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Anesthesia for Cardiac Surgery

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https://www.readbyqxmd.com/read/28928575/referrral-systems-development-and-survey-of-perioperative-and-critical-care-referral-to-anesthetists
#1
P L Narendra, Harihar V Hegde, Maroof Ahmad Khan, Dayanand G Talikoti, Samson Nallamilli
INTRODUCTION: Anesthetists come in contact with more than two-third of hospital patients. Timely referral to anesthetists is vital in perioperative and remote site settings. Delayed referrals, improper referrals, and referrals at inappropriate levels can result in inadequate preparation, perioperative complications, and poor outcome. METHODS: The self administered paper survey to delegates attending anesthesia conferences. Questions were asked on how high-risk, emergency surgical cases remote site and critical care patients were referred to anesthetists and presence of rapid response teams...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28920049/effect-of-selenium-on-stress-response-in-coronary-artery-bypass-graft-surgery-a-clinical-trial
#2
Ali Mirmansouri, Vali Imantalab, Ali Mohammadzadeh Jouryabi, Gholamreza Kanani, Bahram Naderi Nabi, Farnoush Farzi, Gelareh Biazar, Samaneh Ghazanfar Tehran, Masoud Tarbiat
BACKGROUND: In spite of significant improvements in surgical and anesthetic techniques, acute stress response to surgery remains a main cause of mortality and morbidity in coronary artery bypass graft (CABG) surgery patients. Therefore, doing research to find safe and effective modalities with more cardio protective properties seems necessary. OBJECTIVES: In this study, we sought to determine whether intravenous injection of 600 μg Selenium (Se) prior to surgery would limit stress response measured by blood sugar...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28920034/the-use-of-intraoperative-transesophageal-echocardiography-in-thoracic-aortic-dissection-due-to-chronic-cocaine-abuse
#3
Ali Dabbagh, Mohammad Kazem Arabnia, Mahnoosh Foroughi, Mehran Shahzamani, Hassan Rahmian
INTRODUCTION: Aortic dissection is a life threatening disease and is usually accompanied by a high rate of mortality and morbidity. Here we present a case report in which intraoperative tranesophageal echocardiography was used for intraoperative assessments of thoracic aortic dissection due to cocaine abuse. CASE PRESENTATION: A 45- year- old male was admitted to a university hospital due to severe chest pain. He was suffering from severe excruciating chest pain that had started after a psychological stress, leading to heavy cocaine abuse...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28915132/clinical-update-regarding-general-anesthesia-associated-neurotoxicity-in-infants-and-children
#4
M Ruth Graham
PURPOSE OF REVIEW: The U.S. Federal Drug Administration (FDA) recently released a warning stating that 'repeated or lengthy use of general anesthetic and sedation drugs during surgeries or procedures in children younger than 3 years or in pregnant women during their third trimester may affect the development of children's brains' (www.fda.gov/ucm582356.htm). The goal of this article is to review the most recent clinical studies which provide evidence that these concerns may be overstated for the majority of healthy young children who require surgery and anesthesia...
September 14, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28903938/atrial-fibrillation-in-acute-obstructive-sleep-apnea-autonomic-nervous-mechanism-and-modulation
#5
Lilei Yu, Xuefei Li, Bing Huang, Xiaoya Zhou, Menglong Wang, Liping Zhou, Guannan Meng, Yuhong Wang, Zhenya Wang, Jielin Deng, Hong Jiang
BACKGROUND: The mechanisms of atrial fibrillation (AF) induced by obstructive sleep apnea (OSA) are not completely understood. This study investigated the roles of the intrinsic and extrinsic cardiac autonomic nervous system in OSA-induced AF and provided noninvasive autonomic nervous modulation for the suppression of OSA-induced AF by using low-level transcutaneous electrical stimulation (LL-TS) of the auricular branch of the vagus nerve at the tragus. METHODS AND RESULTS: Eighteen dogs received tracheostomy under general anesthesia and were randomly divided into 3 groups: the OSA group (OSA was simulated via clamping of the endotracheal tube at end expiration for 1...
