Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jan 2015
Central Venous-Arterial pCO2 and pH Difference Identifies Microcirculatory Hypoperfusion in Cardiac Surgical Patients With Normal Central Venous Oxygen Saturation: A Retrospective Analysis.
Parameters such as central venous oxygen saturation (ScvO2) are used increasingly to monitor adequate hemodynamic treatment. However, it still remains challenging to identify patients with assumed adequate circulatory status quantified by ScvO2 who suffer from macro- and microcirculatory hypoperfusion. The authors hypothesized that central venous-arterial pCO2 difference (dCO2) could serve as an additional parameter to evaluate the adequacy of perfusion in cardiac surgery patients. ⋯ The authors described dCO2 as a routinely available tool to detect global and microcirculatory hypoperfusion in postoperative cardiac surgical patients. The authors showed that in patients with an ScvO2≥70%, a high dCO2 (≥8 mmHg) was associated with increased postoperative lactate levels and decreased splanchnic function. These findings were associated with a longer need for mechanical ventilation and longer ICU stay.
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J. Cardiothorac. Vasc. Anesth. · Jan 2015
Impact of a Focused Transthoracic Echocardiography Training Course for Rescue Applications Among Anesthesiology and Critical Care Medicine Practitioners: A Prospective Study.
To investigate the impact of a sequence of educational interventions in a one-day course on focused transthoracic echocardiography (FOTE) by anesthesia and critical care practitioners. ⋯ A FOTE training course improves image acquisition skills and knowledge to the same level independently of professional background and level of experience in critical care ultrasound.
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J. Cardiothorac. Vasc. Anesth. · Jan 2015
Observational StudyPreoperative Brain Natriuretic Peptide and Atrial Arrhythmias After Coronary Artery Bypass Graft Surgery.
To assess the association of preoperative brain natriuretic peptide with atrial arrhythmias and length of stay after cardiac surgery. ⋯ The results indicated that elevated brain natriuretic peptide was associated with increased risk of atrial arrhythmias and prolonged length of hospital stay after cardiac surgery. Identifying at-risk patients is important to guide preventative strategies for postoperative atrial arrhythmias.