Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2015
Multicenter Study Observational StudyTransesophageal Echocardiography Guidance of Antegrade Cardioplegia Delivery for Cardiac Surgery.
The initial volume of antegrade cardioplegia used to induce asystole during aortic cross-clamp still is based on empiric methods and may be excessive, potentially leading to hyperkalemia, myocardial edema, and acute left ventricular distention from aortic regurgitation. The objectives were to determine whether the volume of cardioplegia required to induce asystole is proportional to left ventricular mass, and whether the degree of left ventricular distention is proportional to the severity of aortic regurgitation. ⋯ Estimated left ventricular mass is not a useful predictor of the initial volume of antegrade cardioplegia required to induce asystole. However transesophageal echocardiography can predict and monitor for left ventricular distention, which is common.
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J. Cardiothorac. Vasc. Anesth. · Dec 2015
Evaluation of the Double-lumen Tube Vivasight-DL (DLT-ETView): A Prospective Single-center Study.
VivaSight-DL (DLT-ETView) is a single-use double-lumen tube (DLT) with an integrated camera visualizing the carina continuously, which could reduce the need for a routine fiberoptic bronchoscopy. The objective of this study was to evaluate its rate of correct positioning. ⋯ The tube was well positioned in almost all patients. Continuous visualization of the carina is a major improvement for patient care as intraoperative displacement can be diagnosed immediately and corrected. However, an incident induced premature ending of the study.
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J. Cardiothorac. Vasc. Anesth. · Dec 2015
Randomized Controlled TrialVideo Fluoroscopy for Positioning of Pulmonary Artery Catheters in Patients Undergoing Cardiac Surgery.
To determine whether video fluoroscopy combined with traditional pressure waveform analyses facilitates optimal pulmonary artery catheter (PAC) flotation and final positioning compared with the traditional pressure waveform flotation technique alone. ⋯ In cardiac surgery patients at higher risk for PAC complications, video fluoroscopy facilitated faster and safer catheter flotation and positioning compared with the traditional pressure waveform flotation technique.
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J. Cardiothorac. Vasc. Anesth. · Dec 2015
Observational StudyIndependent Risk Factors for Fast-track Failure Using a Predefined Fast-track Protocol in Preselected Cardiac Surgery Patients.
The purpose of this study was to identify the independent risk factors for fast-track failure (FTF) in cardiac surgery patients. ⋯ In a preselected patient population, fast-track treatment could be done with a low FTF rate. Independent risk factors for FTF are age, female sex, prolonged surgery, and prolonged cross-clamp time.
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J. Cardiothorac. Vasc. Anesth. · Dec 2015
Observational StudyUrinary Neutrophil Gelatinase-Associated Lipocalin as Predictor of Short- or Long-Term Outcomes in Cardiac Surgery Patients.
To determine the ability of urinary neutrophil gelatinase-associated lipocalin (uNGAL) to predict cardiac surgery-associated acute kidney injury (CSA-AKI), continuous renal replacement therapy (CRRT), mortality, and a composite outcome of major adverse kidney events at 365 days (MAKE365), and to investigate the influence of cardiopulmonary bypass (CPB) on NGAL release. ⋯ uNGAL had a limited predictive ability for CSA-AKI or other relevant clinical outcomes after cardiac surgery and appeared to be more closely related to the use and duration of CPB. Thus, its levels may represent the aggregate effect of an inflammatory response to CPB as well as a renal response to cardiac surgery and inflammation.