Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Review Meta AnalysisReducing Mortality in Acute Kidney Injury Patients: Systematic Review and International Web-Based Survey.
To identify all interventions that increase or reduce mortality in patients with acute kidney injury (AKI) and to establish the agreement between stated beliefs and actual practice in this setting. ⋯ The authors identified all interventions with at least 1 study suggesting a significant effect on mortality in patients with or at risk of AKI and found that there is discordance between participant stated beliefs and actual practice regarding these topics.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Randomized Controlled Trial Comparative StudyReversal of Decreases in Cerebral Saturation in High-risk Cardiac Surgery.
To measure the incidence of cerebral desaturation during high-risk cardiac surgery and to evaluate strategies to reverse cerebral desaturation. ⋯ Cerebral desaturation in high-risk cardiac surgery is frequent but can be reversed most of the time resulting in a smaller desaturation load. A large randomized study will be needed to measure the impact of reversing cerebral desaturation on patient's outcome.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Randomized Controlled Trial Comparative StudyCognitive Function and Oxidative Stress After Carotid Endarterectomy: Comparison of Propofol to Sevoflurane Anesthesia.
To examine the antioxidant role of propofol in ischemia-reperfusion during carotid endarterectomy (CEA) and its influence on cognitive dysfunction after CEA. ⋯ Propofol seemed to improve cognitive performance after CEA. This improvement was associated with decreased indices of ischemic cerebral damage and seemed to be due to antioxidative effect in the ischemic cerebral circulation.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
ReviewPerioperative Conduction Disturbances after Transcatheter Aortic Valve Replacement.
Cardiac conduction disturbances after transcatheter aortic valve replacement (TAVR) are common and important. The risk factors and outcome effects of atrial fibrillation after TAVR recently have been appreciated. The paucity of clinical trials has resulted in the absence of clinical guidelines for the management of this important arrhythmia in this high-risk patient population. ⋯ The current evidence base has described the incidence, risk factors, and current outcomes of this conduction disturbance in detail. As the practice of TAVR evolves and novel valve prostheses are developed, a focus on minimizing damage to the cardiac conductive system remains paramount. It remains to be seen how the next generation of TAVR prostheses will affect the incidence, risk factors, and clinical outcomes of associated conduction disturbances.
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J. Cardiothorac. Vasc. Anesth. · Dec 2013
Perioperative Acute Myocardial Infarction Increases Mortality Following Noncardiac Surgery.
To provide insight into diagnosis, treatment, and prevention of perioperative myocardial infarction (PMI). ⋯ PMI incidence increased significantly with advanced age. PMI increased mortality following non-cardiac surgery. The independent risk factors for death in PMI patients following noncardiac surgery were lack of anticoagulation/antiplatelet therapy and cardiogenic shock.