Read by QxMD icon Read

Cardiothoracic anesthesia

Joanne F Irons, Lachlan F Miles, Kaustuv R Joshi, Andrew A Klein, Marco Scarci, Piergiorgio Solli, Guillermo Martinez
OBJECTIVE: General anesthesia with endobronchial intubation and one-lung positive-pressure ventilation always has been considered mandatory for thoracic surgery. Recently, there has been interest in nonintubated techniques for video-assisted thoracoscopic surgery (VATS) in awake and sedated patients. The authors' center developed a nonintubated technique with spontaneous ventilation with the patient under general anesthesia using a supraglottic airway device. The authors believe that this was the first study to compare a nonintubated general anesthetic technique with an intubated general anesthetic technique for VATS...
July 7, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Christoph Kampmann, Tariq Abu-Tair, Seyfullah Gökce, Christina Lampe, Jörg Reinke, Eugen Mengel, Julia B Hennermann, Christiane M Wiethoff
BACKGROUND: Mucopolysaccharidosis (MPS) IVA is a rare lysosomal storage disorder with multiple skeletal and non-skeletal abnormalities requiring multiple surgical interventions. It is well known that patients with MPS IVA suffer from tachycardia, but cardiac and hemodynamic alterations have not been reported to date. We investigated the cardiovascular and hemodynamic alterations in patients with MPS IVA and developed a possible patho-mechanism for cardiovascular deterioration during anesthesia...
2016: PloS One
Martin J L Bucx, Piet Krijtenburg, Matthijs Kox
STUDY OBJECTIVE: Although anxiolytic-sedative agents are used preoperatively since the advent of anesthesia, many aspects of this treatment, including the intended effects among which anxiolysis, effectiveness, and optimal agents, remain unclear. The objective of this study was to provide insight into the preoperative use of anxiolytic-sedative agents in the Netherlands and to relate the administration of these agents to the anxiolytic-sedative state of patients. DESIGN: Questionnaire study...
September 2016: Journal of Clinical Anesthesia
Khoa N Nguyen, Heather S Byrd, Jonathan M Tan
AIM: Caudal epidural anesthesia has been shown to reduce stress response and shorten the time to extubation in children after cardiac surgery. Combined with general anesthesia, regional anesthesia has been proven to be safe and efficacious in the pediatric population. It is not known, however, whether the use of caudal anesthesia actually reduces postoperative pain scores and decreases postoperative opioid use. METHODS: We retrospectively analyzed the charts of 199 children who underwent repair for atrial septal defect (ASD), ventricular septal defect (VSD), and Tetralogy of Fallot (TOF) at a major academic children's hospital between 2010 and 2013...
November 2016: Paediatric Anaesthesia
Javier Lasala, Miguel Alejandro Patino, Gabriel Mena, Shital Vachhani, Teresa Moon, Thao Bui, January Tsai
In the United States during the year 2015, approximately 61,560 patients are expected to be diagnosed with kidney cancer and 14,080 to die from the disease. We present the case of a patient with renal cell carcinoma who suffered severe perioperative bleeding and coagulopathy after emergency sternotomy. We also engage in relevant aspects of perioperative anesthesia care including the considerations and management of coagulopathy, liver failure and renal failure in the oncologic patient. The case is a 49-year-old man with vena cava tumor thrombus who underwent radiologic tumor embolization, left radical nephrectomy, and inferior vena cava (IVC) thrombectomy...
2016: Medwave
Travis Schisler, Jose M Marquez, Ibtesam Hilmi, Kathirvel Subramaniam
Anesthesia for lung transplantation remains one of the highest risk surgeries in the domain of the cardiothoracic anesthesiologist. End-stage lung disease, pulmonary hypertension, and right heart dysfunction as well as other comorbid disease factors predispose the patient to cardiovascular, respiratory and metabolic dysfunction during general anesthesia. Perhaps the highest risk phase of surgery in the patient with severe pulmonary hypertension is during the induction of anesthesia when the removal of intrinsic sympathetic tone and onset of positive pressure ventilation can decompensate a severely compromised cardiovascular system...
June 1, 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Joyce H Y Yeung, Simon Gates, Babu V Naidu, Matthew J A Wilson, Fang Gao Smith
BACKGROUND: Operations on structures in the chest (usually the lungs) involve cutting between the ribs (thoracotomy). Severe post-thoracotomy pain can result from pleural (lung lining) and muscular damage, costovertebral joint (ribcage) disruption and intercostal nerve (nerves that run along the ribs) damage during surgery. Poor pain relief after surgery can impede recovery and increase the risks of developing complications such as lung collapse, chest infections and blood clots due to ineffective breathing and clearing of secretions...
