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Cardiac anesthesia

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https://www.readbyqxmd.com/read/29780726/operative-techniques-for-improving-surgical-exposure-in-basic-cardiac-surgery
#1
Dawn S Hui, Jason M Lizalek, Vikram S Chawa, Richard Lee
Operative exposure is key to ensuring surgical efficiency and patient safety in cardiac surgery. As the population ages and the prevalence of obesity increases, cardiac surgeons will be challenged to consider obese patient physiology and body habitus, surgical exposure and sternotomy closure techniques, and postoperative medical management to ensure optimal outcomes. In this article, we describe techniques to improve operative exposure in both obese and non-obese patients undergoing basic cardiac surgery and highlight the roles of surgical team members to ensure patient safety and provide optimal anesthetic management...
2018: Journal of visualized surgery
https://www.readbyqxmd.com/read/29776668/-fatal-cardiac-tamponade-that-developed-in-the-post-anesthesia-care-unit-a-rare-complication-after-lung-lobectomy
#2
Hyung Mook Lee, Young Jae Jeon, Hye Won Chung, Hyo Min Yun, Mi Hyun Kim
BACKGROUND AND OBJECTIVES: Cardiac tamponade is potentially fatal medical condition, which rarely occurs as a complication of lung lobectomy. We present the first case of cardiac tamponade to develop in a Post-Anesthesia Care Unit following a lung lobectomy. CASE REPORT: A 54-year-old man with pulmonary squamous cell carcinoma underwent an apparently uncomplicated lung lobectomy. His hemodynamics was unremarkable throughout the surgery and initially in the Post-Anesthesia Care Unit...
May 15, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29772591/-monitoring-and-modern-hemodynamic-concepts-in-cardiac-anesthesia
#3
Matthias Heringlake, Christian Schmidt, Sebastian Brandt
Patients undergoing cardiac surgery are growing older, present with more comorbidities, and are frequently scheduled for more complex and prolonged surgical procedures. Routine application of neurological as well as extended hemodynamic monitoring combined with goal-directed perioperative hemodynamic optimization, targeting optimization of systemic and cerebral oxygen balance, show promise to reduce postoperative complications and to improve mortality in this high risk population. Expert recommendations suggest to avoid synthetic colloids for fluid optimization...
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29771722/detection-of-deteriorating-patients-on-surgical-wards-outside-the-icu-by-an-automated-mews-based-early-warning-system-with-paging-functionality
#4
Axel R Heller, Sören T Mees, Benjamin Lauterwald, Christian Reeps, Thea Koch, Jürgen Weitz
BACKGROUND: The establishment of early warning systems in hospitals was strongly recommended in recent guidelines to detect deteriorating patients early and direct them to adequate care. Upon reaching predefined trigger criteria, Medical Emergency Teams (MET) should be notified and directed to these patients. The present study analyses the effect of introducing an automated multiparameter early warning score (MEWS)-based early warning system with paging functionality on 2 wards hosting patients recovering from highly complex surgical interventions...
May 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29770180/factors-impacting-arthroscopic-rotator-cuff-repair-operational-throughput-time-at-an-ambulatory-care-center
#5
Emily J Curry, Catherine Logan, Kaytelin Suslavich, Kaitlyn Whitlock, Eric Berkson, Elizabeth Matzkin
Identifying patient factors influencing operational throughput time is becoming more imperative due to an increasing focus on value and cost savings in healthcare. The primary objective of this study was to determine patient factors influencing throughput time for primary rotator cuff repairs. Demographic information, medical history and operative reports of 318 patients from one ambulatory care center were retrospectively reviewed. Operating room set up, incision to closure and recovery room time were collected from anesthesia records...
