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intraoperative cardiac arrest

Jack H Crawford, Matthew S Hull, Santiago Borasino, Brad L Steenwyk, Kristal M Hock, Kevin Wall, Jeffrey A Alten
BACKGROUND: Cardiopulmonary bypass (CPB) may lead to adrenal insufficiency (AI). Emerging evidence supports association of AI with morbidity after cardiac surgery. AIMS: The aim of this study was to define AI incidence in neonates undergoing complex cardiac surgery with CPB and its association with intraoperative post-CPB outcomes. METHODS: Forty subjects enrolled in a prior randomized control trial who received preoperative methylprednisolone as part of our institutional neonatal bypass protocol were included...
October 25, 2016: Paediatric Anaesthesia
Alessia Pedoto, Dawn P Desiderio, David Amar, Robert J Downey
BACKGROUND: Spray cryotherapy (SCT) of airway lesions is used to effectively palliate respiratory symptoms related to airway obstruction, but significant intraoperative hemodynamic complications have been noted. We reviewed the experience at a single institution using SCT for the treatment of obstructive airway tumors. METHODS: A retrospective review of a single institution experience with intraoperative and postoperative hemodynamic complications associated with SCT was performed...
November 2016: Anesthesia and Analgesia
Miklos D Kertai, Sreekanth Cheruku, Wenjing Qi, Yi-Ju Li, G Chad Hughes, Joseph P Mathew, Jörn A Karhausen
OBJECTIVE: Aortic surgeries requiring hypothermic circulatory arrest evoke systemic inflammatory responses that often manifest as vasoplegia and hypotension. Because mast cells can rapidly release vasoactive and proinflammatory effectors, we investigated their role in intraoperative hypotension. METHODS: We studied 31 patients undergoing proximal aortic repair with hypothermic circulatory arrest between June 2013 and April 2015 at Duke University Medical Center...
September 14, 2016: Journal of Thoracic and Cardiovascular Surgery
Todd C Crawford, J Trent Magruder, Joshua C Grimm, Christopher M Sciortino, Kaushik Mandal, Kenton J Zehr, Duke E Cameron, Glenn J Whitman, John V Conte
BACKGROUND: Mediastinal reexplorations for bleeding are associated with significant morbidity and mortality. This study hypothesized that bleeding patients who undergo delayed chest closure after an initial operation experience similar outcomes in comparison with patients who have initial chest closure and later require an unplanned reexploration. METHODS: This study included all patients in the Johns Hopkins University School of Medicine (Baltimore, MD) institutional Society of Thoracic Surgeons (STS) database who underwent cardiac surgical procedures or thoracic transplantation from 2011 to June 2014, had an intraoperative red blood cell transfusion requirement of 2 units or more, and required mediastinal reexploration for bleeding...
September 22, 2016: Annals of Thoracic Surgery
Kurt D Piggott, Grace George, Harun Fakioglu, Carlos Blanco, Sukumar Saguna Narasimhulu, Kamal Pourmoghadam, Hamish Munroe, William Decampli
AIM: To investigate and describe our current institutional management protocol for single-ventricle patients who must undergo a Ladd's procedure. METHODS: We retrospectively reviewed the charts of all patients from January 2005 to March 2014 who were diagnosed with heterotaxy syndrome and an associated intestinal rotation anomaly who carried a cardiac diagnosis of functional single ventricle and were status post stage I palliation. A total of 8 patients with a history of stage I single-ventricle palliation underwent Ladd's procedure during this time period...
August 8, 2016: World Journal of Clinical Pediatrics
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
A Schmutz, P Quaas, S Grundmann
A 32-year-old woman at 32 weeks gestation presented with cardiac arrest due to ventricular tachycardia following acute chest pain at home. After immediate defibrillation with return of spontaneous circulation (ROSC), an ST segment elevation myocardial infarction due to coronary artery dissection was confirmed. Two drug-eluting stents were implanted and she was placed on dual antiplatelet therapy (DAPT). The echocardiogram showed akinesis of the apex and anterior wall. The patients risk for stent thrombosis was considered high and therefore DAPT was continued until cesarean section at 35 weeks gestation...
