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Cardiovascular anesthesia

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https://www.readbyqxmd.com/read/29650544/evaluation-and-management-of-right-sided-heart-failure-a-scientific-statement-from-the-american-heart-association
#1
REVIEW
Marvin A Konstam, Michael S Kiernan, Daniel Bernstein, Biykem Bozkurt, Miriam Jacob, Navin K Kapur, Robb D Kociol, Eldrin F Lewis, Mandeep R Mehra, Francis D Pagani, Amish N Raval, Carey Ward
BACKGROUND AND PURPOSE: The diverse causes of right-sided heart failure (RHF) include, among others, primary cardiomyopathies with right ventricular (RV) involvement, RV ischemia and infarction, volume loading caused by cardiac lesions associated with congenital heart disease and valvular pathologies, and pressure loading resulting from pulmonic stenosis or pulmonary hypertension from a variety of causes, including left-sided heart disease. Progressive RV dysfunction in these disease states is associated with increased morbidity and mortality...
April 12, 2018: Circulation
https://www.readbyqxmd.com/read/29644942/postnatal-undernutrition-in-mice-causes-cardiac-arrhythmogenesis-which-is-exacerbated-when-pharmacologically-stressed
#2
J R Visker, D P Ferguson
Growth restriction caused by postnatal undernutrition increases risk for cardiovascular disease in adulthood with the potential to induce arrhythmogenesis. Thus, the purpose was to determine if undernutrition during development produced arrhythmias at rest and when stressed with dobutamine in adulthood. Mouse dams were fed (CON: 20% protein), or low-protein (LP: 8%) diet before mating. A cross-fostering model was used where pups nursed by dams fed LP diet in early [EUN; postnatal day (PN) 1-10], late (LUN; PN11-21) and whole (PUN; 1-21) phases of postnatal life...
April 12, 2018: Journal of Developmental Origins of Health and Disease
https://www.readbyqxmd.com/read/29643802/the-beneficial-effects-of-cognitive-training-with-simple-calculation-and-reading-aloud-scra-in-the-elderly-postoperative-population-a-pilot-randomized-controlled-trial
#3
Kay Kulason, Rui Nouchi, Yasushi Hoshikawa, Masafumi Noda, Yoshinori Okada, Ryuta Kawashima
Background: There has been little research conducted regarding cognitive treatments for the elderly postsurgical population. Patients aged ≥60 years have an increased risk of postoperative cognitive decline, a condition in which cognitive functions are negatively affected. This cognitive decline can lead to a decline in quality of life. In order to maintain a high quality of life, the elderly postsurgical population may benefit from treatment to maintain and/or improve their cognitive functions. This pilot study investigates the effect of simple calculation and reading aloud (SCRA) cognitive training in elderly Japanese postsurgical patients...
2018: Frontiers in Aging Neuroscience
https://www.readbyqxmd.com/read/29629201/anesthesia-and-fast-track-in-video-assisted-thoracic-surgery-vats-from-evidence-to-practice
#4
REVIEW
Marzia Umari, Stefano Falini, Matteo Segat, Michele Zuliani, Marco Crisman, Lucia Comuzzi, Francesco Pagos, Stefano Lovadina, Umberto Lucangelo
In thoracic surgery, the introduction of video-assisted thoracoscopic techniques has allowed the development of fast-track protocols, with shorter hospital lengths of stay and improved outcomes. The perioperative management needs to be optimized accordingly, with the goal of reducing postoperative complications and speeding recovery times. Premedication performed in the operative room should be wisely administered because often linked to late discharge from the post-anesthesia care unit (PACU). Inhalatory anesthesia, when possible, should be preferred based on protective effects on postoperative lung inflammation...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29628593/comparison-of-esmolol-and-dexmedetomidine-for-suppression-of-hemodynamic-response-to-laryngoscopy-and-endotracheal-intubation-in-adult-patients-undergoing-elective-general-surgery-a-prospective-randomized-controlled-double-blinded-study
#5
