Journal of cardiothoracic and vascular anesthesia
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Over the past decade, the role of the anesthesiologist has evolved continuously into a sine qua non component of the EP team, having intimate knowledge of the complex interventional procedures and the specific demands of the EP environment. With emphasis on coordination of care, resource optimization, and implementation of a climate of teamwork and collaboration, the anesthesiologist very likely will assume an even more enhanced role in the future. Future design of the EP suite ergonomics must take into account the needs of the anesthesia team to improve procedural workflow and maintain the focus on the patient.
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J. Cardiothorac. Vasc. Anesth. · Dec 2014
Acute Kidney Injury Is Independently Associated With Higher Mortality After Cardiac Surgery.
To investigate the incidence of acute kidney injury after cardiac surgery and its association with mortality in a patient population receiving ibuprofen and gentamicin perioperatively. ⋯ More than 28% of the patients undergoing elective or subacute cardiac surgery developed AKI in this contemporary cohort. Furthermore, acute kidney injury was an independent predictor of increased mortality irrespective of the perioperative risk factors.
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J. Cardiothorac. Vasc. Anesth. · Dec 2014
Observational StudyPreoperative Depression Symptom Severity and Its Impact on Adherence to Preoperative Beta-Blocker Therapy.
To test the association among depression symptoms, distressed personality type, and preoperative beta-blocker nonadherence and to estimate the prevalence of untreated major depression in this population. ⋯ Patients with symptoms of depression on chronic beta-blocker therapy are susceptible to medication nonadherence on the day of surgery. Most surgical patients with symptoms of major depression lack a diagnosis of depression. Preoperative depression screening may thus (1) identify a population at increased risk of beta-blocker withdrawal, and (2) identify patients who may benefit from anesthesiologist-initiated referral for this treatable condition.
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J. Cardiothorac. Vasc. Anesth. · Dec 2014
Dose-Dependent Effects of Intraoperative Low Volume Red Blood Cell Transfusions on Postoperative Outcomes in Cardiac Surgery Patients.
To determine the incremental risk associated with each intraoperative red blood cell transfusion in cardiac surgery patients. ⋯ There is a step-wise increase in length of postoperative intubation with each red blood cell transfusion in patients undergoing cardiac surgery. Each additional unit of intraoperative RBC transfusion also may increase postoperative infectious complications. Thus, even single-unit reductions in red blood cell transfusions may have significant impact on outcomes.
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J. Cardiothorac. Vasc. Anesth. · Dec 2014
Real-World Outcomes of Hemostatic Matrices in Cardiac Surgery.
While hemostatic matrices are efficacious in achieving hemostasis, outcomes research is limited; therefore, this study analyzed clinical outcomes of flowable hemostatic matrices in a real-world cardiac surgical population. ⋯ These retrospective outcomes suggested FLOSEAL was associated with fewer negative consequences than SURGIFLO in this surgical population.