison-with-the-open-circuit-acetylene-washin-method
#11
Pavol Sajgalik, Vaclav Kremen, Alex R Carlson, Vratislav Fabian, Chul-Ho Kim, Courtney Wheatley, Vaclav Gerla, John A Schirger, Thomas P Olson, Bruce D Johnson
Cardiac output (CO) assessment as a basic hemodynamic parameter has been of interest in exercise physiology, cardiology, and anesthesiology. Noninvasive techniques available are technically challenging, and thus difficult to use outside of a clinical or laboratory setting. We propose a novel method of noninvasive CO assessment using a single, upper-arm cuff. The method uses the arterial pressure pulse wave signal acquired from the brachial artery during 20-s intervals of suprasystolic occlusion. This method was evaluated in a cohort of 12 healthy individuals (age, 27...
December 1, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27760527/outcome-of-cardiac-surgery-in-patients-with-low-preoperative-ejection-fraction
#12
Marina Pieri, Alessandro Belletti, Fabrizio Monaco, Antonio Pisano, Mario Musu, Veronica Dalessandro, Giacomo Monti, Gabriele Finco, Alberto Zangrillo, Giovanni Landoni
BACKGROUND: In patients undergoing cardiac surgery, a reduced preoperative left ventricular ejection fraction (LVEF) is common and is associated with a worse outcome. Available outcome data for these patients address specific surgical procedures, mainly coronary artery bypass graft (CABG). Aim of our study was to investigate perioperative outcome of surgery on patients with low pre-operative LVEF undergoing a broad range of cardiac surgical procedures. METHODS: Data from patients with pre-operative LVEF ≤40 % undergoing cardiac surgery at a university hospital were reviewed and analyzed...
October 18, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27640906/short-term-postoperative-breast-cancer-outcomes-in-patients-with-advanced-age
#13
COMPARATIVE STUDY
Erica Pettke, Nicole Ilonzo, Martha Ayewah, Sara Tsantes, Alison Estabrook, Aye Moe Thu Ma
BACKGROUND: This study compares early postoperative breast cancer outcomes between patients 80 years and older (older patients) and those younger than 80 years (<80 years). METHODS: The National Surgical Quality Improvement Program database was used to identify patients who had breast surgery between 2005 and 2013 for malignancy. RESULTS: Older patients had a significantly higher percentage of comorbidities and partial mastectomies. Postoperatively, they had higher rates of pneumonia, urinary tract infection, cardiac arrest, and mortality but had lower rates of wound dehiscence, deep wound, and organ space infections...
October 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27640221/the-development-of-pain-medicine-in-italy-and-the-rest-of-europe-40-years-after-the-first-international-association-for-the-study-of-pain-congress
#14
Giustino Varrassi, Antonella Paladini
Professor Giustino Varrassi and Antonella Paladini speak to Jade Parker, Commissioning Editor: Professor Giustino Varrassi is Full Professor of Anesthesiology and Pain Medicine in the LUdeS University, Valletta, Malta. He graduated at the Medical School of the University 'La Sapienza' (Rome, Italy) in 1973, and became board certified in Anesthesiology and Intensive Care in 1976 and in Pneumology in 1978, both in the same Medical School. He is currently President of the European League Against Pain and of the Paolo Procacci Foundation, and is a founding member of both of these...
January 2017: Pain Management
https://www.readbyqxmd.com/read/27522514/presence-of-an-arterial-line-improves-response-to-simulated-hypotension-and-pulseless-electrical-activity
#15
Jonathan Lipps, Andrew Goldberg, Samuel DeMaria, Yury Khelemsky, Adam Levine, Vedat Yildiz, Bryan Mahoney
With pulseless electrical activity (PEA) emerging as one of the leading cardiac arrest arrhythmias, the rapid response and accurate diagnosis of PEA is essential to improve survival rates. Although the use of invasive blood pressure monitoring to more quickly detect changes in blood pressure is widespread, evidence for its use is largely anecdotal and placement is not without risk. This is a prospective, multi-center, randomized controlled trial involving 58 senior anesthesiology residents undergoing a simulation of intraoperative PEA using high-fidelity simulation...