Sandeep Sharma, Om Prakash Suthar, M L Tak, Abhilasha Thanvi, Naveen Paliwal, Rakesh Karnawat
Context: Laryngoscopy and endotracheal intubation lead to strong sympathetic response which may precipitate arrhythmias, myocardial ischemia and cerebrovascular accidents in patients with preexisting cardiovascular disease. Aims: This study was aimed to compare the effect of dexmedetomidine and esmolol on hemodynamic response to laryngoscopy and endotracheal intubation in patients undergoing elective surgery under general anesthesia. Settings and Design: This was a prospective, randomized controlled double-blinded study...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628591/comparison-of-levobupivacaine-and-levobupivacaine-with-dexmedetomidine-in-infraumbilical-surgeries-under-spinal-anesthesia
#6
Amar Parkash Kataria, Vishal Jarewal, Rajan Kumar, Ankush Kashyap
Introduction: Spinal anesthesia is a widely used technique providing faster onset with effective and uniformly distributed sensory and motor block. Due to decreased cardiovascular and central nervous system toxicity, levobupivacaine is a good alternative for spinal anesthesia. Dexmedetomidine when used intrathecally is associated with prolonged motor and sensory block, hemodynamic stability, and less requirement of rescue analgesia in 24 h. Materials and Methods: A prospective, randomized study was carried out which included 60 adult patients between the age group of 20 and 65 years of physical status American Society of Anesthesiologists Classes I and II who underwent infraumbilical surgeries...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628189/development-of-a-congenital-cardiovascular-computed-tomography-imaging-registry-rationale-and-implementation
#7
B Kelly Han, Susan Casey, Dawn Witt, Jonathon Leipsic, Andrew Crean, Edward Nicol, Thomas Semple, James Shambrook, Ashwin Prakash, Puja Banka, Ross Garberich, Cynthia Rigsby, Anthony Hlavacek, John Lesser
BACKGROUND: The cumulative exposure and risk of anesthesia, vascular access, contrast agents and radiation is emerging as a significant lifelong burden in patients with congenital heart disease (CHD). Latest generation computerized tomographic (CT) scanners are increasingly used for high resolution cardiovascular imaging and have both hardware and post processing radiation dose reduction strategies that can be implemented. Currently, these dose reduction strategies are not uniformly applied and there is a large variability in radiation dose used for the performance of CT in CHD...
March 16, 2018: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29624011/comparison-of-the-cardiovascular-and-respiratory-effects-and-sevoflurane-requirement-in-dogs-premedicated-with-two-doses-of-medetomidine-and-butorphanol-undergoing-surgical-sterilization
#8
D Juodzente, A Macas, B Karveliene, S Petkevicius, V Riskeviciene
The aim of this study was to compare the cardiovascular and respiratory effects and sevoflurane requirement in dogs premedicated with two doses of medetomidine and butorphanol undergoing surgical sterilization. The dogs were randomly assigned to two different groups: group 1 received a lower dose of medetomidine (0.014 mg/kg) and butorphanol (0.14 mg/kg) and group 2 received a higher dose of medetomidine (0.024 mg/kg) and butorphanol (0.24 mg/kg). Anesthesia was induced with intravenous propofol and maintained with sevoflurane 2% in pure oxygen...
March 2018: Polish Journal of Veterinary Sciences
https://www.readbyqxmd.com/read/29622310/the-failed-sedation-solutions-for-the-oral-and-maxillofacial-surgeon
#9
REVIEW
Robert C Bosack
Due to wide variation in patient responses, both intended and adverse, it is impossible to successfully sedate all patients. Choosing the right drug and dose regimen can be challenging, especially in patients who are naïve to anesthesia. Underdosing can lead to pain perception, patient movement and combativeness, awareness with recall, and the sympathetic neuroendocrine stress response. Overdosing can lead to unintended loss of upper airway tone, hypoventilation/apnea, adverse cardiovascular changes, and prolonged sedation (with its attendant problems)...
