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Adult Cardiac Anesthesia

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https://www.readbyqxmd.com/read/28183558/frequency-of-inadequate-neuromuscular-blockade-during-general-anesthesia
#1
Timur Dubovoy, Amy M Shanks, Scott Devine, Sachin Kheterpal
STUDY OBJECTIVE: We used electronic health record data to define frequency of inadequate intraoperative neuromuscular blockade (NMB). DESIGN: Retrospective observational study using electronic health record data. SETTING: Operating room in a tertiary care academic hospital. PATIENTS: A total of 129,209 adult patients with American Society of Anesthesiologists physical status 1 to 5 undergoing general anesthesia in an outpatient or inpatient setting who received nondepolarizing NMB...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28169116/utilization-and-effectiveness-of-desmopressin-acetate-after-cardiac-surgery-supplemented-with-point-of-care-hemostatic-testing-a-propensity-score-matched-analysis
#2
David Orlov, Stuart A McCluskey, Jeannie Callum, Vivek Rao, Jacobo Moreno, Keyvan Karkouti
OBJECTIVES: To explore the utilization pattern and hemostatic effectiveness of desmopressin acetate (DDAVP) supplemented with point-of-care (POC) hemostatic testing in contemporary cardiac surgery. DESIGN: Retrospective, observational study. SETTING: Single quaternary care university hospital. PARTICIPANTS: The study comprised 2,468 consecutive patients undergoing cardiac surgery-1,237 before and 1,231 after the introduction of POC testing...
November 17, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28091794/the-impact-of-liver-disorders-on-perioperative-management-of-reoperative-cardiac-surgery-a-retrospective-study-in-adult-congenital-heart-disease-patients
#3
Koko Adachi, Hiroaki Toyama, Yu Kaiho, Osamu Adachi, Hiroto Hudeta, Masanori Yamauchi
PURPOSE: We evaluated the preoperative prevalence of risk factors for liver disorders and the relationship between the liver disorders and perioperative outcomes in adult congenital heart disease (ACHD) patients. METHODS: This retrospective study included 32 ACHD patients who underwent reoperative cardiac surgery. RESULTS: Preoperatively, 38% of the study patients had risk factors, including congestive liver (CL) due to right heart failure (31%), chronic hepatitis C (HC) (22%), and both CL and HC (16%)...
January 16, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28055991/role-of-mir-24-furin-and-transforming-growth-factor-%C3%AE-1-signal-pathway-in-fibrosis-after-cardiac-infarction
#4
Zhufeng Chen, Sumei Lu, Miao Xu, Peng Liu, Rui Ren, Wanshan Ma
BACKGROUND Cardiac fibrosis after primary infarction is a type of pathological phenomena as shown by increased collagen in myocardial cells. Transforming growth factor (TGF)-β1 is a critical factor participating in myocardial fibrosis. A previous study has shown the inhibitory role on TGF-β1 by microRNA-24 (miR-24) via targeting Furin. This study thus investigated the role of miR-24 and Furin/TGF-β1 in rat myocardial fibrosis. MATERIAL AND METHODS A total of 40 adult SD rats (both males and females) were prepared for myocardial infarction model by ligating the descending branch of left coronary artery after anesthesia...
January 5, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28006942/propofol-induced-mitochondrial-and-contractile-dysfunction-of-the-rat-ventricular-myocardium
#5
M Grundmanová, D Jarkovská, A Süß, Z Tůma, M Marková, Z Grundman, A El-Kadi, M Čedíková, M Štengl, J Kuncová
Propofol is a short-acting hypnotic agent used in human medicine for sedation and general anesthesia. Its administration can be associated with serious cardiovascular side-effects that include decrease in arterial blood pressure and cardiac output. The aim of the present study was to evaluate propofol effects on mitochondrial respiration, myocardial contractility and electrophysiology in the same samples isolated from the heart ventricles of adult rats. Mitochondrial oxygen consumption was measured in permeabilized samples dissected from free walls of both ventricles using high-resolution respirometry...
