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cardiac surgery and anesthesia

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https://www.readbyqxmd.com/read/29457116/a-spinal-cord-infarction-that-occurred-after-laparoscopic-gastrectomy-performed-under-general-anesthesia-and-epidural-analgesia
#1
Kei Houri, Shinichi Hamasaki, Takatoshi Tsujimoto, Tomohisa Uchida, Tatsushige Iwamoto, Toru Shirai, Shinichi Nakao
Background: Spinal cord infarction (SCI) after epidural anesthesia is quite rare. Although most cases of perioperative SCI are associated with aortic, cardiac, or spinal surgery, and/or abnormal preoperative conditions, such as spinal stenosis or hypercoagulopathy, intraoperative events, such as severe hypotension or epidural puncture and catheterization, can be contributory factors. Case presentation: A 52-year-old male was underwent laparoscopic gastrectomy. Before induction of general anesthesia, an epidural catheter was placed without any problems...
2018: JA Clin Rep
https://www.readbyqxmd.com/read/29430523/plasma-catecholamine-levels-on-the-morning-of-surgery-predict-post-operative-atrial-fibrillation
#2
Ethan J Anderson, Jimmy T Efird, Andy C Kiser, Patricia B Crane, Wesley T O'Neal, T Bruce Ferguson, Hazaim Alwair, Kendal Carter, J Mark Williams, Anil K Gehi, Alan P Kypson
OBJECTIVES: This study sought to determine whether plasma catecholamines and monoamine oxidase-B (MOA-B) are associated with post-operative atrial fibrillation (POAF) in patients undergoing elective cardiac surgery. BACKGROUND: Although intra- and post-operative adrenergic tone has been demonstrated to be an causative factor for POAF, the role and association of pre-operative plasma catecholamines remains unclear. METHODS: Prior to administration of anesthesia on the morning of surgery, blood samples were obtained from 324 patients undergoing nonemergent coronary artery bypass graft and/or aortic valve surgery with cardiopulmonary bypass at East Carolina Heart Institute...
December 11, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29427974/time-of-day-is-not-associated-with-increased-rates-of-mortality-in-emergency-surgery-an-analysis-of-49-196-surgical-procedures
#3
Rodney A Gabriel, Alison M A'Court, Ulrich H Schmidt, Richard P Dutton, Richard D Urman
STUDY OBJECTIVE: There is a lack of large, multi-institutional studies analyzing the association of timing of emergency surgery with death occurring either intraoperatively or in the recovery room setting. The primary objective of this study was to determine if time of day for emergency surgeries was associated with mortality. DESIGN: Retrospective analysis. SETTING: U.S. healthcare facilities. PATIENTS: Adult patients undergoing emergency surgery and general anesthesia...
February 7, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29424263/intraoperative-transesophageal-echocardiogram-during-orthotopic-liver-transplantation-tee-to-the-rescue
#4
Lorenzo De Marchi, Janice Lee, Nina Rawtani, Vinh Nguyen
Supported by a growing number of studies and case reports in the literature, perioperative use of TEE in non-cardiac cases has significantly increased the past two decades. The utility of TEE in monitoring hemodynamic, and diagnosing causes of hypotension refractory to conventional therapy, have made it an almost indispensible tool during major surgeries, such liver transplantation. Despite this fact, compared to the adult population, there is a lack of an equivalent amount of literature on the perioperative use of TEE in pediatric cases...
February 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29423554/performance-of-a-second-generation-pulmonary-capnotracking-system-for-continuous-monitoring-of-cardiac-output
#5
Philip J Peyton, Monique Kozub
Technologies for minimally-invasive cardiac output measurement in patients during surgery remain little used in routine practice. We tested a redeveloped system based on CO 2 elimination (VCO 2 ) by the lungs for use in ventilated patients, which can be seamlessly integrated into a modern anesthesia/monitoring platform, and provides automated, continuous breath-by-breath cardiac output monitoring. A prototype measurement system was constructed to measure VCO 2 and end-tidal CO 2 concentration with each breath...
