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Anesthesia cardiothoracic

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https://www.readbyqxmd.com/read/29369877/a-multidisciplinary-qi-initiative-to-improve-or-icu-handovers
#1
Dawn Krimminger, Carrie Sona, Elaine Thomas-Horton, Marilyn Schallom
: Background: Handover from the operating room (OR) staff to the ICU staff is a critical transition time for patients, in which the potential for error and miscommunication is high. Therefore, minimization of extraneous interruptions during the exchange of crucial information between the anesthesia and surgical teams and the nursing, respiratory therapy, and medical teams is imperative. OBJECTIVES: The aim of this quality improvement (QI) initiative was, first, to examine the impact of a standardized handover process between the OR and the ICU on process and information-sharing errors, and second, to examine provider satisfaction with the handover process...
February 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29325842/use-of-dexmedetomidine-in-cardiothoracic-and-vascular-anesthesia
#2
REVIEW
Lucía Gallego-Ligorit, Marc Vives, Jorge Vallés-Torres, T Alberto Sanjuán-Villarreal, Azucena Pajares, Mario Iglesias
Dexmedetomidine is a highly selective α2-adrenergic agonist with analgesic and sedative properties. In the United States, the Food and Drug Administration approved the use of the drug for short-lasting sedation (24 h) in intensive care units (ICUs) in patients undergoing mechanical ventilation and endotracheal intubation. In October 2008, the Food and Drug Administration extended use of the drug for the sedation of nonintubated patients before and during surgical and nonsurgical procedures. In the European Union, the European Medicine Agency approved the use of dexmedetomidine in September 2011 with a single recognized indication: ICU adult patients requiring mild sedation and awakening in response to verbal stimulus...
December 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29204888/initial-robotic-assistance-in-the-surgical-management-of-renal-cell-carcinoma-with-level-4-cavoatrial-thrombus
#3
Isaac Palma-Zamora, Deepansh Dalela, Ravi Barod, Linda Hsu, Mani Menon, Craig G Rogers
We report a case of left-sided renal cell carcinoma (RCC) with level 4 cavoatrial tumor thrombus where robotic assistance was used to achieve hemostasis around the kidney in order to minimize coagulopathic hemorrhage from the nephrectomy bed during subsequent open completion nephrectomy and cavoatrial thrombectomy under extracorporeal circulation and hypothermic circulatory arrest. Robotic assistance allowed for meticulous dissection and ligation of parasitic and arterial vessels to the kidney, release of renal attachments, and exposure of the inferior vena cava...
December 4, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/29183368/incidence-of-orthostatic-hypotension-and-cardiovascular-response-to-postoperative-early-mobilization-in-patients-undergoing-cardiothoracic-and-abdominal-surgery
#4
Masatoshi Hanada, Yuichi Tawara, Takuro Miyazaki, Shuntaro Sato, Yosuke Morimoto, Masato Oikawa, Hiroshi Niwa, Kiyoyuki Eishi, Takeshi Nagayasu, Susumu Eguchi, Ryo Kozu
BACKGROUND: In cardiothoracic and abdominal surgery, postoperative complications remain major clinical problems. Early mobilization has been widely practiced and is an important component in preventing complications, including orthostatic hypotension (OH) during postoperative management. We investigated cardiovascular response during early mobilization and the incidence of OH after cardiothoracic and abdominal surgery. METHODS: In this prospective observational study, we consecutively analyzed data from 495 patients who underwent elective cardiothoracic and abdominal surgery...
November 28, 2017: BMC Surgery
https://www.readbyqxmd.com/read/29174660/the-year-in-cardiothoracic-and-vascular-anesthesia-selected-highlights-from-2017
#5
Adam S Evans, Menachem Weiner, Prakash A Patel, Elvera L Baron, Jacob T Gutsche, Arun Jayaraman, J Ross Renew, Archer K Martin, Ashley V Fritz, Emily K Gordon, Hynek Riha, Saumil Patel, Kamrouz Ghadimi, Eric Guelaff, Jared W Feinman, Jillian Dashell, Ray Munroe, Derek Lauter, Stuart J Weiss, George Silvay, John G Augoustides, Harish Ramakrishna
No abstract text is available yet for this article.
