Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2018
Observational StudyPerioperative Hyperlactemia Is a Poor Predictor of Outcome in Patients Undergoing Surgery for Acute Type-A Aortic Dissection.
In patients presenting with acute type-A aortic dissection (aTAAD), lactic acid measurement is a frequently used analysis for diagnosis of acute ischemia, which may have a dismal prognosis. The aim of the current study was to determine the performance of perioperative arterial lactic acid measurements in predicting outcome in aTAAD patients. ⋯ Although hyperlactemia in aTAAD indicates an increased risk of postoperative mortality, the sole use of lactic acid levels as a tool for accurate assessment of postoperative mortality is inadvisable due to its poor discriminatory performance.
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J. Cardiothorac. Vasc. Anesth. · Dec 2018
Impact of Obesity on Noninvasive Cardiac Hemodynamic Measurement by Electrical Cardiometry in Adults With Aortic Stenosis.
There are substantial potential benefits to noninvasive cardiac monitoring methods, such as electrical cardiometry (EC), over more invasive methods, including significantly reduced risk of complications, lower up-front and operational costs, ease of use, and continuous monitoring. To take advantage of these technologies, clinical equivalence to currently established methods must be determined. The authors sought to determine if the noninvasive measurement of cardiac index (CI) by EC was clinically equivalent to thermodilution (TD) in adult patients with aortic stenosis (AS). ⋯ Overall, the ICON device produced lower CO and index measurements relative to TD in adult patients with AS. Overweight and obesity also significantly affected the relative precision and accuracy of the ICON electrical cardiometric device to measure CI in these patients.
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J. Cardiothorac. Vasc. Anesth. · Dec 2018
Correlating Oxygen Delivery During Cardiopulmonary Bypass With the Neurologic Injury Biomarker Ubiquitin C-Terminal Hydrolase L1 (UCH-L1).
The authors sought to assess the relationship between low oxygen delivery (DO2) during cardiopulmonary bypass (CPB) and a neuron-specific biomarker of neurologic injury, ubiquitin C-terminal hydrolase L1 (UCH-L1). ⋯ This is the first study to demonstrate an independent association between DO2 during CPB and elevations of a brain injury biomarker; additional study is needed to clarify the clinical significance of these results.
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J. Cardiothorac. Vasc. Anesth. · Dec 2018
Readmission to the Intensive Care Unit Following Cardiac Surgery: A Derived and Validated Risk Prediction Model in 4,869 Patients.
To derive and validate a clinical risk index that can predict readmission to the intensive care unit (ICU) after cardiac surgery. ⋯ From a comprehensive perioperative dataset, the authors have derived and internally validated a risk index incorporating 9 easily identifiable and routinely collected variables to predict readmission following cardiac surgery.