December 22, 2016: Physiological Research
https://www.readbyqxmd.com/read/27901396/effects-of-dobutamine-hydrochloride-on-cardiovascular-function-in-horses-anesthetized-with-isoflurane-with-or-without-acepromazine-maleate-premedication
#6
RANDOMIZED CONTROLLED TRIAL
Mara F Schier, Anthea L Raisis, Cristy J Secombe, Giselle Hosgood, Gabrielle C Musk, Guy D Lester
OBJECTIVE To determine the effects of acepromazine maleate premedication on cardiovascular function before and after infusion of dobutamine hydrochloride for 30 minutes in isoflurane-anesthetized horses. ANIMALS 6 healthy adult horses. PROCEDURES Each horse was anesthetized once following premedication with acepromazine (0.02 mg/kg, IV) administered 30 minutes prior to anesthetic induction (ACP+ treatment) and once without premedication (ACP- treatment). Anesthesia was induced with IV administration of xylazine hydrochloride (0...
December 2016: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/27858963/resting-state-functional-connectivity-and-cognition-after-major-cardiac-surgery-in-older-adults-without-preoperative-cognitive-impairment-preliminary-findings
#7
Jeffrey N Browndyke, Miles Berger, Todd B Harshbarger, Patrick J Smith, William White, Tiffany L Bisanar, John H Alexander, Jeffrey G Gaca, Kathleen Welsh-Bohmer, Mark F Newman, Joseph P Mathew
OBJECTIVES: To look for changes in intrinsic functional brain connectivity associated with postoperative changes in cognition, a common complication in seniors undergoing major surgery, using resting-state functional magnetic resonance imaging. DESIGN: Objective cognitive testing and functional brain imaging were prospectively performed at preoperative baseline and 6 weeks after surgery and at the same time intervals in nonsurgical controls. SETTING: Academic medical center...
January 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27793208/myocardial-function-at-the-early-phase-of-traumatic-brain-injury-a-prospective-controlled-study
#8
Adrien Cuisinier, Claire Maufrais, Jean-François Payen, Stephane Nottin, Guillaume Walther, Pierre Bouzat
BACKGROUND: The concept of brain-heart interaction has been described in several brain injuries. Traumatic brain injury (TBI) may also lead to cardiac dysfunction but evidences are mainly based upon experimental and clinical retrospective studies. METHODS: We conducted a prospective case-control study in a level I trauma center. Twenty consecutive adult patients with severe TBI were matched according to age and gender with 20 control patients. The control group included adult patients undergoing a general anesthesia for a peripheral trauma surgery...
October 28, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27737403/dexmedetomidine-as-an-anesthetic-adjuvant-in-cardiac-surgery-a-cohort-study
#9
Paulo Gabriel Melo Brandão, Francisco Ricardo Lobo, Serginando Laudenir Ramin, Yasser Sakr, Mauricio Nassau Machado, Suzana Margareth Lobo
Objective: α-2-agonists cause sympathetic inhibition combined with parasympathetic activation and have other properties that could be beneficial during cardiac anesthesia. We evaluated the effects of dexmedetomidine as an anesthetic adjuvant compared to a control group during cardiac surgery. Methods: We performed a retrospective analysis of prospectively collected data from all adult patients (> 18 years old) undergoing cardiac surgery. Patients were divided into two groups, regarding the use of dexmedetomidine as an adjuvant intraoperatively (DEX group) and a control group who did not receive α-2-agonist (CON group)...
May 2016: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27725150/anesthesia-specific-differences-in-a-cardio-pulmonary-resuscitation-rat-model-halothane-versus-sevoflurane
#10
Torben Esser, Gerburg Keilhoff, Uwe Ebmeyer
OBJECTIVE: Our asphyxia cardiac arrest (ACA) rat model is well established. The original model was designed in the 1990(th) using halothane and nitrous oxide for pre-insult anesthesia. Because of its hepato-toxicity and its potential to induce severe liver failures, halothane is no longer used in clinical anesthesia for several years. In order to minimize the health risk for our laboratory staff as well as to keep the experimental settings of our model on a clinically oriented basis we decided to replace halothane by sevoflurane...
