Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Dec 2014
P-Wave Characteristics on Routine Preoperative Electrocardiogram Improve Prediction of New-Onset Postoperative Atrial Fibrillation in Cardiac Surgery.
To test the hypothesis that including preoperative electrocardiogram (ECG) characteristics with clinical variables significantly improves the new-onset postoperative atrial fibrillation prediction model. ⋯ Several p-wave characteristics are independently associated with postoperative atrial fibrillation. Addition of these parameters improves the postoperative atrial fibrillation prediction model.
-
J. Cardiothorac. Vasc. Anesth. · Dec 2014
Observational StudyAortic Valve Replacement Reduces Valvuloarterial Impedance but Does Not Affect Systemic Arterial Compliance in Elderly Men with Degenerative Calcific Trileaflet Aortic Valve Stenosis.
Standard methods of quantifying aortic valve stenosis (AS), which focus entirely on the valve itself, do not adequately characterize the magnitude, predict the onset, progression, and severity of symptoms, or identify the incidence of subsequent adverse events. Valvuloarterial impedance (Z(va)) is an index of global left ventricular (LV) afterload that incorporates valvular and arterial loads. The authors tested the hypothesis that aortic valve replacement (AVR) reduces Z(va) but does not affect the arterial component of LV afterload in elderly patients with degenerative calcific trileaflet AS. ⋯ The current results showed that AVR acutely reduced Zva, improved energy loss index, and decreased stroke work loss, but did not affect systemic arterial compliance in elderly men with degenerative calcific trileaflet AS.
-
J. Cardiothorac. Vasc. Anesth. · Dec 2014
Association of Preoperative Uric Acid and Acute Kidney Injury Following Cardiovascular Surgery.
Recent studies suggested that elevated serum uric acid levels may be associated with the risk of acute kidney injury (AKI) in several settings. However, the effect of uric acid on the risk of AKI after cardiovascular surgery remains uncertain. ⋯ Preoperative elevated serum uric acid is an independent risk factor for AKI in patients undergoing cardiovascular surgery. This finding suggests that preoperative measurements of serum uric acid concentration may help stratify risks for AKI in these patients.
-
J. Cardiothorac. Vasc. Anesth. · Dec 2014
Advancing Extubation Time for Cardiac Surgery Patients Using Lean Work Design.
Early extubation in select cardiac surgery patients reduces tracheal intubation times, intensive care unit length of stay, and hospital length of stay. While there is good evidence in the literature to support early extubation, there is very little published research that describes how to study and redesign processes of care to increase early extubation rates. ⋯ The closely planned, coordinated, and integrated care paradigm dramatically increased the likelihood of extubation within 6 hours of arrival in the SICU.