2016: Cochrane Database of Systematic Reviews
Harish Ramakrishna, Jacob T Gutsche, Adam S Evans, Prakash A Patel, Menachem Weiner, Steven T Morozowich, Emily K Gordon, Hynek Riha, Ronak Shah, Kamrouz Ghadimi, Elizabeth Zhou, Rohesh Fernadno, Jeongae Yoon, Mathew Wakim, Lance Atchley, Stuart J Weiss, Erica Stein, George Silvay, John G T Augoustides
No abstract text is available yet for this article.
January 2016: Journal of Cardiothoracic and Vascular Anesthesia
Lily D Zainudin, Muhammad I Abdul Hafidz, Ahmad F Zakaria, Mohd A Mohd Zim, Ahmad I Ismail, Mohammed F Abdul Rani
We report a case of a 34-year-old lady with past history of asthma and pulmonary tuberculosis, who presented 5 weeks pregnant with acute dyspnea. Her chest X-ray showed left-sided complete lung collapse and concomitant right-sided pneumothorax. The pneumothorax was initially managed conservatively with a chest tube but due to its persistence despite suction, was subsequently changed to a Pneumostat(TM), with which she was later discharged. She had a normal echocardiography (ejection fraction [EF] 67%) at 5 weeks of gestation but developed pulmonary hypertension (EF 55%, pulmonary arterial pressure 40...
March 2016: Respirology Case Reports
Dirk J Varelmann, J Daniel Muehlschlegel
Large multicenter, randomized controlled trials published in reputable journals had a large impact on the world of cardiothoracic anesthesia in 2015. We as cardiac anesthesiologists pride ourselves as being experts in applied physiology, physics, ultrasonography, and pharmacology/pharmacotherapy. The selected studies added to our knowledge in the fields of echocardiography, pharmacology, molecular biology, and genetics. Outcome studies shine a light on important topics that are relevant to all cardiac anesthesiologists: does surgical atrial fibrillation ablation during mitral valve surgery reduce the recurrence of atrial fibrillation at 1 year after surgery? Does remote ischemic preconditioning live up to its promise to reduce postoperative major cardiac and cerebral events? Although we still do not have the answer to all the questions, the year 2015 has been a great step toward the goal of understanding molecular mechanisms of ischemic myocardial injury and toward providing evidence-based medicine for improving patient outcome...
March 2016: Seminars in Cardiothoracic and Vascular Anesthesia
Macaulay Amechi Chukwukadibia Onuigbo, Nneoma Agbasi
Acute kidney injury (AKI) is a relatively common complication of cardiothoracic surgery and has both short- and long-term survival implications, even when AKI does not progress to severe renal failure. Given that currently, there are no active effective treatments for AKI, other than renal replacement therapy when indicated, the focus of clinicians ought to be on prevention and risk factor management. In the AKI-surgery literature, there exists this general consensus that intraoperative hypotension (IH) following hypotensive anesthesia (HA) or controlled hypotension (CH) in the operating room has no significant short-term and long-term impacts on renal function...
2015: Journal of Renal Injury Prevention
R Clive Landis
The "systemic inflammatory response" has never been defined from a cardiothoracic surgery perspective, but borrowed its definition from the critical care field at a landmark 1992 definition conference on sepsis. It is unclear why the diagnostic criteria for the Systemic Inflammatory Response Syndrome (SIRS) were adopted in isolation, ignoring other potentially more useful definitions for Severe Septic Shock or Secondary Multiple Organ Dysfunction Syndrome. The 1992 SIRS definition for sepsis has since been updated at a conference in 2001 advocating PIRO (Predisposition, Infection, host Response, Organ dysfunction) as a hypothetical model to better link sepsis with clinical outcome...
March 2015: Journal of Extra-corporeal Technology
Christopher A Thunberg, Harish Ramakrishna
Intimo-intimal intussusception is a very rare and unusual complication of type A dissections, typically noted on TEE exam. It has been reported in a few cases in the cardiothoracic surgical and radiology literature, and even more rarely in the cardiac anesthesia/TEE literature. This uncommon variation occurs in severe, acute, type A dissections when the ascending aortic intima circumferentially strips and detaches from the media and forms a tube-like structure which may either prolapse antegrade into the ascending aortic lumen or retrograde into the left ventricular (LV) outflow tract and LV cavity...
