Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Comparative StudyCardiac Index Assessment by the Pressure Recording Analytic Method in Critically Ill Unstable Patients After Cardiac Surgery.
The authors measured cardiac index in unstable patients after cardiac surgery with the Pressure Recording Analytic Method (PRAM) and compared it with the reference method of thermodilution (ThD) with the pulmonary artery catheter; using the hypothesis that there were no significant differences between the 2 methods. ⋯ Cardiac index measurements after cardiac surgery performed with PRAM and with ThD showed a good agreement in hemodynamically unstable patients given high doses of inotropes and/or an IABP in patients in sinus rhythm, but not in those with atrial fibrillation.
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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 StudyEvaluation of the Impact of a Quality Improvement Program and Intensivist-Directed ICU Team on Mortality After Cardiac Surgery.
Quality improvement is an important pursuit for critical care teams. ⋯ Appointment of an intensivist-directed team model and introduction of quality improvement interventions were associated with decreased mortality after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Simplified Clinical Risk Score to Predict Acute Kidney Injury After Aortic Surgery.
The authors identified risk factors for acute kidney injury (AKI) defined by risk, injury, failure, loss, end-stage (RIFLE) criteria after aortic surgery with cardiopulmonary bypass and constructed a simplified risk score for the prediction of AKI. ⋯ The model would provide a simplified clinical score stratifying the risk of postoperative AKI in patients undergoing aortic surgery.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Transfusion of Allogeneic Blood Products in Proximal Aortic Surgery With Hypothermic Circulatory Arrest: Effect of Thromboelastometry-Guided Transfusion Management.
Proximal aortic surgery with hypothermic circulatory arrest (HCA) commonly involves perioperative transfusion of allogeneic blood products, including red blood cells, plasma, and platelets. The authors hypothesized that surgery with HCA could be performed without allogeneic blood products and that a thromboelastometry-guided algorithm would reduce the transfusion of allogeneic blood products. ⋯ Allogeneic blood products were avoided in a proportion of patients. The findings further suggest that thromboelastometry-guided coagulation management promoting the use of coagulation factor concentrates decreased the use of allogeneic blood products during complex cardiac surgery.