May 2018: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/29621201/remote-ischemic-preconditioning-does-not-affect-the-release-of-humoral-factors-in-propofol-anesthetized-cardiac-surgery-patients-a-secondary-analysis-of-the-ripheart-study
#10
Julia Ney, Katleen Hoffmann, Patrick Meybohm, Andreas Goetzenich, Sandra Kraemer, Carina Benstöm, Nina C Weber, Johannes Bickenbach, Rolf Rossaint, Gernot Marx, Kai Zacharowski, Jürgen Bernhagen, Christian Stoppe
In contrast to several smaller studies, which demonstrate that remote ischemic preconditioning (RIPC) reduces myocardial injury in patients that undergo cardiovascular surgery, the RIPHeart study failed to demonstrate beneficial effects of troponin release and clinical outcome in propofol-anesthetized cardiac surgery patients. Therefore, we addressed the potential biochemical mechanisms triggered by RIPC. This is a predefined prospective sub-analysis of the randomized and controlled RIPHeart study in cardiac surgery patients ( n = 40) that was recently published...
April 5, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29616915/refractory-hypoxemia-in-a-patient-with-submassive-pulmonary-embolism-and-an-intracardiac-shunt-a-case-report-and-review-of-the-literature
#11
REVIEW
Jean Liew, Janelle Stevens, Christopher Slatore
INTRODUCTION: Acute pulmonary embolism is the third leading cause of cardiovascular death. Management options include anticoagulation with or without thrombolysis. Concurrent persistent hypoxemia should be a clue to the existence of an intracardiac shunt. CASE PRESENTATION: A 46-year-old man experienced acute hypoxemic respiratory failure requiring mechanical ventilation after anesthesia induction for elective hip arthroplasty. He was found to have submassive bilateral pulmonary emboli with acute right ventricular dysfunction and a coexisting patent foramen ovale with right-to-left shunt...
March 2, 2018: Permanente Journal
https://www.readbyqxmd.com/read/29616230/anesthesia-associated-relative-hypovolemia-mechanisms-monitoring-and-treatment-considerations
#12
Jessica Noel-Morgan, William W Muir
Although the utility and benefits of anesthesia and analgesia are irrefutable, their practice is not void of risks. Almost all drugs that produce anesthesia endanger cardiovascular stability by producing dose-dependent impairment of cardiac function, vascular reactivity, and compensatory autoregulatory responses. Whereas anesthesia-related depression of cardiac performance and arterial vasodilation are well recognized adverse effects contributing to anesthetic risk, far less emphasis has been placed on effects impacting venous physiology and venous return...
2018: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29608502/xenon-an-emerging-neuroprotectant-with-potential-application-for-cardiac-arrest-care
#13
Mohammad Roostan, William H Frishman
Xenon is an inert, highly polarizable noble gas with demonstrated safety and application in general anesthesia for over fifty years. A potent inhibitor of the N-methyl-D-aspartate subtype of glutamate receptors, xenon has a well-documented ameliorating effect on excitotoxic neuronal injury in numerous cellular and animal models of hypoxic-ischemic brain injury. The most important determinant of overall survival and morbidity in out-of-hospital cardiac arrest is the severity of neurological injury. The only approved neuroprotective strategy in this setting is mild therapeutic hypothermia, which has demonstrated significant, albeit modest, improvements in mortality...
March 30, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29594157/use-of-nasotracheal-intubation-during-general-anesthesia-in-two-ponies-with-tracheal-collapse
#14
Keila K Ida, Aurélie Sauvage, Alexandra Gougnard, Magda Grauwels, Didier Serteyn, Charlotte Sandersen
Ponies with tracheal collapse may have an increased anesthetic risk due to airway obstruction during induction and recovery. To our knowledge, there are no anesthetic descriptions of these patients, despite a reported 5.6% incidence and 77% mortality rate. Two Shetland ponies with tracheal collapse, a 12-year-old male (pony 1) and a 27-year-old female (pony 2), were referred for right eye enucleation due to a perforating corneal ulcer and severe recurrent uveitis, respectively. Pony 1 was stressed, had lung stridor and hyperthermia, and developed inspiratory dyspnea with handling...
2018: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29573263/effect-of-pre-operative-methylprednisolone-on-orthostatic-hypotension-during-early-mobilization-after-total-hip-arthroplasty
#15
V Lindberg-Larsen, P B Petersen, Ø Jans, T Beck, H Kehlet
BACKGROUND: Orthostatic hypotension (OH) and intolerance (OI) are common after total hip arthroplasty (THA) and may delay early mobilization. The pathology of OH and OI includes a dysregulated post-operative vasopressor response, by a hitherto unknown mechanism. We hypothesized that OI could be related to the inflammatory stress response which is inhibited by steroid administration. Consequently, this study evaluated the effect of a pre-operative high-dose methylprednisolone on OH and OI early after THA...