September 13, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28893702/risk-factors-associated-with-perioperative-myocardial-infarction-in-major-open-vascular-surgery
#6
Danielle C Sutzko, Elizabeth A Andraska, Andrea T Obi, Peter K Henke, Nicholas H Osborne
BACKGROUND: Among patients undergoing non-cardiac surgery, major vascular surgery is associated with a high risk of perioperative myocardial infarction (MI). Currently there are no perioperative MI risk calculators accounting for intraoperative and postoperative risk factors in vascular surgery patients. We aimed to investigate specific risk factors for perioperative MI after major open vascular surgery to determine which patients are at highest risk of MI, and the association of perioperative MI with perioperative transfusion...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28893433/effects-of-remote-ischemic-preconditioning-in-patients-with-concentric-myocardial-hypertrophy-a-randomized-controlled-trial-with-molecular-insights
#7
Young Song, Jong Wook Song, Sak Lee, Ji-Hae Jun, Young-Lan Kwak, Jae-Kwang Shim
BACKGROUND: Efficacy of remote ischemic preconditioning (RIPC) for cardioprotection in cardiac surgery is controversial. We aimed to evaluate the clinical and molecular effects of RIPC on the concentrically hypertrophied myocardium. METHODS: Seventy-two aortic stenosis patients receiving aortic valve replacement (AVR) under sevoflurane anesthesia were randomly allocated to RIPC (3cycles of 5-min inflation [300mmHg] and deflation on the left arm) or control (deflated cuff placement) group...
September 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28891855/patient-satisfaction-with-propofol-for-outpatient-colonoscopy-a-prospective-randomized-double-blind-study
#8
Anantha Padmanabhan, Christoforos Frangopoulos, Lynn E T Shaffer
BACKGROUND: Previous literature has shown that propofol has ideal anesthetic properties for patients undergoing colonoscopy, a common procedure at outpatient surgery centers. However, there is a paucity of information regarding patient satisfaction with propofol. OBJECTIVE: The aim of this study was to evaluate patient satisfaction with propofol compared with nonpropofol (fentanyl/midazolam) anesthesia for outpatient colonoscopies. Safety and complications were secondary end points...
October 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28887248/positive-impact-of-an-aortic-center-designation
#9
Adam Tanious, Mathew Wooster, Marcelo Giarelli, Paul A Armstrong, Brad Johnson, Karl A Illig, Bruce Zwiebel, Lawrence S Grundy, Robert Hooker, Christiano Caldeira, Martin A Back, Murray L Shames
BACKGROUND: In January 2015 we created a multidisciplinary Aortic Center with the collaboration of Vascular Surgery, Cardiac Surgery, Interventional Radiology, Anesthesia and Hospital Administration. We report the initial success of creating a Comprehensive Aortic Center. METHODS: All aortic procedures performed from January 1, 2015 until December 31, 2016 were entered into a prospectively collected database and compared with available data for 2014. Primary outcomes included the number of all aortic related procedures, transfer acceptance rate, transfer time and proportion of elective/emergent referrals...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28885216/microcirculation-measurements-barriers-for-use-in-clinical-routine
#10
Dietrich Henzler, Matthias Scheffler, Arne Westheider, Thomas Köhler
BACKGROUND: In patients with shock, inflammation and sepsis alterations in microcirculation are common problems. Although the pathophysiologic consequences are well understood, measurements of microcirculation have not entered clinical routine so far. OBJECTIVE: To characterize the requirements for clinical microcirculation measurement techniques and the barriers for implementation into routine practice. METHODS: Clinical review of reliability, reproducibility, validity, availability and usefulness of clinically available measurement techniques to be used in patients with sepsis or cardiac surgery with cardiopulmonary bypass...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28877873/the-in-vitro-zebrafish-heart-as-a-model-to-investigate-the-chronotropic-effects-of-vapor-anesthetics
#11
Matthew R Stoyek, Michael K Schmidt, Florentin M Wilfart, Roger P Croll, Frank M Smith
In addition to their intended clinical actions, all general anesthetic agents in common use have detrimental intra- and post-surgical side effects on organs and systems including the heart. The major cardiac side effect of anesthesia is bradycardia, which increases the probability of insufficient systemic perfusion during surgery. These side effects also occur in all vertebrate species so far examined, but the underlying mechanisms are not clear. The zebrafish heart is a powerful model for studying cardiac electrophysiology, employing the same pacemaker system and neural control as do mammalian hearts...