March 29, 2018: Orthopedic Reviews
https://www.readbyqxmd.com/read/29768341/the-plethysmographic-variability-index-does-not-predict-fluid-responsiveness-estimated-by-esophageal-doppler-during-kidney-transplantation-a-controlled-study
#6
Morgan Le Guen, Arnaud Follin, Etienne Gayat, Marc Fischler
Research is ongoing to find a noninvasive method of monitoring, which can predict fluid responsiveness in patients undergoing kidney transplantation.To compare the responses to fluid challenges with the Pleth Variability Index, a noninvasive dynamic index derived from plethysmographic variability (Radical 7 pulse oximeter; Masimo Corporation, Irvine, CA), and the esophageal Doppler, the criterion standard.Observational study.University hospital; study from May 2011 and May 2012.Forty-eight patients with end-renal function were included and 44 analyzed...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29764373/a-subclinical-high-tricuspid-regurgitation-pressure-gradient-independent-of-the-mean-pulmonary-artery-pressure-is-a-risk-factor-for-the-survival-after-living-donor-liver-transplantation
#7
Yosuke Saragai, Akinobu Takaki, Yuzo Umeda, Takashi Matsusaki, Tetsuya Yasunaka, Atsushi Oyama, Ryuji Kaku, Kazufumi Nakamura, Ryuichi Yoshida, Daisuke Nobuoka, Takashi Kuise, Kosei Takagi, Takuya Adachi, Nozomu Wada, Yasuto Takeuchi, Kazuko Koike, Fusao Ikeda, Hideki Onishi, Hidenori Shiraha, Shinichiro Nakamura, Hiroshi Morimatsu, Hiroshi Ito, Toshiyoshi Fujiwara, Takahito Yagi, Hiroyuki Okada
BACKGROUND: Portopulmonary hypertension (POPH) is characterized by pulmonary vasoconstriction, while hepatopulmonary syndrome (HPS) is characterized by vasodilation. Definite POPH is a risk factor for the survival after orthotopic liver transplantation (OLT), as the congestive pressure affects the grafted liver, while subclinical pulmonary hypertension (PH) has been acknowledged as a non-risk factor for deceased donor OLT. Given that PH measurement requires cardiac catheterization, the tricuspid regurgitation pressure gradient (TRPG) measured by echocardiography is used to screen for PH and congestive pressure to the liver...
May 15, 2018: BMC Gastroenterology
https://www.readbyqxmd.com/read/29762314/effectiveness-of-dexmedetomidine-versus-propofol-on-extubation-times-length-of-stay-and-mortality-rates-in-adult-cardiac-surgery-patients-a-systematic-review-and-meta-analysis
#8
John Nguyen, Noel Nacpil
OBJECTIVE: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients. INTRODUCTION: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine...
May 2018: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29756460/inhaled-fasudil-lacks-pulmonary-selectivity-in-thromboxane-induced-acute-pulmonary-hypertension-in-newborn-lambs
#9
Shawn F L Hanson, Michael H Terry, Dafne T Moretta, Gordon G Power, Sean M Wilson, Farzana Alam, Fakhrul Ahsan, Arlin B Blood, Paresh C Giri
INTRODUCTION: Pulmonary hypertension (PH) is a potentially deadly disease for infants and adults with few existing medical interventions and no cure. In PH, increased blood pressure in the pulmonary artery eventually leads to heart failure. Fasudil, an antagonist of Rho-kinase, causes vasodilation leading to decreased systemic artery pressure and pulmonary artery pressure (PAP). This study compared the effects of fasudil administered as either an intravenous infusion or inhaled aerosol in newborn lambs...
January 1, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29754394/anesthesia-for-subcutaneous-implantable-cardioverter-defibrillator-implantation-perspectives-from-the-clinical-experience-of-a-us-panel-of-physicians
#10
Michael K Essandoh, George E Mark, Johan D Aasbo, Charles A Joyner, Saumya Sharma, Beningo F Decena, Eric D Bolin, Raul Weiss, Martin C Burke, Timothy R McClernon, Emile G Daoud, Michael R Gold
BACKGROUND AND OBJECTIVE: Worldwide adoption of the subcutaneous implantable cardioverter-defibrillator (S-ICD) for preventing sudden cardiac death continues to increase, as longer-term evidence demonstrating the safety and efficacy of the S-ICD expands. As a relatively new technology, comprehensive anesthesia guidance for the management of patients undergoing S-ICD placement is lacking. This article presents advantages and disadvantages of different peri-procedural sedation and anesthesia options for S-ICD implants including general anesthesia, monitored anesthesia care, regional anesthesia, and nonanesthesia personnel administered sedation and analgesia...
