Journal of cardiothoracic and vascular anesthesia
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In this review, the authors discussed criteria for diagnosing ALI; incidence, etiology, preoperative risk factors, intraoperative management, risk-reduction strategies, treatment, and prognosis. The anesthesiologist needs to maintain an index of suspicion for ALI in the perioperative period of thoracic surgery, particularly after lung resection on the right side. Acute hypoxemia, imaging analysis for diffuse infiltrates, and detecting a noncardiogenic origin for pulmonary edema are important hallmarks of acute lung injury. ⋯ NO is not recommended as a treatment. Strategies such as bronchodilation, smoking cessation, steroids, and recruitment maneuvers are unproven to benefit mortality although symptomatically they often have been shown to help ALI patients. Further studies to isolate biomarkers active in the acute setting of lung injury and pharmacologic agents to inhibit inflammatory intermediates may help improve management of this complex disease.
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J. Cardiothorac. Vasc. Anesth. · Aug 2010
Comparative StudyComparison of spectral entropy and bispectral index electroencephalography in coronary artery bypass graft surgery.
The study's aim was to compare response entropy (RE) and state entropy (SE) with bispectral index (BIS) electroencephalography (EEG) as an alternative cerebral monitoring tool in patients scheduled for coronary artery bypass graft surgery. ⋯ RE and SE are comparable with the BIS but showed significantly less interference from f-EMG and superior resistance against artifacts. Thus, spectral entropy is more suitable than the BIS during propofol-remifentanil anesthesia in cardiac surgery patients.
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J. Cardiothorac. Vasc. Anesth. · Aug 2010
Comparative StudyPreoperative dispositional optimism correlates with a reduced incidence of postoperative delirium and recovery of postoperative cognitive function in cardiac surgical patients.
To determine if preoperative psychosocial factors including dispositional optimism, perceived social support, and perceived stress correlate with the recovery of postoperative cognition. ⋯ Preoperative dispositional optimism, but not perceived social support, perceived stress, and depression positively correlated with a reduced incidence of postoperative delirium within 5 days and recovery of cognitive performance 1 week after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Aug 2010
Comparative StudyExtending the use of the pacing pulmonary artery catheter for safe minimally invasive cardiac surgery.
In this study, the therapeutic use of pacing pulmonary artery catheters in association with minimally invasive cardiac surgery was evaluated. ⋯ In combination with minimally invasive cardiac surgery, pacing pulmonary artery catheters were therapeutically useful to induce ventricular fibrillatory arrest intraoperatively and for obtaining pacing capability in the postoperative period. Their use was associated with a low number of complications.