September 6, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28872484/effect-of-xenon-anesthesia-compared-to-sevoflurane-and-total-intravenous-anesthesia-for-coronary-artery-bypass-graft-surgery-on-postoperative-cardiac-troponin-release-an-international-multicenter-phase-3-single-blinded-randomized-noninferiority-trial
#12
Jan Hofland, Alexandre Ouattara, Jean-Luc Fellahi, Matthias Gruenewald, Jean Hazebroucq, Claude Ecoffey, Pierre Joseph, Matthias Heringlake, Annick Steib, Mark Coburn, Julien Amour, Bertrand Rozec, Inge de Liefde, Patrick Meybohm, Benedikt Preckel, Jean-Luc Hanouz, Luigi Tritapepe, Peter Tonner, Hamina Benhaoua, Jan Patrick Roesner, Berthold Bein, Luc Hanouz, Rob Tenbrinck, Ad J J C Bogers, Bert G Mik, Alain Coiffic, Jochen Renner, Markus Steinfath, Helga Francksen, Ole Broch, Assad Haneya, Manuella Schaller, Patrick Guinet, Lauren Daviet, Corinne Brianchon, Sebastien Rosier, Jean-Jacques Lehot, Hauke Paarmann, Julika Schön, Thorsten Hanke, Joachym Ettel, Silke Olsson, Stefan Klotz, Amir Samet, Giedrius Laurinenas, Adrien Thibaud, Mircea Cristinar, Olivier Collanges, François Levy, Rolf Rossaint, Ana Stevanovic, Gereon Schaelte, Christian Stoppe, Nora Ait Hamou, Sarah Hariri, Astrid Quessard, Aude Carillion, Hélène Morin, Jacqueline Silleran, David Robert, Anne-Sophie Crouzet, Kai Zacharowski, Christian Reyher, Sonja Iken, Nina C Weber, Marcus Hollmann, Susanne Eberl, Giovanni Carriero, Daria Collacchi, Alessandra Di Persio, Olivier Fourcade, Stefan Bergt, Angela Alms
BACKGROUND: Ischemic myocardial damage accompanying coronary artery bypass graft surgery remains a clinical challenge. We investigated whether xenon anesthesia could limit myocardial damage in coronary artery bypass graft surgery patients, as has been reported for animal ischemia models. METHODS: In 17 university hospitals in France, Germany, Italy, and The Netherlands, low-risk elective, on-pump coronary artery bypass graft surgery patients were randomized to receive xenon, sevoflurane, or propofol-based total intravenous anesthesia for anesthesia maintenance...
September 5, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28861414/continuous-spinal-anesthesia-for-obstetric-anesthesia-and-analgesia
#13
REVIEW
Ivan Veličković, Borislava Pujic, Charles W Baysinger, Curtis L Baysinger
The widespread use of continuous spinal anesthesia (CSA) in obstetrics has been slow because of the high risk for post-dural puncture headache (PDPH) associated with epidural needles and catheters. New advances in equipment and technique have not significantly overcome this disadvantage. However, CSA offers an alternative to epidural anesthesia in morbidly obese women, women with severe cardiac disease, and patients with prior spinal surgery. It should be strongly considered in parturients who receive an accidental dural puncture with a large bore needle, on the basis of recent work suggesting significant reduction in PDPH when intrathecal catheters are used...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28859124/effect-of-general-anesthesia-on-neonatal-aeeg-a-cohort-study-of-patients-with-non-cardiac-congenital-anomalies
#14
Lisanne J Stolwijk, Lauren C Weeke, Linda S de Vries, Maud Y A van Herwaarden, David C van der Zee, Desiree B M van der Werff, Manon J N L Benders, Mona Toet, Petra M A Lemmers
INTRODUCTION: The aim of the current study was to determine the effect of general anesthesia on neonatal brain activity using amplitude-integrated EEG (aEEG). METHODS: A prospective cohort study of neonates (January 2013-December 2015), who underwent major neonatal surgery for non-cardiac congenital anomalies. Anesthesia was administered at the discretion of the anesthetist. aEEG monitoring was started six hours preoperatively until 24 hours after surgery. Analysis of classes of aEEG background patterns, ranging from continuous normal voltage to flat trace in six classes, and quantitative EEG-measures, using spontaneous activity transients (SATs) and interSATintervals (ISI), was performed...
2017: PloS One
https://www.readbyqxmd.com/read/28858551/the-anesthetic-management-for-a-patient-with-trisomy-13
#15
Masanori Tsukamoto, Takashi Hitosugi, Kanako Esaki, Takeshi Yokoyama
Trisomy 13 is a chromosomal disorder that occurs in complete or partial mosaic forms. It is characterized by central apnea, mental retardation, seizure and congenital heart disease. The survival of the patients with trisomy 13 is the majority dying before one month. Trisomy 13 is the worst life prognosis among all trisomy syndromes. It is reported the cause of death is central apnea. Special needs patients with mental retardation are recognized to have poorer oral health condition. Oral health related quality of life reflects daily activity and well-being...