October 14, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29162132/comparison-of-the-effect-of-high-versus-low-mean-arterial-pressure-levels-on-clinical-outcomes-and-complications-in-elderly-patients-during-non-cardiothoracic-surgery-under-general-anesthesia-study-protocol-for-a-randomized-controlled-trial
#6
Anmin Hu, Yan Qiu, Peng Zhang, Bailong Hu, Yali Yang, Shutao Li, Rui Zhao, Zhongjun Zhang, Yaoxian Zhang, Zihao Zheng, Chen Qiu, Furong Li, Xiaolei Gong
BACKGROUND: Intraoperative blood pressure (BP) is a concern in daily clinic anesthesia and contributes to the differences in clinical outcome. We conducted a randomized controlled trial (RCT) to compare the effect of high vs. low mean arterial pressure (MAP) levels on clinical outcomes and complications in elderly patients under general anesthesia (GA). METHODS: In this multicenter, randomized, parallel-controlled, open-label, assessor-blinded clinical trial, 322 patients aged more than 65 years will be randomized for a low-level MAP (60-70 mmHg) or high-level MAP (90-100 mmHg) during non-cardiothoracic surgery under GA...
November 21, 2017: Trials
https://www.readbyqxmd.com/read/28713211/early-extubation-in-pediatric-heart-surgery-across-a-spectrum-of-case-complexity-impact-on-hospital-length-of-stay-and-chest-tube-days
#7
Staci Beamer, Sunita Ferns, Lloyd Edwards, Greer Gunther, Jennifer Nelson
Early extubation is increasingly common in congenital heart surgery, but there are limited outcomes data across the spectrum of case complexity. We performed a retrospective review of 201 pediatric operations using cardiopulmonary bypass between 2012 and 2014. Patients extubated in the operating room or immediately on arrival to the ICU were compared to those extubated by traditional protocols. In-hospital mortality, major complications, need for re-intubation, hospital length of stay, and chest-tube days were compared between groups and by Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery Congenital Heart Surgery (STAT) mortality category...
June 2017: Progress in Pediatric Cardiology
https://www.readbyqxmd.com/read/28678115/a-theoretical-model-of-flow-disruptions-for-the-anesthesia-team-during-cardiovascular-surgery
#8
Albert Boquet, Tara Cohen, Fawaaz Diljohn, Jennifer Cabrera, Scott Reeves, Scott Shappell
OBJECTIVES: This investigation explores flow disruptions observed during cardiothoracic surgery and how they serve to disconnect anesthesia providers from their primary task. We can improve our understanding of this disengagement by exploring what we call the error space or the accumulated time required to resolve disruptions. METHODS: Trained human factors students observed 10 cardiac procedures for disruptions impacting the anesthesia team and recorded the time required to resolve these events...
July 3, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28478908/corrigendum-to-prolonged-hypotension-following-innominate-and-left-common-carotid-artery-bypass-journal-of-cardiothoracic-and-vascular-anesthesia-30-2016-154-157
#9
Geoffrey Hobika, Jahan Porhomayon, Remek Kocz, Benjamin Matson, Matthew Paladino
No abstract text is available yet for this article.
June 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28254101/electroacupuncture-assisted-craniotomy-on-an-awake-patient
#10
Amritpal Sidhu, Trushna Murgahayah, Vairavan Narayanan, Hari Chandran, Vicknes Waran
Although acupuncture has existed for over 2000 years, its application as an anesthetic aid began in the 1950s in China. The first surgical procedure performed under acupuncture anesthesia was a tonsillectomy. Soon thereafter, major and minor surgical procedures took place with electroacupuncture alone providing the anesthesia. The procedures performed were diverse, ranging from cardiothoracic surgery to dental extractions. Usage of acupuncture anesthesia, specifically in neurosurgery, has been well documented in hospitals across China, especially in Beijing, dating back to the 1970s...
