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Anesthesia for Cardiac Surgery

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https://www.readbyqxmd.com/read/29776668/-fatal-cardiac-tamponade-that-developed-in-the-post-anesthesia-care-unit-a-rare-complication-after-lung-lobectomy
#1
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
#2
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
#3
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
#4
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/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
#5
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/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
#6
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/29742788/-the-relevance-of-hemolysis-in-anesthesia-and-intensive-care-medicine
#7
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/29734243/incidence-and-risk-factors-for-perioperative-cardiovascular-and-respiratory-adverse-events-in-pediatric-patients-with-congenital-heart-disease-undergoing-noncardiac-procedures
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/29725794/cardiac-output-measurement-in-liver-transplantation-patients-using-pulmonary-and-transpulmonary-thermodilution-a-comparative-study
#12
Luigi Vetrugno, Elena Bignami, Federico Barbariol, Nicola Langiano, Francesco De Lorenzo, Carola Matellon, Giuseppe Menegoz, Giorgio Della Rocca
During liver transplantation surgery, the pulmonary artery catheter-despite its invasiveness-remains the gold standard for measuring cardiac output. However, the new EV1000 transpulmonary thermodilution calibration technique was recently introduced into the market by Edwards LifeSciences. We designed a single-center prospective observational study to determine if these two techniques for measuring cardiac output are interchangeable in this group of patients. Patients were monitored with both pulmonary artery catheter and the EV1000 system...
May 3, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29702994/a-case-report-regarding-general-anesthesia-management-of-a-patient-with-pulmonary-vein-stenosis-that-underwent-balloon-dilatation-and-stent-implantation
#13
Fangzhou Li, Guoyan Qiao, Peng Liang, Jin Liu
RATIONALE: Pulmonary vein stenosis (PVS) is a rare cardiovascular deformity that can lead to high mortality if left untreated. Patients frequently experience multiple complications such as hemoptysis, pulmonary hypertension, bronchial venous rupture and cardiac insufficiency. Currently, pulmonary vein stenosis balloon dilatation (stent implantation) is the only treatment, and this can be performed under local or general anesthesia. However, a case report on the general anesthesia management of PVS has not been previously reported...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29701191/-influential-factors-of-cerebral-oxygen-saturation-in-pediatric-cardiovascular-surgery
#14
Qian Li, Mao'en Zhu, Yanrong Zhang, Sisi Dai, Junjie Zhang, Qulian Guo, E Wang
To determine the intervention measures for the decrease of cerebral tissue oxygen saturation during anesthesia for the congenital heart disease in children.
 Methods: Twenty-eight children with cardiac surgery were enrolled. Anesthesia was deepened with propofol (3 mg/kg) intravenous injection. The data of cerebral tissue oxygen saturation(SctO2), mean arterial pressure (MAP), HR, bispectral index (BIS), arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), hemoglobin (Hb) and middle cerebral artery (MCA) mean flow velocity (Vm) at different points were collected after intravenous injection of propofol at 3 mg/kg...
March 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29700275/anesthesia-management-of-modified-ex-vivo-liver-resection-and-autotransplantation
#15
Fujun Cheng, Zhiyong Yang, Jing Zeng, Jianteng Gu, Jian Cui, Jiaoning Ning, Bin Yi
BACKGROUND Ex situ liver surgery allows liver resection and vascular reconstruction in patients who have liver tumors located in critical sites. Only a small series of studies about ex situ liver surgery is available in the literature. No anesthesia management experience has been previously published. The aim of the currents study was to summarize our experience with anesthetic management of patients during ex vivo liver surgery. MATERIAL AND METHODS The first 43 patients who received ex vivo liver surgery between January 2007 and April 2012 were included...
April 27, 2018: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29696106/evaluation-of-the-effect-of-aminophylline-in-reducing-the-incidence-of-acute-kidney-injury-after-cardiac-surgery
#16
Shahrbanoo Shahbazi, Peyman Alishahi, Elham Asadpour
Objectives: Acute renal failure is a common complication of major cardiovascular surgeries (One-third of patients). Adenosine release as a vascular vasodilator increases after cardiac surgery, which reduces renal and glomerular blood flow and subsequently causes kidney ischemic damage. The present study aimed at evaluating the impact of aminophylline as an adenosine receptor antagonist on renal function after cardiac surgery hoping to find an appropriate method to reduce acute kidney injury...
