Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2018
Multicenter Study Observational StudyPerioperative Risk Factors Associated With Postoperative Unplanned Intubation After Lung Resection.
Postoperative respiratory failure requiring reintubation is associated with a significant increase in mortality. However, perioperative risk factors and their effects on unplanned 30-day reintubation and postoperative outcomes after unplanned reintubation following lung resection are not described well. The aim of this study was to determine whether certain comorbidities, demographic factors, and postoperative outcomes are associated with 30-day reintubation after thoracic surgery. ⋯ Nonmodifiable and modifiable preoperative risk factors were associated with increased odds of unplanned reintubation. Patients who experienced unplanned intubation were at considerable risk for 30-day mortality, reoperation, postoperative blood transfusion, and increased hospital length of stay.
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J. Cardiothorac. Vasc. Anesth. · Aug 2018
Observational StudyEvaluation of Cardiac Index and Extravascular Lung Water After Single-Lung Transplantation Using the Transpulmonary Thermodilution Technique by the PiCCO2 Device.
First evaluation of the transpulmonary thermodilution technique by the PiCCO2 device to assess cardiac index and pulmonary edema during the postoperative course after single-lung transplantation. ⋯ PiCCO2 device systematically overestimated cardiac index compared with pulmonary artery catheter. However, it might be useful to assess pulmonary edema in acute respiratory failure after single-lung transplantation.
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J. Cardiothorac. Vasc. Anesth. · Aug 2018
Advanced Age Attenuates Left Ventricular Filling Efficiency Quantified Using Vortex Formation Time: A Study of Octogenarians With Normal Left Ventricular Systolic Function Undergoing Coronary Artery Surgery.
Blood flow across the mitral valve during early left ventricular (LV) filling produces a 3-dimensional rotational fluid body, known as a vortex ring, that enhances LV filling efficiency. Diastolic dysfunction is common in elderly patients, but the influence of advanced age on vortex formation is unknown. The authors tested the hypothesis that advanced age is associated with a reduction in LV filling efficiency quantified using vortex formation time (VFT) in octogenarians undergoing coronary artery bypass graft (CABG) surgery. ⋯ The results indicate that LV filling efficiency quantified using VFT is reduced in octogenarians compared with younger patients undergoing coronary artery bypass grafting.
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To test the feasibility and reliability of using a vendor-neutral platform to evaluate right ventricular (RV) strain. Reliability was determined by comparing intra- and inter-observer variability between RV strain assessments. The secondary objective was to assess strain's correlation with conventional RV functional parameters to evaluate its feasibility as a RV systolic functional assessment tool. ⋯ It is feasible to assess RV strain across multiple platforms in a reproducible and reliable fashion. Furthermore, RV strain demonstrated good correlation with conventional RV functional parameters, suggesting its feasibility as a sensitive RV function assessment tool.