Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Takotsubo cardiomyopathy (TTCM) is a form of stress cardiomyopathy that may occur in the perioperative period and among the critically ill. Therefore, anesthesiologists should be aware of its diagnosis and treatment. The aim of this narrative review is describe the features of TTCM and its relevance to the practice of anesthesiology. ⋯ Perioperative TTCM is more common than appreciated and should be considered in any hospitalized patient presenting with acute coronary syndrome and/or hemodynamic instability, acute respiratory distress, as well as cardiac arrhythmias and arrest.
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Comparative Study
Postoperative environmental anesthetic vapour concentrations following removal of the airway device in the operating room versus the postanesthesia care unit.
This study was designed to compare waste anesthetic gas (WAG) concentrations within patients' breathing zones after removal of the patient's airway device in the postanesthesia care unit (PACU) vs in the operating room (OR). ⋯ After a volatile-based anesthetic, our results suggest that removal of the airway device in the PACU vs in the OR increases the amount of waste anesthetic gas in a patient's breathing zone and thus potentially in the PACU nurse's working zone.
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Observational Study
Assessment of fluid responsiveness with end-tidal carbon dioxide using a simplified passive leg raising maneuver: a prospective observational study.
Assessing fluid responsiveness is important in the management of patients with hemodynamic instability. Passive leg raising (PLR) is a validated dynamic method to induce a transient increase in cardiac preload and predict fluid responsiveness. Variations in end-tidal carbon dioxide (ETCO2) obtained by capnography correlate closely with variations in cardiac output when alveolar ventilation and carbon dioxide production are kept constant. In this prospective observational study, we tested the hypothesis that variations in ETCO2 induced by a simplified PLR maneuver can track changes in the cardiac index (CI) and thus predict fluid responsiveness. ⋯ Use of a passive leg raising maneuver to induce variation in ETCO2 is a noninvasive and useful method to assess fluid responsiveness in paralyzed cardiac surgery patients receiving mechanical ventilation. Given its high NPV, fluid responsiveness is unlikely if a passive leg raising maneuver induces ΔETCO2 of < 2 mmHg.
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Letter Randomized Controlled Trial
Dual-route tranexamic acid to reduce blood loss in coronary artery bypass graft surgery: a randomized controlled trial.