October 7, 2016: Brain Research
https://www.readbyqxmd.com/read/27703286/a-comparison-between-the-hemodynamic-effects-of-cisatracurium-and-atracurium-in-patient-with-low-function-of-left-ventricle-who-are-candidate-for-open-heart-surgery
#11
Masoud Ghorbanlo, Mahmoud Reza Mohaghegh, Forozan Yazdanian, Mehrdad Mesbah, Ziya Totonchi
BACKGROUND: The need for muscle relaxants in general anesthesia in different surgeries including cardiac surgeries, and the type of relaxant to be used considering its different hemodynamic effects on patients with heart disease can be of considerable importance. In this study, the hemodynamic effects of two muscle relaxants, Cisatracurium and Atracurium in patients whit low function of left ventricle who are candidate for open heart surgery have been considered. METHOD: This study has been designed as a randomized prospective double-blind clinical trial...
July 27, 2016: Medical Archives
https://www.readbyqxmd.com/read/27687440/sevoflurane-induced-arrhythmia-in-healthy-adult
#12
João Santos, Vera Santos, Paula Gago, Nuno Cortez-Dias
Inhalatory anesthetic agents are frequently used for anesthesia maintenance. Sevoflurane is considered one of the safest regarding its cardiac effects. We report a case of a cardiac arrhythmia induced by sevoflurane in an otherwise healthy adult and discuss sevoflurane's cardiac effects.
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27665951/inhibition-of-inducible-nitric-oxide-synthase-inos-by-simvastatin-attenuates-cardiac-hypertrophy-in-rats
#13
Aly Mohamed Ahmed
The left ventricular hypertrophy (LVH) occurs in response to the hemodynamic overload in some physiological and pathological conditions. This study was designed to investigate the possible cardioprotective effect of simvastatin (SIM) treatment against isoproterenol (ISO)-induced LVH and the probable underlying mechanism in adult male Wistar rats. Animals were allocated into 4 groups. Rats of control group received normal saline orally for 30 days and intraperitoneally for the last 7 days. Rats of SIM group received SIM orally (10 mg/kg/day in saline) for 30 days...
September 26, 2016: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/27648689/hyperoxia-induces-inflammation-and-cytotoxicity-in-human-adult-cardiac-myocytes
#14
Christina Hafner, Jing Wu, Akos Tiboldi, Moritz Hess, Goran Mitulovic, Christoph Kaun, Konstantin Alexander Krychtiuk, Johann Wojta, Roman Ullrich, Eva Verena Tretter, Klaus Markstaller, Klaus Ulrich Klein
Supplemental oxygen (O2) is used as adjunct therapy in anesthesia, emergency and intensive care medicine. We hypothesized that excessive O2 levels (hyperoxia) can directly injure human adult cardiac myocytes (HACMs). HACMs obtained from the explanted hearts of transplantation patients were exposed to constant hyperoxia (95% O2), intermittent hyperoxia (alternating 10 min exposures to 5% and 95% O2), constant normoxia (21% O2), or constant mild hypoxia (5% O2) using a bioreactor. Changes in cell morphology, viability as assessed by lactate dehydrogenase (LDH) release and trypan blue (TB) staining, and secretion of vascular endothelial growth factor (VEGF), macrophage migration inhibitory factor (MIF), and various pro-inflammatory cytokines (interleukin, IL; chemokine C-X-C motif ligand, CXC; granulocyte-colony stimulating factor, G-CSF; intercellular adhesion molecule, ICAM; chemokine C-C motif ligand, CCL) were compared among treatment groups at baseline (0 h) and after 8 h, 24 h, and 72 h of treatment...
September 19, 2016: Shock
https://www.readbyqxmd.com/read/27635468/rapid-induction-of-therapeutic-hypothermia-using-transnasal-high-flow-dry-air
#15
Raghuram Chava, Menekhem Zviman, Madhavan Srinivas Raghavan, Henry Halperin, Farhan Maqbool, Romergryko Geocadin, Alfredo Quinones-Hinojosa, Aravindan Kolandaivelu, Benjamin A Rosen, Harikrishna Tandri
Early induction of therapeutic hypothermia (TH) is recommended in out-of-hospital cardiac arrest (CA); however, currently no reliable methods exist to initiate cooling. We investigated the effect of high flow transnasal dry air on brain and body temperatures in adult porcine animals. Adult porcine animals (n = 23) under general anesthesia were subject to high flow of transnasal dry air. Mouth was kept open to create a unidirectional airflow, in through the nostrils and out through the mouth. Brain, internal jugular, and aortic temperatures were recorded...