September 2016: Der Anaesthesist
Hilary P Grocott, Emma Ambrose, Mike Moon
PURPOSE: Selective antegrade cerebral perfusion (SACP) involving cannulation of either the axillary or innominate artery is a commonly used technique for maintaining cerebral blood flow (CBF) during the use of hypothermic cardiac arrest (HCA) for operations on the aortic arch. Nevertheless, asymmetrical CBF with hypoperfusion of the left cerebral hemisphere is a common occurrence during SACP. The purpose of this report is to describe an adjunctive maneuver to improve left hemispheric CBF during SACP by applying extrinsic compression to the left carotid artery...
October 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Gregory J Latham, Faith J Ross, Michael J Eisses, Michael J Richards, Jeremy M Geiduschek, Denise C Joffe
BACKGROUND: Children with elastin arteriopathy (EA), the majority of whom have Williams-Beuren syndrome, are at high risk for sudden death. Case reports suggest that the risk of perioperative cardiac arrest and death is high, but none have reported the frequency or risk factors for morbidity and mortality in an entire cohort of children with EA undergoing anesthesia. AIM: The aim of this study was to present one institution's rate of morbidity and mortality in all children with EA undergoing anesthesia and to examine patient characteristics that pose the greatest risk...
September 2016: Paediatric Anaesthesia
Miroslav Marković, Ivan Tomić, Nikola Ilić, Marko Dragaš, Igor Končar, Zoran Bukumirić, Miloš Sladojević, Lazar Davidović
BACKGROUND: Mortality after open repair of ruptured abdominal aortic aneurysms (RAAAs) remains high. The purpose of this study is to present the results of open RAAA treatment observing 2 different 10-year periods in a single high-volume center and to consider the possibilities of result improvement in the future. METHODS: Retrospective analysis of 729 RAAA patients who were treated through 1991-2001 (229 patients, Group A) and 2002-2011 (500 patients, Group B) was performed...
October 2016: Annals of Vascular Surgery
Kimitoshi Sato, Katsutoshi Abe, Yasuharu Kosaka, Takeshi Ohuchi, Hirotsugu Okamoto, Junya Ako, Toshihiro Kumabe
Coronary vasospasm(CV)can cause severe arrhythmia and myocardial infarction(MI). Intraoperative CV is not limited to cardiac surgery alone. We report the case of a patient who experienced cardiac arrest after the induction of general anesthesia, but did not demonstrate any abnormalities on preoperative examination. The patient was a 60-year-old man with no history of ischemic heart disease, with NASCET 80% asymptomatic left internal carotid stenosis(ICS). We decided to perform carotid endarterectomy(CEA). Preoperative stress myocardial scintigraphy did not reveal decreased local uptake...
July 2016: No Shinkei Geka. Neurological Surgery
Mohammed Al Harbi, Derar Al Rifai, Hassan Al Habeeb, Freddie Wambi, Georges Geldhof, Vassilios Dimitriou
We report a case of intraoperative severe bradycardia that resulted in asystole and cardiac arrest shortly after (<2 min) intravenous granisetron 1mg for postoperative nausea and vomiting prophylaxis, that occurred in a female patient who underwent an elective total thyroidectomy. After two cycles of cardiopulmonary resuscitation and defibrillation, spontaneous circulation and sinus rhythm returned successfully. Postoperatively, the patient was diagnosed with a drug-induced long QT syndrome. At the time of the event, granisetron was the only medication administered...
February 2016: Middle East Journal of Anesthesiology
Z Kamalak, N Köşüş, Ü Isaoğlu, E Ç Tanriverdi, N Isaoğlu
Data consistently show that in experienced trained hands, laparoscopic tubal sterilization is safe and highly effective regardless of the approach or occlusive method. The known mortality rate is between four and eight deaths per 100,000 cases and the rate of intraoperative and postoperative major complications is less than 1%. The anesthetic complication rate for laparoscopy is between 0.016% and 0.75%. Carbon dioxide (CO2) pneumoperitoneum effects are still controversial. Here the authors present a case report of patient who suffered from intraoperative cardiac arrest during laparoscopic tubal ligation under general anesthesia...
