Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Jan 2019
Correlation of 2-Dimensional and 3-Dimensional Echocardiographic Analysis to Surgical Measurements of the Tricuspid Valve Annular Diameter.
This study sought to determine if 3-dimensional (3D) echocardiography would more closely correspond to direct surgical measurements of the maximal tricuspid valve (TV) annular diameter than 2-dimensional (2D) measurements. ⋯ Three-dimensional imaging and measurement of the TV annular diameter is feasible in the OR setting. The superiority of the 3D measurements versus 2D measurements allows for greater precision and accuracy and may guide better intraoperative surgical decision-making.
-
J. Cardiothorac. Vasc. Anesth. · Jan 2019
The Effect of Modified Ultrafiltration on Serum Vancomycin Levels During Cardiopulmonary Bypass in Cardiac Surgery.
The aim of this study was to investigate whether the use of modified ultrafiltration at the end of cardiopulmonary bypass for cardiac surgical procedures significantly changes vancomycin serum concentrations. ⋯ Using modified ultrafiltration at the end of cardiopulmonary bypass significantly decreases serum vancomycin levels, but not by a clinically relevant amount. The decrease is to a concentration that is still significantly higher than the minimum inhibitory concentration for Staphylococcus epidermidis and Staphylococcus aureus; thus additional vancomycin administration is not recommended.
-
Patients with pericardial disease often require interventional therapies or surgery, making it essential for anesthesiologists to understand the altered physiology of these disease states and the resultant impact on perioperative management. The broad spectrum of syndromes involving the pericardium present with varying degrees of clinical significance, from asymptomatic presentations to life-threatening emergencies. Impaired diastolic filling of the heart represents a common theme of pericardial disease, with the rate of onset of pericardial pathology largely determining the extent of this impairment and subsequent severity of presentation. This review highlights recent updates in the literature regarding the diagnostic evaluation, medical therapy, and invasive therapeutic procedures for common pericardial syndromes from the perspective of a perioperative physician.