Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2014
Randomized Controlled TrialImpact of Perioperative Blood Pressure Variability on Health Resource Utilization After Cardiac Surgery: An Analysis of the ECLIPSE Trials.
To examine the impact of blood pressure control on hospital health resource utilization using data from the ECLIPSE trials. ⋯ Based on data derived from the ECLIPSE studies, increased perioperative BP variability is associated with delayed time to extubation and increased postoperative LOS.
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J. Cardiothorac. Vasc. Anesth. · Jun 2014
Observational StudyDecline in serum hemoglobin in the 7 days after cardiac catheterization.
Bleeding is an established complication following cardiac catheterization and lower preoperative hemoglobin concentration is a potentially modifiable risk factor for adverse outcomes after cardiac surgery. However, typical changes in serum hemoglobin concentration after cardiac catheterization are poorly defined. The authors sought to identify the pattern of change in serum hemoglobin concentration within 7 days after cardiovascular catheterization, factors associated with this change and any association with adverse outcomes. ⋯ In a cohort of patients before cardiac surgery serum hemoglobin declines during the week after cardiac catheterization, with maximal average decline observed 5 to 7 days after catheterization.
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J. Cardiothorac. Vasc. Anesth. · Jun 2014
Case Reports Observational StudyIntrathecal Lactate as a Predictor of Early- but Not Late-Onset Spinal Cord Injury in Thoracoabdominal Aneurysmectomy.
To evaluate the role of intrathecal lactate as an early predictor of spinal cord injury during thoracoabdominal aortic aneurysmectomy. ⋯ Preoperative cerebrospinal lactate concentration is elevated in patients who will develop early-onset spinal cord injury after thoracoabdominal aortic aneurysmectomy. This may allow a better stratification of these patients, suggesting a more aggressive strategy of spinal cord function preservation, such as systematic reimplanting of intercostal arteries, and possibly obtaining a better outcome.
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J. Cardiothorac. Vasc. Anesth. · Jun 2014
Clinical TrialTissue Hemoglobin Monitoring Is Unable to Follow Variations of Arterial Hemoglobin During Transitions From Pulsatile to Constant Flow in Cardiac Surgery.
To test whether the variations of tissue hemoglobin concentration (∆THb) measured by the FORE-SIGHT(TM) cerebral oximeter can accurately detect changes in arterial hemoglobin concentration (∆AHb) before, during, and after cardiopulmonary bypass. ⋯ Continuous monitoring of THb cannot accurately track variations of AHb during the transition from pulsatile to continuous flow and vice versa in cardiac surgery. Local hemodynamic factors such as PaCO2 and vasodilation significantly impact THb. In this setting, THb monitoring should not be used to guide eventual blood transfusion management.
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J. Cardiothorac. Vasc. Anesth. · Jun 2014
Comparative StudyComparison of Pulmonary Complications in Patients Undergoing Transcatheter Aortic Valve Implantation Versus Open Aortic Valve Replacement.
The purpose of this study was to investigate and compare the differences in postoperative pulmonary complications in patients undergoing aortic valve replacement by open repair (OAVR) versus those undergoing transcatheter aortic valve implantation by the transapical approach (TAVI-A) or transfemoral approach (TAVI-F). ⋯ Due to the high incidence of multiple comorbidities and increased age, it is important to take into consideration the risk of pulmonary complications when choosing the surgical and anesthetic approach to TAVI in this high-risk group of patients.