Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2017
Randomized Controlled TrialUse of McGrath MAC Videolaryngoscope to Assist Transesophageal Echocardiography Probe Insertion in Intubated Patients.
Transesophageal echocardiography (TEE) probe insertion with the conventional blind insertion technique may be difficult in anesthetized and intubated patients. The use of a videolaryngoscope may facilitate the insertion of the TEE probe. The aim of this study was to compare the conventional technique with the use of the McGrath MAC videolaryngoscope for TEE probe insertion in terms of success rate, duration of insertion, and complications in patients undergoing cardiovascular surgery. ⋯ The use of the McGrath MAC videolaryngoscope for TEE insertion in cardiovascular surgery patients increases the success rate and reduces pharyngeal injuries compared to the conventional technique. The use of the McGrath MAC videolaryngoscope for TEE insertion causes similar hemodynamic changes as in the conventional blind insertion technique.
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J. Cardiothorac. Vasc. Anesth. · Feb 2017
Surgery Start Time Does Not Impact Outcome in Elective Cardiac Surgery.
Determine if surgery start time impacts patient outcomes in elective cardiac surgery. ⋯ The authors' results suggested that elective cardiac surgery may be performed late at night without adverse effects, although institutional support for this effort (such as 24-hour intensivist coverage to facilitate fast-track extubation) may have been integral to their findings.
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J. Cardiothorac. Vasc. Anesth. · Feb 2017
Observational StudyReinfusate Heparin Concentrations Produced by Two Autotransfusion Systems.
Cell saver reinfusate ideally should contain low, clinically insignificant heparin concentrations. The American Association of Blood Banks has defined the clinically insignificant threshold as 0.5 IU/mL. Furthermore, there is uncertainty about the meaning of cell saver "heparin elimination rates." These concerns prompted the authors' independent investigation of reinfusate heparin concentrations of devices used in their institution. It was hypothesized that cell saver reinfusates contain clinically insignificant heparin concentrations. ⋯ Sorin (Dideco) Electa reinfusates contained heparin concentrations below the American Association of Blood Banks recommended threshold in 90.6% of cases, while Sorin Xtra reinfusate heparin concentrations exceeded this recommendation in 56% of cases. Measurement of cell saver reinfusate heparin concentrations necessitates the use of a modified chromogenic assay. Studies explicitly should confirm that such a modification was indeed used. Periodic quality control of reinfusate composition is recommended.
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J. Cardiothorac. Vasc. Anesth. · Feb 2017
Pulmonary Artery Catheter Placement Using Transesophageal Echocardiography.
To assess the feasibility of pulmonary artery catheter placement using transesophageal echocardiography inclusive of a description of the technique. ⋯ Transesophageal echocardiography is a viable adjunctive method to conventional pressure waveform placement of pulmonary artery catheters in potentially difficult patients.