2016: Clinical and Experimental Obstetrics & Gynecology
Tania Di Renna, Simone Crooks, Ashlee-Ann Pigford, Chantalle Clarkin, Amy B Fraser, Alexandra C Bunting, M Dylan Bould, Sylvain Boet
This study aimed to assess the perceived value of the Cognitive Aids for Role Definition (CARD) protocol for simulated intraoperative cardiac arrests. Sixteen interprofessional operating room teams completed three consecutive simulated intraoperative cardiac arrest scenarios: current standard, no CARD; CARD, no CARD teaching; and CARD, didactic teaching. Each team participated in a focus group interview immediately following the third scenario; data were transcribed verbatim and qualitatively analysed. After 6 months, participants formed eight new teams randomised to two groups (CARD or no CARD) and completed a retention intraoperative cardiac arrest simulation scenario...
September 2016: Journal of Interprofessional Care
Sang Kim, Samuel DeMaria, Edmond Cohen, George Silvay, Jeron Zerillo
We report the case of successful resuscitation after prolonged cardiac arrest during orthotopic liver transplantation. After reperfusion, the patient developed ventricular tachycardia, complicated by intracardiac clot formation and massive hemorrhage. Transesophageal echocardiography demonstrated stunned and nonfunctioning right and left ventricles, with developing intracardiac clots. Treatment with heparin, massive transfusion and prolonged cardiopulmonary resuscitation ensued for 51 minutes. Serial arterial blood gases demonstrated adequate oxygenation and ventilation during cardiopulmonary resuscitation...
September 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Berker Özkan, Alper Toker
OBJECTIVES: Several series have demonstrated that video-assisted thoracoscopic (VAT) thymectomy is feasible and safe. However, VAT thymectomy is an operation that could invite catastrophes, such as major vascular injuries. We aimed to analyse the events and define the management and outcomes of these serious complications. METHODS: All patients who underwent VAT thymectomy/thymothymectomy recorded in our clinical database were evaluated. A catastrophic complication was defined as any situation that resulted in an additional unplanned major surgical procedure other than the planned closed thymic surgery...
September 2016: Interactive Cardiovascular and Thoracic Surgery
Bradford B Smith, Andrew S Nickels, Hans P Sviggum
A 75-year-old female presented for left total hip reimplantation and suffered pulseless electrical activity arrest upon lateral positioning and administering vancomycin. Resuscitation was achieved according to Advanced Cardiac Life Support protocol. Post-event echocardiography showed hypertrophic cardiomyopathy with asymmetrical septal thickening, an under-filled left ventricle, dynamic left ventricular outflow obstruction, and severe mitral regurgitation related to systolic anterior motion of the mitral valve...
June 2016: Journal of Clinical Anesthesia
Robert Zant, Christian Stocker, Luregn Jan Schlapbach, Sara Mayfield, Tom Karl, Andreas Schibler
OBJECTIVE: Procalcitonin has emerged as a promising infection marker, but previous reports from small-sized studies suggest nonspecific elevation of procalcitonin after pediatric heart surgery. As procalcitonin is increasingly used as a marker for infection in the PICU, the aim of this study was to identify factors associated with postoperative procalcitonin elevation and to investigate the role of procalcitonin as an early marker of outcome after cardiac surgery. DESIGN: Prospective observational study...
July 2016: Pediatric Critical Care Medicine
Andrew A Fanous, Robert C Tick, Eugene Y Gu, Robert A Fenstermaker
BACKGROUND: Mannitol is the most commonly used intraoperative hypertonic solution in patients undergoing craniotomy. However, its use has been reported to be associated with hyperkalemia, which can occasionally be life threatening. CASE DESCRIPTION AND LITERATURE REVIEW: In this report, we discuss the case of a patient who had intraoperative cardiac arrest secondary to mannitol-induced hyperkalemia during a craniotomy for tumor resection. In addition, we provide a comprehensive review of the literature concerning similar cases previously reported, as well as a discussion of the pathophysiology of mannitol-induced hyperkalemia...
July 2016: World Neurosurgery
Akira Fujii, Junichi Sakata
A 69-year-old man underwent mitral valve replacement for suspected infective endocarditis and coronary artery bypass grafting with left internal thoracic artery and saphenous vein graft. During the period of coming off cardiopulmonary bypass, enlargement of the ascending aorta and bleeding from the suture line were observed. Intraoperative transesophageal echocardiography and direct epi-aortic echography revealed acute aortic dissection extending from the ascending aorta to the descending aorta. Replacement of the ascending aorta was performed under deep hypothermic circulatory arrest and continuous retrograde cerebral perfusion through the superior vena cava...
February 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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