February 8, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29422283/minimally-invasive-determinations-of-oxygen-delivery-and-consumption-in-cardiac-surgery-an-observational-study
#6
David T M Burtman, Annick Stolze, Selma E Kaffka Genaamd Dengler, Alexander B A Vonk, Christa Boer
OBJECTIVE: Evaluate minimally invasive assessment of oxygen delivery (DO2) and oxygen consumption (VO2) and determine its level of agreement with the gold standard approach of those measurements in patients undergoing cardiac surgery. DESIGN: Observational study. SETTING: Single center, VU University Medical Center (Amsterdam, The Netherlands). PARTICIPANTS: The study comprised 29 adult patients. INTERVENTION: Parallel measurements of invasive and minimally invasive parameters required for the calculation of DO2 and VO2...
June 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29398384/ultra-short-acting-%C3%AE-blockers-esmolol-and-landiolol-in-the-perioperative-period-and-in-critically-ill-patients
#7
REVIEW
Ricardo Poveda-Jaramillo, Fabrizio Monaco, Alberto Zangrillo, Giovanni Landoni
β-Blockers are useful drugs in several clinical cardiologic scenarios. Their use in the perioperative period and in critically ill patients is increasing, but their effect on clinically relevant outcomes remains controversial. Long-acting β-blockers can have detrimental effects that are difficult to be counteracted in these settings. The authors describe the possible clinical uses of ultra-short-acting β-blockers (esmolol and landiolol) in the perioperative period and in critically ill patients because these drugs have the beneficial effects of β-blockers, but do not have the detrimental effects of long-acting agents...
November 23, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29398373/history-of-cardiac-anesthesia-in-india
#8
Deepak K Tempe, Indira Malik
Before the 19th century, the heart was considered as a "no-go" area, although minor and superficial procedures were performed in the early 1800s. It was only in the later part of the century that surgical repair of the wounds of the cardiac chambers was attempted. Cardiac surgery came to India in the mid-20th century and the operations performed were minor and extracardiac. Initially, the surgeries were performed at a select few centers located at Mumbai, Vellore, Delhi, Chennai, and Kolkata. The anesthesiologists of an earlier era in India worked with limited facilities, and with their interest and devotion contributed immensely to the growth of the specialty of cardiac anesthesia...
December 20, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29390298/comparison-of-hemodynamic-effects-of-sevoflurane-and-ketamine-as-basal-anesthesia-by-a-new-and-direct-monitoring-during-induction-in-children-with-ventricular-septal-defect-a-prospective-randomized-research
#9
Ding Han, Ya-Guang Liu, Shoudong Pan, Yi Luo, Jia Li, Chuan Ou-Yang
BACKGROUND: Sevoflurane and ketamine are commonly used to obtain sedation and facilitate intravenous anesthetic induction in children undergoing cardiac surgery who are uncooperative. We used a new and direct systemic hemodynamic monitoring technique pressure recording analytical method and compared the hemodynamic effects of sevoflurane and ketamine to facilitate intravenous anesthetic induction. METHODS: Forty-four children with ventricular septal defect (2.2 ± 1...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29390270/anesthetic-management-of-off-pump-simultaneous-coronary-artery-bypass-grafting-and-lobectomy-case-report-and-literature-review
#10
Xian Zhao, Yuhong Li, Hai-Ying Kong, Lin Zhang, Xiao-Hong Wen
RATIONALE: Survey data show approximately 10% patients with lung cancer may present concomitant coronary heart disease. Simultaneous surgery is a challenge for anesthetist. We review our experience in the anesthesia with 5 patients who required simultaneous off-pump coronary artery bypass grafting (OPCABG) and pulmonary resection for lung cancer. PATIENT CONCERNS: Between 2014 and 2016, 5 patients with ASA (American Society of Anesthesiologists) grade II or III, underwent combined OPCABG and lung resection in the first Affiliated Hospital, Zhejiang University School of Medicine...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29357431/vascular-endothelial-cell-changes-in-post-cardiac-surgery-acute-kidney-injury
#11
Saqib H Qureshi, Nishith N Patel, Gavin J Murphy
BACKGROUND: Acute Kidney Injury (AKI) is common complication of cardiac surgery however the phenotype of this condition is poorly defined. The aim of this study was to characterize changes in endothelial structure and function that underlie post cardiopulmonary bypass (CPB) AKI. METHODS: Adult pigs (N=16) were randomised to undergo following procedures; (n=8 per group); Group 1: sham operation-neck dissection with 2.5hr of general anesthesia and Group 2: CPB-2.5hr of cardiopulmonary bypass...