September 16, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27607474/baseline-pulse-pressure-acute-kidney-injury-and-mortality-after-noncardiac-surgery
#16
Adriana D Oprea, Frederick W Lombard, Wen-Wei Liu, William D White, Jörn A Karhausen, Yi-Ju Li, Timothy E Miller, Solomon Aronson, Tong J Gan, Manuel L Fontes, Miklos D Kertai
BACKGROUND: Increased pulse pressure (PP) is an important independent predictor of cardiovascular outcome and acute kidney injury (AKI) after cardiac surgery. The objective of this study was to determine whether elevated baseline PP is associated with postoperative AKI and 30-day mortality after noncardiac surgery. METHODS: We evaluated 9125 adult patients who underwent noncardiac surgery at Duke University Medical Center between January 2006 and December 2009. Baseline arterial blood pressure was defined as the mean of the first 5 measurements recorded by the automated record keeping system before inducing anesthesia...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27590462/vapocoolant-spray-versus-lidocaine-infiltration-for-radial-artery-cannulation-a-prospective-randomized-controlled-clinical-trial
#17
Dirk Rüsch, Tilo Koch, Florian Seel, Leopold Eberhart
OBJECTIVES: Local infiltration with lidocaine is a frequently used measure to prevent pain during arterial cannulation. Its administration is associated with pain. Vapocoolants like ethyl chloride or alkanes also affect rapid-onset anesthesia. However, their administration causes less discomfort compared with administration of lidocaine. The effectiveness of vapocoolants in mitigating discomfort associated with arterial cannulation never has been studied. The authors therefore compared vapocoolant with lidocaine for reducing discomfort caused by arterial cannulation...
June 8, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27559005/pediatric-patient-blood-management-programs-not-just-transfusing-little-adults
#18
REVIEW
Ruchika Goel, Melissa M Cushing, Aaron A R Tobian
Red blood cell transfusions are a common life-saving intervention for neonates and children with anemia, but transfusion decisions, indications, and doses in neonates and children are different from those of adults. Patient blood management (PBM) programs are designed to assist clinicians with appropriately transfusing patients. Although PBM programs are well recognized and appreciated in the adult setting, they are quite far from standard of care in the pediatric patient population. Adult PBM standards cannot be uniformly applied to children, and there currently is significant variation in transfusion practices...
October 2016: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/27554234/continuous-monitoring-of-lactate-using-intravascular-microdialysis-in-high-risk-cardiac-surgery-a-prospective-observational-study
#19
Pavel I Lenkin, Alexey A Smetkin, Ayyaz Hussain, Andrey I Lenkin, Konstantin V Paromov, Alexey A Ushakov, Maria M Krygina, Vsevolod V Kuzkov, Mikhail Y Kirov
OBJECTIVE: To assess the accuracy and applicability of a novel system, not requiring calibration, for continuous lactate monitoring with intravascular microdialysis in high-risk cardiac surgery. DESIGN: Single-center prospective observational study. SETTING: City Hospital #1 of Arkhangelsk, Russian Federation. PARTICIPANTS: Twenty-one adult patients undergoing elective complex repair or replacement of two or more valves or combined valve and coronary artery cardiac surgery...
April 13, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27546828/bedside-assessment-of-the-microvascular-venous-compartment-in-cardiac-surgery-patients-with-valvular-diseases-undergoing-cardiopulmonary-bypass
#20
Roberto Alberto De Blasi, Stefano Romagnoli, Monica Rocco
OBJECTIVE: Blood volume reserve for venous return and the effects of cardiopulmonary bypass (CPB) on microvascular bed partitioning and blood flow were examined in patients with valvular diseases. DESIGN: Prospective, consecutive, case-control study. SETTING: Single university hospital. PARTICIPANTS: The study comprised 20 adult cardiac surgery patients and 20 healthy volunteers. INTERVENTIONS: Cardiovascular and microvascular variables were collected soon after the induction of anesthesia, after commencement of CPB, 20 minutes after separation from CPB, and in the intensive care unit...
June 3, 2016: Journal of Cardiothoracic and Vascular Anesthesia
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