Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2018
ReviewA Comprehensive Review of Transesophageal Echocardiography During Orthotopic Liver Transplantation.
Orthotopic liver transplantation (OLT) is characterized by significant hemodynamic disturbances and anesthetic challenges. Intraoperative transesophageal echocardiography (TEE) can be used to guide management during these procedures. This review examines the role of echocardiography during OLT, presents common TEE findings during each phase of OLT, and discusses the benefits demonstrated with TEE use and the safety of TEE in this patient population. Finally, the authors propose an algorithm for the safe use of TEE during OLT.
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J. Cardiothorac. Vasc. Anesth. · Aug 2018
ReviewUpdate on Cardiovascular Implantable Electronic Devices for Anesthesiologists.
With the advent of "wireless" endocardial pacing, the subcutaneous implantable cardioverter defibrillator, and leadless pacemakers comes an added layer of complexity to the perioperative management of cardiovascular implantable electronic devices (CIED). Since no formal recommendations currently exist for these new CIED technologies, preoperative identification of these devices, understanding their functionality, and developing an individualized perioperative management plan are imperative for the anesthesiologist. The following review is intended to provide the background information required to devise a successful perioperative management strategy for newer CIEDs.
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As the complexity and duration of cardiac ablation procedures increase, there is a growing demand for anesthesiologist involvement in the electrophysiology suites for sedation and anesthesia provision, hemodynamic and neuromonitoring, and procedural guidance through transesophageal echocardiography. To deliver high-quality perioperative care, it is important that the anesthesiologist is intimately familiar with the evolving techniques and technologies, the anesthetic options and ventilation strategies, and the anticipated postprocedural complications.
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J. Cardiothorac. Vasc. Anesth. · Aug 2018
High Ionized Calcium Concentration Is Associated With Prolonged Length of Stay in the Intensive Care Unit for Postoperative Pediatric Cardiac Patients.
There has been controversy regarding the beneficial effects of calcium on myocardial contractility and the harmful effects on myocardial cells, especially in children. The aim of this study was to investigate an association between ionized calcium concentration (iCa) and outcomes for pediatric patients after cardiac surgery. ⋯ Higher iCa within 24 hours after congenital cardiac surgery using CPB was independently associated with longer LOS in the ICU.