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
Meta AnalysisMeta-analysis on the Performance of the EuroSCORE II and the Society of Thoracic Surgeons Scores in Patients Undergoing Aortic Valve Replacement.
To evaluate the performance of the EuroSCORE II (ESII) and the Society of Thoracic Surgeons (STS) scores in surgical (SAVR) or transcatheter aortic valve replacement (TAVR). ⋯ The ESII and STS scores have good O/E ratios for either TAVR or SAVR patients, but both scores significantly underpredicted the risk of TAVR patients. ESII seemed to be accurate in predicting the risk of SAVR patients.
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J. Cardiothorac. Vasc. Anesth. · Dec 2014
ReviewThe PhysiologicPerspective in FluidManagement in VascularAnesthesiology.
Vascular surgery patients frequently suffer from atherosclerosis and peripheral arterial occlusive disease generating endothelial dysfunction. Furthermore, ischemia and reperfusion during surgery damage endothelial cells and, especially, the endothelial glycocalix. The damage of the glycocalix promotes an increase in permeability. ⋯ From a theoretical physiologic point of view, iso-osmolar albumin is the best choice regarding volume effect, antioxidative properties, and protection against destruction of the glycocalix. Nonetheless, albumin experimentally has not lived up to its promise in the clinical setting. Thus, further well-conducted large randomized clinical trials are necessary to ascertain the optimal fluid therapy in vascular surgery patients.