December 20, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29318860/-effect-of-transcutaneous-acupoint-electrical-stimulation-on-hemodynamic-fluctuation-caused-by-loosing-tourniquet-in-elderly-patients-undergoing-knee-joint-replacement
#12
Han-Sheng Liang, Yi Feng
OBJECTIVE: To observe the effect of transcutaneous acupoint electrical stimulation (TAES) on hemodynamic fluctuation caused by loosing tourniquet in the elderly patients undergoing knee joint replacement. METHODS: A total of 60 ASA (America Society Anesthesiologist) I or II elderly patients for elective knee joint replacement surgery were randomly divided into control group (30 cases) and TAES group (30 cases). Patients of both groups were treated by intravenous anesthesia, and monitored with bispectral index (BIS, between 45-60) for anesthesia depth, stroke volume variation (SVV) for fluid management, mean arterial pressure (MAP) and cardiac index (CI) for hemodynamic fluctuation evaluation, and with analgesia nociception index (ANI, between 50-70) for remifentanil dosage adjustment...
December 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
https://www.readbyqxmd.com/read/29318795/isoflurane-s-effect-on-intraoperative-systolic-left-ventricular-performance-in-cardiac-valve-surgery-patients
#13
Ju Deok Kim, Ilsoon Son, Won Kyoung Kwon, Tae Yun Sung, Hanafi Sidik, Karam Kim, Hyun Kang, Jiyon Bang, Gwi Eun Yeo, Dong Kyu Lee, Tae Yop Kim
BACKGROUND: Isoflurane, a common anesthetic for cardiac surgery, reduced myocardial contractility in many experimental studies, few studies have determined isoflurane's direct impact on the left ventricular (LV) contractile function during cardiac surgery. We determined whether isoflurane dose-dependently reduces the peak systolic velocity of the lateral mitral annulus in tissue Doppler imaging (S') in patients undergoing cardiac surgery. METHODS: During isoflurane-supplemented remifentanil-based anesthesia for patients undergoing cardiac surgery with preoperative LV ejection fraction greater than 50% (n = 20), we analyzed the changes of S' at each isoflurane dose increment (1...
January 22, 2018: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/29317969/pulse-pressure-analysis-to-guide-intraoperative-phlebotomy-prior-to-cardiac-surgery
#14
Brian Schloss, Dmitry Tumin, Aymen Naguib, Julie Rice, Mark Galantowicz, Joseph D Tobias
Background: The aim of this study was to evaluate the response of the LiDCO-rapid™ during intraoperative phlebotomy in anesthetized children prior to surgery for congenital heart disease. Methods: After the induction of general anesthesia and endotracheal intubation, baseline vital signs were recorded, along with pulse pressure variability (PPV) and stroke volume variability (SVV) from the LiDCO-rapid™ and cerebral oxygenation (rSO2) using near-infrared spectroscopy (NIRS)...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29301459/the-effect-of-ultrafiltration-on-end-cardiopulmonary-bypass-hematocrit-during-cardiac-surgery
#15
Linda Mongero, Alfred Stammers, Eric Tesdahl, Andrew Stasko, Samuel Weinstein
OBJECTIVE: Ultrafiltration (UF) during cardiopulmonary bypass (CPB) is a well-accepted method for hemoconcentration to reduce excess fluid and increase hematocrit, platelet count and plasma constituents. The efficacy of this technique may confer specific benefit to certain patients presenting with acquired cardiac defects. The purpose of this study was to retrospectively evaluate the effect of UF on end-CPB hematocrit by cardiac surgical procedure type. METHODS: A review of 73,506 cardiac procedures from a national registry (SCOPE) was conducted between April 2012 and October 2016 at 197 institutions...