April 2015: Annals of Cardiac Anaesthesia
Martin J L Bucx, Jouke J J Landman, Hein A W van Onzenoort, Matthijs Kox, Gert-Jan Scheffer
STUDY OBJECTIVE: The study objective is to investigate the effects of a simple price list sticker placed on vaporizers on anesthetic use and costs. The price list only showed the cost per hour of the annually most expensive drugs, which had a low-cost alternative. DESIGN: The design is a prospective database study with historical controls. SETTING: The setting is at operating rooms. PATIENTS: All patients are undergoing a surgical procedure under anesthesia in both study periods, except cardiothoracic and day care patients...
June 2015: Journal of Clinical Anesthesia
José L Díaz-Gómez, Silvia Perez-Protto, Jennifer Hargrave, Angela Builes, Michelle Capdeville, Emir Festic, Sajid Shahul
OBJECTIVE: To investigate the impact of a sequence of educational interventions in a one-day course on focused transthoracic echocardiography (FOTE) by anesthesia and critical care practitioners. DESIGN: A prospective analysis of the educational data. SETTING: Educational setting in two academic medical centers and a medical meeting workshop organized by one of these institutions. PARTICIPANTS: Fifty-six anesthesia and critical care providers, divided into three groups, participated separately in a FOTE training course...
2015: Journal of Cardiothoracic and Vascular Anesthesia
Jacob T Gutsche, Prakash A Patel, Frederick C Cobey, Harish Ramakrishna, Emily K Gordon, Hynek Riha, Aris Sophocles, Kamrouz Ghadimi, Michael Fabbro, Lourdes Al-Ghofaily, Sy-Yeu S Chern, Sophia Cisler, Gurmukh S Sahota, Elizabeth Valentine, Stuart J Weiss, Michael Andritsos, George Silvay, John G T Augoustides
No abstract text is available yet for this article.
February 2015: Journal of Cardiothoracic and Vascular Anesthesia
Rebecca Marcantuono, Jacob Gutsche, Maureen Burke-Julien, Saif Anwaruddin, John G Augoustides, David Jones, Lisa Mangino-Blanchard, Nicole Hoke, Stephanie Houseman, Robert Li, Prakash Patel, Robert Stetson, Elizabeth Walsh, Wilson Y Szeto, Howard C Herrmann
BACKGROUND: The care pathway for patients undergoing transcatheter aortic valve replacement (TAVR), particularly in the US, was initially based on open surgical techniques and often includes general anesthesia, transesophageal echocardiographic monitoring, and cardiothoracic intensive care unit (ICU) stays. Whether a subgroup of patients could benefit from early extubation, fewer days in the ICU, and early ambulation in terms of both cost and effectiveness is unknown. METHODS AND RESULTS: A fast track (FT) protocol was initiated at two institutions in our health system with specific inclusion criteria...
March 2015: Catheterization and Cardiovascular Interventions
Brandi Bottiger, Sharon McCartney, Igor Akushevich, Alina Nicoara, Mamata Yanamadala, Madhav Swaminathan
PURPOSE: Timely communication of intraoperative transesophageal echocardiography (TEE) findings to the postoperative care team is critical to optimizing patient care. We compared the use of a personal computer (PC) system with the use of a mobile tablet device (MTD) system for point-of-care TEE data entry and hypothesized that the MTD-based system would reduce the time to preliminary TEE reporting and decrease the incidence of delinquent reporting by 50%. METHODS: In this historical cohort study, we reviewed 508 perioperative TEE reports entered by cardiothoracic anesthesia fellows...
January 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Harish Ramakrishna
Patients with pulmonary hypertension continue to present for both cardiac and non-cardiac surgery in greater numbers worldwide, and are usually managed by cardiothoracic anesthesiologists. These specialists have traditionally used intravenous therapy in the operating room to manipulate hemodynamics (cardiac output systemic and pulmonary vascular resistance), to effectively manage these high risk patients. General anesthesia involves the administration of both intravenous and inhaled drug therapy to achieve the desired goals, i...
2014: Recent Patents on Cardiovascular Drug Discovery
Daniel Ocazionez, Demetrius L Dicks, Jennifer L Favinger, Girish S Shroff, Sidhdharth Damani, Gregory A Kicska, Gautham P Reddy
Patient safety is a priority for patients undergoing magnetic resonance imaging (MRI). This article reviews MRI safety issues related to devices, pharmacologic stress agents, contrast agents, anesthesia, and external equipment, focusing on cardiothoracic MRI.
September 2014: Journal of Thoracic Imaging
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"