Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2016
Observational StudyPrognosis of Prolonged Intensive Care Unit Stay After Aortic Valve Replacement for Severe Aortic Stenosis in Octogenarians.
Octogenarians considered for cardiac surgery encounter more complications than other patients. Postoperative complications raise the question of continuation of high-cost care for patients with limited life expectancy. Duration of hospitalization in intensive care after cardiac surgery may differ between octogenarians and other patients. The objectives were evaluating the mortality rate of octogenarians experiencing prolonged hospitalization in intensive care and defining the best cut-off for prolonged intensive care unit length of stay. ⋯ Prolonged length of stay in ICU without organ failure is not associated with increased mortality. No specific duration of hospitalization in intensive care was associated with increased mortality. Continuation of care should be discussed on an individual basis.
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J. Cardiothorac. Vasc. Anesth. · Dec 2016
Observational StudyEffects of Levosimendan on Endothelial Function and Hemodynamics During Weaning From Veno-Arterial Extracorporeal Life Support.
Weaning from veno-arterial extracorporeal life support is challenging. The objective of this trial was to investigate the endothelial and hemodynamic effects of levosimendan in cardiogenic shock patients supported with veno-arterial extracorporeal life support. ⋯ In conclusion, in the authors' study population of adult cardiogenic shock patients supported with veno-arterial extracorporeal life support, their observations supported the use of levosimendan to improve endothelial function and hemodynamics and facilitate weaning from the extracorporeal support.
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J. Cardiothorac. Vasc. Anesth. · Dec 2016
Intra-abdominal Hypertension and Postoperative Kidney Dysfunction in Cardiac Surgery Patients.
To determine the incidence of intra-abdominal hypertension (IAH) in adult cardiac surgery patients and its association with postoperative kidney dysfunction. ⋯ IAH occurs frequently during the perioperative period in cardiac surgery patients and may be associated with postoperative kidney dysfunction.
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J. Cardiothorac. Vasc. Anesth. · Dec 2016
Controlled Clinical TrialThe Effect of Dexmedetomidine on Outcomes of Cardiac Surgery in Elderly Patients.
The goal of this retrospective study was to investigate the effects of perioperative use of dexmedetomidine (Dex) on outcomes for older patients undergoing cardiac surgery. ⋯ Results from this study (ClinicalTrials.gov identifier: NCT01683448) suggested perioperative use of dexmedetomidine was associated with decreases in in-hospital and operative mortality in elderly patients following cardiac surgery. It also reduced incidences of postoperative stroke and delirium in elderly patients.