January 2017: Journal of Acupuncture and Meridian Studies
https://www.readbyqxmd.com/read/28074028/assessment-of-postoperative-pain-control-with-an-elastomeric-pain-pump-following-cardiothoracic-surgery
#11
Anuvrat Chopra, Jeff Hurren, Susan Szpunar, Stephanie B Edwin
Objective: To assess the effectiveness of local anesthesia, delivered via elastomeric pump to manage pain in patients undergoing cardiothoracic surgery. Methods: A retrospective, comparative analysis evaluating adult cardiothoracic surgery patients (by median sternotomy) who received continuous infusion bupivacaine + traditional methods of pain control (N = 100) or traditional pain control alone (N = 100) from July 2011-October 2013. The primary efficacy end point was total postoperative opioid requirements for 96 hours following surgery...
August 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28041810/the-year-in-cardiothoracic-and-vascular-anesthesia-selected-highlights-from-2016
#12
REVIEW
Harish Ramakrishna, Jacob T Gutsche, Prakash A Patel, Adam S Evans, Menachem Weiner, Steven T Morozowich, Emily K Gordon, Hynek Riha, Joseph Bracker, Kamrouz Ghadimi, Sunberri Murphy, Warren Spitz, Emily MacKay, Theodore J Cios, Anita K Malhotra, Elvera Baron, Shahzad Shaefi, Jens Fassl, Stuart J Weiss, George Silvay, John G T Augoustides
No abstract text is available yet for this article.
February 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27929384/noninvasive-treatment-of-acquired-subglottic-stenosis
#13
Kayhan Ozturk, Omer Erdur, Fuad Sofiyev, Ibrahim Ozkan Onal, Ali Annagur
A 23-day-old infant referred to the neonatal intensive care unit with difficulty breathing and inspiratory stridor increasing with exercise. Medical history included a cardiothoracic surgery for transposition of the great arteries, patent ductus arteriosus, atrial septal defect, and a history of intensive care unit from surgery. Flexible fiberoptic transnasal laryngoscopy revealed subglottic stenosis that was probably caused by prolonged intubation with a higher airway pressure. Computed tomographic scan of the neck showed a tiny stenosis without cartilage deformity and limited in subglottic region...
July 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27916222/acute-amiodarone-pulmonary-toxicity-after-surgical-procedures
#14
REVIEW
Jirapat Teerakanok, Pakpoom Tantrachoti, Phumpattra Chariyawong, Kenneth Nugent
Amiodarone can cause toxicity in several organs, including amiodarone-induced pulmonary toxicity which is a subacute or chronic complication. Amiodarone-induced acute respiratory distress syndrome (ARDS) in postoperative patients is a rare acute complication. The PubMed and Google Scholar databases were searched. Seven retrospective and prospective case series and 10 case reports of amiodarone-induced postoperative ARDS were reviewed. All patients received amiodarone chronically or during the perioperative period...
December 2016: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/27692903/intubated-versus-nonintubated-general-anesthesia-for-video-assisted-thoracoscopic-surgery-a-case-control-study
#15
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...
April 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27610627/heart-and-cardiovascular-involvement-in-patients-with-mucopolysaccharidosis-type-iva-morquio-a-syndrome
#16
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
https://www.readbyqxmd.com/read/27555147/preoperative-use-of-anxiolytic-sedative-agents-are-we-on-the-right-track
#17
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
https://www.readbyqxmd.com/read/27550555/caudal-analgesia-and-cardiothoracic-surgery-a-look-at-postoperative-pain-scores-in-a-pediatric-population
#18
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
https://www.readbyqxmd.com/read/27420728/severe-perioperative-bleeding-in-renal-cell-carcinoma-after-elective-pericardiocentesis-associated-left-ventricular-puncture-case-report
#19
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...
July 12, 2016: Medwave
https://www.readbyqxmd.com/read/27252226/pulmonary-hypertensive-crisis-on-induction-of-anesthesia
#20
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...
March 2017: Seminars in Cardiothoracic and Vascular Anesthesia
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