Showing papers in "Journal of Cardiothoracic and Vascular Anesthesia in 2013"

TL;DR: The resuscitation of hemodynamically unstable patients requires an accurate assessment of the patients' intravascular volume status (cardiac preload) and the ability to predict the hemodynamic response after a fluid challenge (volume responsiveness) to minimize the risks of over- or under-resuscitation.

TL;DR: Bivalirudin-based antICOagulation may represent a new method of anticoagulation for reducing thromboembolic and bleeding complications, which still jeopardize the application of extracorporeal membrane oxygenation.

TL;DR: The use of point-of-care transfusion and coagulation management algorithms guided by viscoelastic tests based on first-line therapy with fibrinogen and prothrombin complex concentrate have been associated with reduced allogeneic blood transfusion requirements, reduced incidence of thrombotic/thromboembolic and transfusion-related adverse events, and improved outcomes in cardiac surgery.

TL;DR: Levosimendan was associated with reduced mortality and other adverse outcomes in patients undergoing cardiac surgery, and these benefits were greatest in patients with reduced EF, supporting the need for adequately powered randomized clinical trials to confirm the benefits of levosimendedan.

TL;DR: The cardioprotective effect may be attenuated when combined with β-blockers or volatile anesthetics, and available data from this meta-analysis further confirmed theCardioprotection conferred by RIPC in adult cardiac surgery.

TL;DR: A comprehensive compilation of inammatory mediators released during cardiac surgery and involved in intervention-driven therapies to ameliorate he inflammatory response and the development of subsequent rgan dysfunction has not been reviewed recently.

TL;DR: All interventions with at least 1 study suggesting a significant effect on mortality in patients with or at risk of AKI are identified and it is found that there is discordance between participant stated beliefs and actual practice regarding these topics.

TL;DR: Allogeneic blood products were avoided in a proportion of patients and thromboelastometry-guided coagulation management promoting the use of coagulations factor concentrates decreased the useof allogeneicBlood products during complex cardiac surgery.

TL;DR: Three-dimensional TEE can be used to measure the tricuspid annular area in a clinically feasible fashion, with an eccentric dilation seen in patients with TR, which is found that patients with greater TR had an eccentrically dilated annulus with a largerannular area.

TL;DR: Both EACA and TXA were equally effective in reducing the perioperative blood loss and transfusion requirement in patients undergoing thoracic aortic surgery and there was a tendency for higher incidence of seizure with TXA.

TL;DR: The use of methylene blue as treatment for vasoplegia to be independently associated with poor outcomes is identified and, perhaps, it should be relegated to rescue use and not as first-line therapy.

TL;DR: Volatile anesthetics were shown to protect myocardium against ischemic injury and maintain contractile function and ultrastructural integrity during reperfusion after normothermic cardioplegic arrest in isolated rat hearts.

TL;DR: Cerebral desaturation in high-risk cardiac surgery is frequent but can be reversed most of the time resulting in a smaller desaturation load and a large randomized study will be needed to measure the impact of reversing cerebral desaturation on patient's outcome.

TL;DR: Acute Kidney Injury Network oliguric criteria applied over 48 hours after surgery dramatically increased the measured incidence of AKI after cardiac surgery, but was not associated with adverse outcomes.

TL;DR: A simplified risk score based on regression β-coefficient would provide a simplified clinical score stratifying the risk of postoperative AKI in patients undergoing aortic surgery and showed a better performance compared with previously reported indices.

TL;DR: A reduction in RV failure with tezosentan was not observed in this study, and there was no difference in the incidence of RV failure between the two treatment groups.

TL;DR: General anesthesia is the predominant practice in North America and only 5% use sedation for TAVR cases, whereas sedation is more common in Europe.

TL;DR: Heparin rebound and incomplete heparin reversal are very common phenomena after cardiac surgery with CPB; ACT is not able to detect residual hepar in activity, whereas TEG analysis with and without heparInase allows the diagnosis of heparins rebound.

TL;DR: The results suggested that CPB may not be associated with cognitive decline that is associated with CABG surgery, and systematic review and meta-analysis of randomized control trials comparing cognitive outcome in patients undergoing CabG surgery on- or off-pump suggested this.

TL;DR: The specialty of LTX is likely to continue to flourish even more, given these pervasive advances, and the organization of dedicated anesthesia care teams for LTX improves perioperative outcome, which is receiving systematic attention to optimize safety and quality.

TL;DR: An updated meta-analysis of randomized trials in patients undergoing cardiac surgery to determine if milrinone impacted survival was unable to confirm an adverse effect on survival, but sensitivity analysis of high-quality trials showed a trend toward increased mortality with Milrinone.

TL;DR: The first decade of TAVR has ushered in a new paradigm for the multidisciplinary management of valvular heart disease and the second decade likely will build on this wave of initial success with further significant innovations.

TL;DR: The results of this survey showed that Italian anesthesiologist follow the recommended standard of care for anesthetic management during OLV, and thoracic epidural analgesia represented the "gold standard" for post-thoracotomy pain relief in combination with intravenous analgesia.

TL;DR: Doppler-based RRI can be helpful for noninvasive assessment of renal function recovery after cardiac surgery by using RRI(T0) to predict persistent acute kidney injury (AKI).

TL;DR: In this paper, the effects of propofol-based and dexmedetomidine-based sedation regimens on achieving early extubation, length of stay (LOS), ICU-LOS, total hospital costs, and mortality rates in cardiac surgery patients were evaluated.

TL;DR: The active long-lived me-tabolite OR-1896, also an inodilator, shows-sensitizing effect in the cardiac myofilaments.

TL;DR: Fibrinogen concentration significantly decreases after cardiopulmonary bypass and ROTEM helps in its fast detection.

TL;DR: In this paper, changes in PETCO2 and exhaled CO2 (VCO2) can predict fluid responsiveness after a preload challenge in a medical intensive care unit of a university-affiliated tertiary care hospital.