March 24, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29572733/williams-syndrome-and-anesthesia-for-non-cardiac-surgery-high-risk-can-be-mitigated-with-appropriate-planning
#16
Morgan L Brown, Viviane G Nasr, Rebecca Toohey, James A DiNardo
Patients with Williams syndrome are considered at high risk for anesthesia-related adverse events. At our institution, all William syndrome patients undergoing cardiac surgical, cardiac catheterization/interventional procedures, and cardiac imaging studies are cared for by cardiac anesthesiologists. All William syndrome patients undergoing non-cardiac surgical, interventional, or imaging studies are cared for by main operating room pediatric anesthesiologists with consultative input from a cardiac anesthesiologist...
March 23, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29557595/complications-during-esophageal-endoscopy-with-or-without-baloon-dilation-under-general-anesthesia-in-pediatric-patients-a-prospective-and-observational-study
#17
Pinar Kendigelen, Ayse C Tutuncu, Senol Emre, Fatis Altindas, Guner Kaya
BACKGROUND: Complications can occur during esophagoscopy as a result of applied procedure in children, especially during dilation techic. Our aim was to identify cardio-respiratory alterations during esophagoscopy with or without baloon dilation under anesthesia in children, and to investigate the postoperative complications. METHODS: Prospective, observational study of endoscopic procedures in patients 0-16 years. The patients were divided into two groups: the endoscopy-dilation group (Group ED: endoscopy and balloon dilation due to esophageal stricture) and endoscopy without dilation (Group E: endoscopy for diagnostic reasons, control esophagoscopy or sclerotherapy)...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29553542/novel-approach-for-simultaneous-recording-of-renal-sympathetic-nerve-activity-and-blood-pressure-with-intravenous-infusion-in-conscious-unrestrained-mice
#18
Shereen M Hamza, John E Hall
Renal sympathetic nerves contribute significantly to both physiological and pathophysiological phenomena. Evaluating renal sympathetic nerve activity (RSNA) is of great interest in many areas of research such as chronic kidney disease, hypertension, heart failure, diabetes and obesity. Unequivocal assessment of the role of the sympathetic nervous system is thus imperative for proper interpretation of experimental results and understanding of disease processes. RSNA has been traditionally measured in anesthetized rodents, including mice...
February 14, 2018: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29544752/management-of-an-internal-carotid-artery-injury-caused-by-a-displaced-titanium-plate-with-a-combination-of-interventional-vascular-radiology-and-surgery
#19
Yoshitaka Shimizu, Takahito Okazaki, Tomoaki Hamana, Masahiro Irifune
Treatment of pseudoaneurysms in the internal carotid artery (ICA) is associated with a high risk of cerebral infarction; therefore, vessel ligation for hemostasis must be avoided. A 66-year-old man had intraoral hemorrhaging. At the time of the initial examination, computed tomography angiography showed jaw plate displacement near the ICA. A more detailed image was obtained using digital-subtraction angiography. After evaluation of the image, a pseudoaneurysm was diagnosed. Six days later, there were concerns about aspiration and airway obstruction; therefore, tracheostomy was performed...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29544611/the-western-denmark-heart-registry-its-influence-on-cardiovascular-patient-care
#20
REVIEW
Morten Schmidt, Michael Maeng, Morten Madsen, Henrik Toft Sørensen, Lisette Okkels Jensen, Carl-Johan Jakobsen
The WDHR (Western Denmark Heart Registry) is a seminational, multicenter-based registry with longitudinal registration of detailed patient and procedure data since 1999. The registry includes as of January 1, 2017 approximately 240,000 coronary angiographies, 90,000 percutaneous coronary interventions, 60,000 cardiac computed tomographies, 40,000 cardiac operations, and 2,000 transcatheter aortic valve replacements. Positron emission tomography/computed tomography, single-photon emission computed tomography, and magnetic resonance imaging are soon to be added...
March 20, 2018: Journal of the American College of Cardiology
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