August 13, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27498374/levosimendan-beyond-inotropy-and-acute-heart-failure-evidence-of-pleiotropic-effects-on-the-heart-and-other-organs-an-expert-panel-position-paper
#16
REVIEW
Dimitrios Farmakis, Julian Alvarez, Tuvia Ben Gal, Dulce Brito, Francesco Fedele, Candida Fonseca, Anthony C Gordon, Israel Gotsman, Elena Grossini, Fabio Guarracino, Veli-Pekka Harjola, Yaron Hellman, Leo Heunks, Visnja Ivancan, Apostolos Karavidas, Matti Kivikko, Vladimir Lomivorotov, Dan Longrois, Josep Masip, Marco Metra, Andrea Morelli, Maria Nikolaou, Zoltán Papp, Alexander Parkhomenko, Gerhard Poelzl, Piero Pollesello, Hanne Berg Ravn, Steffen Rex, Hynek Riha, Sven-Erik Ricksten, Robert H G Schwinger, Bojan Vrtovec, M Birhan Yilmaz, Marzenna Zielinska, John Parissis
Levosimendan is a positive inotrope with vasodilating properties (inodilator) indicated for decompensated heart failure (HF) patients with low cardiac output. Accumulated evidence supports several pleiotropic effects of levosimendan beyond inotropy, the heart and decompensated HF. Those effects are not readily explained by cardiac function enhancement and seem to be related to additional properties of the drug such as anti-inflammatory, anti-oxidative and anti-apoptotic ones. Mechanistic and proof-of-concept studies are still required to clarify the underlying mechanisms involved, while properly designed clinical trials are warranted to translate preclinical or early-phase clinical data into more robust clinical evidence...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27496437/hrv-influence-during-renal-transplantation-procedure-on-long-term-mortality
#17
J Biernawska, K Kotfis, M Kaczmarczyk, W Błaszczyk, E Barnik, M Żukowski
BACKGROUND: The autonomic nervous system plays an important role in heart function regulation. One of the most acknowledged methods for noninvasive measurement of autonomic system activity is to determine heart rate variability (HRV). Reduced HRV parameters-heart rate rigidity/stiffness-are an independent prognostic factor of sudden cardiac death risk because of arrhythmia. Renal transplantation is an important factor in HRV changes because of hemodynamic and ion disturbances. The main purpose of this study was to determine the influence of HRV disturbances during renal transplantation procedures on long-term mortality in patients with chronic kidney disease...
June 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27493092/efficacy-and-safety-of-fibrinogen-concentrate-in-surgical-patients-a-meta-analysis-of-randomized-controlled-trials
#18
Evgeny Fominskiy, Valeriy A Nepomniashchikh, Vladimir V Lomivorotov, Fabrizio Monaco, Chiara Vitiello, Alberto Zangrillo, Giovanni Landoni
OBJECTIVES: To investigate the efficacy and safety of fibrinogen concentrate (FC) in surgical patients. DESIGN: Meta-analysis of randomized controlled studies (RCTs). SETTING: Perioperative. PARTICIPANTS: Adult and pediatric surgical patients. INTERVENTIONS: A search of PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials, Transfusion Evidence Library, Google Scholar, and the proceedings from major international anesthesiology meetings up to February 1, 2016 for RCTs that compared FC with placebo or other comparators...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27479258/-cardiac-evaluation-before-non-cardiac-surgery
#19
Jan Menzenbach, Olaf Boehm
Before non-cardiac surgery, evaluation of cardiac function is no frequent part of surgical treatment. European societies of anesthesiology and cardiology published consensus-guidelines in 2014 to present a reasonable approach for preoperative evaluation. This paper intends to differentiate the composite of perioperative risk and to display the guidelines methodical approach to handle it. Features to identify patients at risk from an ageing population with comorbidities, are the classification of surgical risk, functional capacity and risk indices...
July 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27466988/anaesthesiological-strategies-to-improve-outcome-in-liver-transplantation-recipients
#20
V Perilli, P Aceto, T Sacco, C Modesti, P Ciocchetti, F Vitale, A Russo, G Fasano, A Dottorelli, L Sollazzi
Graft and patients survival are the main goal of anesthesiological management in patients undergoing liver transplantation (LT). Even if anesthesiological practice sustained major developments over time, some evidence-based intraoperative strategies have not yet been widely applied. The aim of this review was to summarize intraoperative anesthesiological strategies which could have the potential to improve LT graft and/or recipient survival. Monitoring must be as accurate as possible in order to manage intraoperative hemodynamic changes...
July 2016: European Review for Medical and Pharmacological Sciences
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