Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Comparative Study Observational StudyFloTrac/Vigileo(TM) (Third Generation) and MostCare(®)/PRAM Versus Echocardiography for Cardiac Output Estimation in Vascular Surgery.
To compare the FloTrac/Vigileo(TM) cardiac output (COFT/V) and the MostCare(®)/PRAM cardiac output (COMC/P) versus transthoracic echocardiographic cardiac output estimation (reference method; CO(ECHO)). ⋯ In patients undergoing vascular surgery, the FloTrac/Vigileo(TM) did not demonstrate that it was a reliable system for CO monitoring when compared with echocardiography-derived CO. However, MostCare(®)/PRAM was shown to estimate CO with a good level of agreement with echocardiographic measures.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Case ReportsEffects of Body Surface Area-Indexed Calculations in the Morbidly Obese: A Mathematical Analysis.
Cardiac and stroke indices routinely are used to communicate the adequacy of circulation, especially by cardiac anesthesiologists. However, indexed values may be distorted when derived using conventional formulae on morbidly obese patients. In extreme cases, distortion of the raw value by the indexed value may suggest inappropriate therapeutic interventions. This study attempted to highlight threshold values of body surface area (BSA) that place morbidly obese patients at risk of being overtreated. ⋯ In morbidly obese patients, cardiac and stroke indices can be misleading relative to the underlying raw values (CO and SV) as a result of distortion by widely used BSA formulae. The authors caution against relying on threshold cardiac and stroke indices as triggers for the initiation of hemodynamic therapies in the morbidly obese. Further research on what BSA formula should be used on patients with very extreme body types is warranted.
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The object of this study was to conduct and analyze the output of a survey involving a cohort of all Italian hospitals performing thoracic surgery to gather data on anesthetic management, one-lung ventilation (OLV) management, and post-thoracotomy pain relief in thoracic anesthesia. ⋯ The results of this survey showed that Italian anesthesiologist follow the recommended standard of care for anesthetic management during OLV.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Review Comparative StudyGeneral Versus Regional Anesthesia for Carotid Endarterectomy.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Observational StudyIncorporating Oliguria Into the Diagnostic Criteria for Acute Kidney Injury After On-Pump Cardiac Surgery: Impact on Incidence and Outcomes.
Consensus definitions represent an important step toward defining the epidemiology of acute kidney injury (AKI). However, the oliguric component of these definitions remains of uncertain impact and utility after cardiac surgery. The authors sought to define the specific impact of oliguric criteria, both alone and in combination with serum creatinine criteria, on the observed incidence of AKI and associated adverse outcomes following adult cardiac surgery. ⋯ 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.