Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2014
Observational StudyEffectiveness of Laser Doppler Perfusion Monitoring in the Assessment of Microvascular Function in Patients Undergoing On-Pump Coronary Artery Bypass Grafting.
To evaluate the effectiveness of single-point laser Doppler perfusion monitoring (LDPM) in the assessment of microvascular reactivity in the skin during cardiopulmonary bypass (CPB). ⋯ Using LDPM, the authors showed that the microcirculatory bed of the skin of the forehead, which is readily accessible during cardiac surgery, is a suitable model for the study of microvascular reactivity and tissue perfusion in cardiovascular surgical procedures using CPB. This technique could, thus, be suitable for evaluating the effects of drugs or technical procedures on tissue perfusion during cardiac surgery under cardiopulmonary bypass.
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J. Cardiothorac. Vasc. Anesth. · Oct 2014
Current Use of Ultrasound Transmission Gel for Transesophageal Echocardiogram Examinations: A Survey of Cardiothoracic Anesthesiology Fellowship Directors.
Ultrasound transmission gel (USTG) is used routinely to enhance the image quality during transesophageal echocardiogram examinations. Ultrasound gel is manufactured in both sterile and non-sterile preparations, and both preparations have been used during transesophageal echocardiograms in the United States. The United States Food and Drug Administration (FDA) currently recommends that all transesophageal echocardiogram (TEE) examinations be performed using sterile ultrasound gel. The authors sought to identify if anesthesiology departments with cardiothoracic fellowship programs follow current FDA recommendations of using sterile ultrasound gel during TEE examination. ⋯ A majority of cardiothoracic program director respondents to the authors' survey do not utilize single-use sterile packets of USTG for TEE examinations. While the infectious risk of USTG used for TEE examinations from multiple-use containers versus single-use sterile containers has not been established clearly, a change in practice to follow the current FDA recommendations may be advised.
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J. Cardiothorac. Vasc. Anesth. · Oct 2014
Anesthesia and LEOPARD Syndrome: A Review of Forty-nine Anesthetic Exposures.
LEOPARD syndrome is a rare congenital disease that can manifest with cardiac anomalies, multiple lentigines, ocular hypertelorism, growth retardation, and deafness. The purpose of this case series was to review the most prominent comorbidities associated with LEOPARD syndrome, and describe perioperative outcomes in a series of patients undergoing anesthesia. ⋯ Dominant pathology associated with perioperative complications in patients with LEOPARD syndrome is related to cardiac disease. A large proportion of patients with this condition have ventricular septal hypertrophy, which tends to progress with age; therefore, these patients undergoing anesthesia should have recent cardiologist evaluation.