2017: Anesthesia Progress
https://www.readbyqxmd.com/read/28851292/combined-spinal-epidural-anesthesia-for-cesarean-delivery-in-a-patient-with-cor-triloculare-biventriculare
#16
Yuan Han, Zhenfeng Zhang, Qingchun Sun, Ke Ding, Liu Han, Mengmeng Dong, Yifan Xu, Lei Ge
BACKGROUND: Cor triloculare biventriculare accounts for approximately 0.31% of cases of congenital heart disease (CHD). Moreover, people with cor triloculare biventriculare always have shorter life spans, and cases of gestation are rare. There have been various related reports of cor triloculare biventriculare in recent years. CASE PRESENTATION: We described an emergency cesarean section of a 30-year-old, 38-weeks-pregnant woman suffering from cardiac insufficiency and fetal distress...
August 29, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28833618/intraoperative-predictors-of-postoperative-takotsubo-syndrome-in-liver-transplant-recipients-an-exploratory-case-control-study
#17
Stephen Aniskevich, Ryan M Chadha, Prith Peiris, C Burcin Taner, Klaus L Torp, Colleen S Thomas, Maria L Yataco, Sher-Lu Pai
INTRODUCTION: Takotsubo syndrome (TTS), also known as Takotsubo's cardiomyopathy or stress induced cardiomyopathy, has been described following a variety of surgeries and disease states. The relationship between intraoperative anesthesia management and the development of this syndrome has never been fully elucidated. OBJECTIVES: The primary objective of this study was to determine the relationship of multiple intraoperative factors on the pathogenesis of TTS. METHODS: A single center retrospective review of all liver transplants performed at Mayo Clinic Florida from January 2005- December 2014...
August 22, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28828046/modern-use-of-echocardiography-in-transcatheter-aortic-valve-replacement-an-up-date
#18
Cristina Caldararu, Serban Balanescu
Echocardiography is the cornerstone in the diagnosis of any valvular heart disease. The accurate diagnosis of aortic stenosis, the left ventricle function and the other heart valves evaluation are currently done by ultrasound alone. Prosthetic valve choice and dimensions prior to implantation can be done solely by proper use of echocardiography. The emergence of new methods to cure aortic stenosis such as trans-catheter aortic valve replacement (TAVR) emphasized the diagnostic value of cardiac ultrasound. The usefulness of echocardiography in TAVR can be divided in the baseline assessment (common to patients treated by conventional surgery), intra-procedural guidance of valve deployment and post-procedural follow-up...
December 2016: Mædica
https://www.readbyqxmd.com/read/28820035/changes-in-heparin-dose-response-slope-during-cardiac-surgery-possible-result-in-inaccuracy-in-predicting-heparin-bolus-dose-requirement-to-achieve-target-act
#19
Junko Ichikawa, Tetsu Mori, Mitsuharu Kodaka, Keiko Nishiyama, Makoto Ozaki, Makiko Komori
INTRODUCTION: The substantial interpatient variability in heparin requirement has led to the use of a heparin dose response (HDR) technique. The accuracy of Hepcon-based heparin administration in achieving a target activated clotting time (ACT) using an HDR slope remains controversial. METHODS: We prospectively studied 86 adult patients scheduled for cardiac surgery requiring cardiopulmonary bypass. The total dose of calculated heparin required for patient and pump priming was administered simultaneously to achieve a target ACT of 450 s for HDR on the Hepcon HMS system...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28818338/spinal-anesthesia-for-pediatric-urological-surgery-reducing-the-theoretic-neurotoxic-effects-of-general-anesthesia
#20
Emmett E Whitaker, Brianne Z Wiemann, Daniel G DaJusta, Seth A Alpert, Christina B Ching, Daryl J McLeod, Joseph D Tobias, Venkata R Jayanthi
BACKGROUND: Spinal anesthesia (SA) is an effective technique that has been used in children for years. With growing concern with regard to the risks of general anesthesia (GA), we developed a SA program to provide an alternative option. We present our initial experience with this program. OBJECTIVE: To implement a SA program at a large tertiary care pediatric center and assess the safety and efficacy of the technique as an alternative to GA for urologic surgery...
July 14, 2017: Journal of Pediatric Urology
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