May 13, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29753669/does-the-weekend-effect-for-postoperative-mortality-stand-up-to-scrutiny-association-for-cardiothoracic-anesthesia-and-critical-care-cohort-study-of-110-728-cardiac-surgical-patients
#11
Olympia Papachristofi, Andrew A Klein, John Mackay, Samer Nashef, Nick S Fletcher, Linda D Sharples
OBJECTIVE: Ongoing debate focuses on whether patients admitted to the hospital on weekends have higher mortality than those admitted on weekdays. Whether this apparent "weekend effect" reflects differing patient risk, care quality differences, or inadequate adjustment for risk during analysis remains unclear. This study aimed to examine the existence of a "weekend effect" for risk-adjusted in-hospital mortality after cardiac surgery. DESIGN: Retrospective analysis of prospectively collected cardiac registry data...
April 5, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29749582/naloxone-induced-non-cardiogenic-pulmonary-edema-a-case-report
#12
Nasheena Jiwa, Himesh Sheth, Richard Silverman
A 22-year-old man was admitted for an elective right-shoulder open subacromial decompression and distal clavicle excision. He received a single intravenous dose of fentanyl 50 μg for anesthesia. His procedure was completed without intra-operative complications; however, he developed post-operative respiratory depression in the setting of narcotic administration. He was given naloxone 0.2 mg intravenously once to reverse this effect, which subsequently led to acute hypoxic respiratory failure secondary to pulmonary edema shortly after administration of naloxone...
May 10, 2018: Drug Safety—Case Reports
https://www.readbyqxmd.com/read/29745073/hemodynamic-stability-achievement-by-application-of-goal-directed-fluid-therapy-with-different-infusion-solutions-in-colorectal-surgery
#13
Ana Cvetkovic, Nevena Kalezic, Biljana Milicic, Srdjan Nikolic, Milan Zegarac, Dejan Stojiljkovic, Merima Goran, Marina Stojanovic
PURPOSE: To determine whether there was a correlation between the type of administered infusion solutions intraoperatively with the quantity of administered infusion solutions, differences in values of cardiac output (CO) and cardiac index (CI) and need to use vasopressors and inotropes, between control and research groups. METHODS: This randomized prospective study included 55 patients with colorectal cancer. Subjects in the control group received only crystalloid solutions intraoperatively and postoperatively...
March 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29742788/-the-relevance-of-hemolysis-in-anesthesia-and-intensive-care-medicine
#14
Jan A Graw, David M Baron, Roland C E Francis
Hemolysis leads to an increase of circulating intravascular cell-free hemoglobin. Increased plasma concentrations of cell-free hemoglobin are relevant in critically ill patients because cell-free hemoglobin causes vasoconstriction by depletion of endothelial nitric oxide, oxidative stress, and inflammation. Furthermore, cell-free hemoglobin contributes to tissue injuries such as renal failure and intestinal mucosa damage after cardiac surgery. High concentrations of cell-free hemoglobin are associated with an increased mortality in patients with sepsis...
April 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29739535/do-we-feel-pain-during-anesthesia-a-critical-review-on-surgery-evoked-circulatory-changes-and-pain-perception
#15
REVIEW
A Cividjian, F Petitjeans, N Liu, M Ghignone, M de Kock, L Quintin
The difficulty of defining the three so-called components of « an-esthesia » is emphasized: hypnosis, absence of movement, and adequacy of anti-nociception (intraoperative « analgesia »). Data obtained from anesthetized animals or humans delineate the activation of cardiac and vasomotor sympathetic reflex (somato-sympathetic reflex) and the cardiac parasympathetic deactivation observed following somatic stimuli. Sympathetic activation and parasympathetic deactivation are used as monitors to address the adequacy of intraoperative anti-nociception...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29735348/carney-complex-and-cardiac-anesthesia
#16
EDITORIAL
George S Plummer, Frederick C Cobey
No abstract text is available yet for this article.
