Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Dec 2013
Preoperative Mild Cognitive Dysfunction Predicts Pulmonary Complications After Coronary Artery Bypass Graft Surgery.
In elderly patients with mild cognitive impairment, noncompliance with respiratory exercises, ineffective expectoration, reluctance in mobilization, and difficulty in learning the use of drugs such as inhalers were observed in the early postoperative period after coronary artery bypass graft surgery. It was hypothesized that respiratory complications may be more frequent in these patients, and so the postoperative respiratory complications in patients with preoperative mild cognitive impairment were compared with the postoperative respiratory complications of a control group. ⋯ This study suggested that mild cognitive impairment was associated with pulmonary complications after coronary artery bypass graft surgery.
-
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.
-
J. Cardiothorac. Vasc. Anesth. · Dec 2013
High Thoracic Epidural Analgesia as an Adjunct to General Anesthesia is Associated with Better Outcome in Low-to-Moderate Risk Cardiac Surgery Patients.
The purpose of this study was to evaluate the addition of high thoracic epidural analgesia (HTEA) to general anesthesia in cardiac surgery patients to enhance the fast-track and improvement in outcome. ⋯ This large, uniquely matched single-center cohort was generated, and, subject to the listed limitations the authors concluded that supplemental HTEA to general anesthesia had a better outcome in low-risk cardiac surgery patients, with a significantly lower 6-month mortality rate compared with the control group. However, regression analysis revealed that HTEA only had an independently positive effect on the frequency of postoperative dialysis.