August 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29693944/unexpected-systolic-anterior-motion-of-the-mitral-valve-diagnosed-by-transthoracic-echocardiography-after-the-induction-of-general-anesthesia
#17
Toshiyuki Nakanishi, Manabu Yoshimura, Seishi Sakamoto, Takashi Toriumi
We report an 87-year-old woman who presented with unexpected systolic anterior motion (SAM) of the mitral valve after the induction of general anesthesia. She was receiving medication for hypertension and cerebral infarction. There were no abnormal findings on her preoperative transthoracic echocardiography (TTE) examination. After the induction of general anesthesia, she presented with refractory hypotension. We performed TTE and diagnosed SAM of the mitral valve. Her hemodynamic state was improved by fluid infusion and administering intravenous phenylephrine...
May 2017: Masui. the Japanese Journal of Anesthesiology
https://www.readbyqxmd.com/read/29692229/corticosteroids-and-other-anti-inflammatory-strategies-in-pediatric-heart-surgery-a-national-survey-of-practice
#18
Daniel P Fudulu, Alvin Schadenberg, Ben Gibbison, Ian Jenkins, Stafford Lightman, Gianni D Angelini, Serban Stoica
BACKGROUND: The role of steroids to mitigate the deleterious effects of pediatric cardiopulmonary bypass (CPB) remains a matter of debate; therefore, we aimed to assess preferences in administering corticosteroids (CSs) and the use of other anti-inflammatory strategies in pediatric cardiac surgery. METHODS: A 19-question survey was distributed to consultants in pediatric cardiac anesthesia from 12 centers across the United Kingdom and Ireland. RESULTS: Of the 37 respondents (37/60, 62%), 24 (65%) use CSs, while 13 (35%) do not use steroids at all...
May 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29685887/cardiopulmonary-resuscitation-in-infants-and-children-with-cardiac-disease-a-scientific-statement-from-the-american-heart-association
#19
REVIEW
Bradley S Marino, Sarah Tabbutt, Graeme MacLaren, Mary Fran Hazinski, Ian Adatia, Dianne L Atkins, Paul A Checchia, Allan DeCaen, Ericka L Fink, George M Hoffman, John L Jefferies, Monica Kleinman, Catherine D Krawczeski, Daniel J Licht, Duncan Macrae, Chitra Ravishankar, Ricardo A Samson, Ravi R Thiagarajan, Rune Toms, James Tweddell, Peter C Laussen
Cardiac arrest occurs at a higher rate in children with heart disease than in healthy children. Pediatric basic life support and advanced life support guidelines focus on delivering high-quality resuscitation in children with normal hearts. The complexity and variability in pediatric heart disease pose unique challenges during resuscitation. A writing group appointed by the American Heart Association reviewed the literature addressing resuscitation in children with heart disease. MEDLINE and Google Scholar databases were searched from 1966 to 2015, cross-referencing pediatric heart disease with pertinent resuscitation search terms...
April 23, 2018: Circulation
https://www.readbyqxmd.com/read/29685796/fluids-and-organ-dysfunction-a-narrative-review-of-the-literature-and-discussion-of-5-controversial-topics
#20
Adam J Kingeter, Meredith A Kingeter, Andrew D Shaw
Evidence-based clinical decision making is at the forefront of modern cardiothoracic anesthesia practice. Therefore, as a field, cardiac anesthesiologist should strive to ensure that the available evidence is of the highest possible quality. In this narrative review, 5 important topics that the authors believe require additional investigation in cardiothoracic anesthesia and critical care related to fluid therapy and organ dysfunction are outlined briefly. In particular, the authors believe that the areas of pulmonary artery catheter use, restrictive versus liberal transfusion strategies, cardiopulmonary bypass prime composition, colloid use in resuscitation and its effects on acute kidney injury, and management of acute kidney injury after cardiac surgery hold many unanswered questions and opportunities for continued improvement in the specialty of cardiac anesthesia...
March 13, 2018: Journal of Cardiothoracic and Vascular Anesthesia
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