June 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29734243/incidence-and-risk-factors-for-perioperative-cardiovascular-and-respiratory-adverse-events-in-pediatric-patients-with-congenital-heart-disease-undergoing-noncardiac-procedures
#17
Sandra Lee, Elise Reddington, Sophia Koutsogiannaki, Michael R Hernandez, Kirsten C Odegard, James A DiNardo, Koichi Yuki
BACKGROUND: While mortality and adverse perioperative events after noncardiac surgery in children with a broad range of congenital cardiac lesions have been investigated using large multiinstitutional databases, to date single-center studies addressing adverse outcomes in children with congenital heart disease (CHD) undergoing noncardiac surgery have only included small numbers of patients with significant heart disease. The primary objective of this study was to determine the incidences of perioperative cardiovascular and respiratory events in a large cohort of patients from a single institution with a broad range of congenital cardiac lesions undergoing noncardiac procedures and to determine risk factors for these events...
April 27, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29733822/cardiopulmonary-bypass-glial-fibrillary-acidic-protein-correlates-with-neurocognitive-skills
#18
Luca Vedovelli, Massimo Padalino, Agnese Suppiej, Stefano Sartori, Gianclaudio Falasco, Manuela Simonato, Virgilio P Carnielli, Giovanni Stellin, Paola Cogo
BACKGROUND: Neuro-cognitive deficits at school starting age may affect as many as 50% of children who underwent cardiac surgery for complex congenital heart diseases (CHD). The aim of this study was to identify which phases of cardiopulmonary bypass (CPB) are associated with an increased risk of impaired neurodevelopmental skills in children with complex CHD. This was assessed by means of glial fibrillary acidic protein (GFAP) plasma levels during CPB for CHD surgery, as a marker of neurological insult...
May 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29727761/systematic-review-and-meta-analyses-of-tranexamic-acid-use-for-bleeding-reduction-in-prostate-surgery
#19
REVIEW
Marcelo A Longo, Bárbara T Cavalheiro, Getúlio R de Oliveira Filho
BACKGROUND: Prostate cancer and benign prostatic hyperplasia have an increased incidence with aging. The most effective treatments are radical prostatectomy and transurethral resection of the prostate. To reduce perioperative bleeding in these surgeries, an approach is the use of tranexamic acid (TXA). Studies show that TXA is effective in reducing the blood loss and the need for transfusion in cardiac, orthopedic, and gynecological surgeries. In prostate surgeries, its efficacy and safety have not been established yet...
May 1, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29727370/effect-of-a-perioperative-intra-aortic-balloon-pump-in-high-risk-cardiac-surgery-patients-a-randomized-clinical-trial
#20
Graziela Santos Rocha Ferreira, Juliano Pinheiro de Almeida, Giovanni Landoni, Jean Louis Vincent, Evgeny Fominskiy, Filomena Regina Barbosa Gomes Galas, Fabio A Gaiotto, Luís Oliveira Dallan, Rafael Alves Franco, Luiz Augusto Lisboa, Luis Roberto Palma Dallan, Julia Tizue Fukushima, Stephanie Itala Rizk, Clarice Lee Park, Tânia Mara Strabelli, Silvia Helena Gelas Lage, Ligia Camara, Suely Zeferino, Jaquelline Jardim, Elisandra Cristina Trevisan Calvo Arita, Juliana Caldas Ribeiro, Silvia Moreira Ayub-Ferreira, Jose Otavio Costa Auler, Roberto Kalil Filho, Fabio Biscegli Jatene, Ludhmila Abrahao Hajjar
OBJECTIVES: The aim of this study was to evaluate the efficacy of perioperative intra-aortic balloon pump use in high-risk cardiac surgery patients. DESIGN: A single-center randomized controlled trial and a meta-analysis of randomized controlled trials. SETTING: Heart Institute of São Paulo University. PATIENTS: High-risk patients undergoing elective coronary artery bypass surgery. INTERVENTION: Patients were randomized to receive preskin incision intra-aortic balloon pump insertion after anesthesia induction versus no intra-aortic balloon pump use...
April 30, 2018: Critical Care Medicine
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