January 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29296053/nonfatal-pulmonary-embolism-associated-with-the-use-of-compression-stockings-in-the-lithotomy-position-after-spinal-anesthesia
#16
I-Wen Chen, Cheuk-Kwan Sun, Jen-Yin Chen, Chien-Ming Lin, Kuo-Chuan Hung
A 73-year-old male (height, 156 cm; body weight, 51 kg), without a history of cardiovascular disease or thromboembolic events, was scheduled for transurethral resection of the prostate under spinal anesthesia. Spinal anesthesia was administered with hyperbaric bupivacaine, resulting in an upper anesthetic level of T6. Before surgery, compression stockings were applied to both lower limbs, and the patient was placed in the lithotomy position. Approximately 15 min later, he complained of intolerable chest tightness, followed by tachycardia (heart rate, 110 beats/min) and desaturation (oxygen saturation [SaO2], 90%)...
October 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29289367/characterizing-predictors-and-severity-of-vasoplegia-syndrome-after-heart-transplantation
#17
Joshua L Chan, Jon A Kobashigawa, Tamar L Aintablian, Sadia J Dimbil, Paul A Perry, Jignesh K Patel, Michelle M Kittleson, Lawrence S Czer, Parham Zarrini, Angela Velleca, Jenna Rush, Francisco A Arabia, Alfredo Trento, Fardad Esmailian
BACKGROUND: Vasoplegia is characterized as a severe vasodilatory shock after cardiac surgery, and can be associated with substantial morbidity. Increased systemic inflammation and endothelial dysfunction, often related to prolonged cardiopulmonary bypass times, anesthesia, or mechanical circulatory support have been shown to be associated with the development of vasoplegia. We sought to identify risk factors and the impact of various degrees of vasoplegia after heart transplantation. METHODS: A retrospective review was conducted of 244 consecutive patients who underwent heart transplantation over a 3-year period...
December 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29286275/the-2017-seventh-world-congress-of-pediatric-cardiology-cardiac-surgery-week-in-review-congenital-cardiac-anaesthesia
#18
Mark Twite, Wanda Miller-Hance
The seventh meeting of the World Congress of Pediatric Cardiology and Cardiac Surgery was an opportunity for healthcare professionals from around the world to meet and discuss current issues affecting patients with acquired and CHD. A dedicated anaesthesia track facilitated the exchange of ideas and fostered many new friendships. This review highlights the congenital cardiac anaesthesia track and the involvement of the Congenital Cardiac Anesthesia Society in the congress.
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29285132/effects-of-dexmedetomidine-on-h-fabp-ck-mb-ctni-levels-neurological-function-and-near-term-prognosis-in-patients-undergoing-heart-valve-replacement
#19
Zhi Wang, Qiang Chen, Hao Guo, Zhishan Li, Jinfeng Zhang, Lei Lv, Yongqing Guo
This study investigated the effects of dexmedetomidine on heart-type fatty acid binding protein (H-FABP), creatine kinase isoenzymes (CK-MB), and troponin I (cTnI) levels, neurological function and near-term prognosis in patients undergoing heart valve replacement. Patients undergoing heart valve replacement were randomly allocated to remifentanil anesthesia (control group, n=48) or dexmedetomidine anesthesia (observation group, n=48). Hemodynamic parameters were measured before anesthesia induction (T1), 1 min after intubation (T2), 10 min after start of surgery (T3), and on completion of surgery (T4)...
December 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29284891/anesthetic-management-of-a-patient-with-dilated-cardiomyopathy-and-end-stage-renal-disease-for-emergency-strangulated-hernia-repair-surgery
#20
Gaurav Sindwani, Aditi Suri, Amit Rastogi
Dilated cardiomyopathy (DCMP) is a myocardial disease associated with dilatation of one or both the ventricles, impaired myocardial contractility, decreased cardiac output, and increased ventricular filling pressures. Patients with end-stage renal disease are dependent on renal replacement therapy to survive and often manifest with a variety of pathological organ dysfunction. We present a case of DCMP and chronic kidney disease posted for emergency reduction of strangulated umbilical hernia under general plus epidural anesthesia...
October 2017: Anesthesia, Essays and Researches
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