Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2019
Randomized Controlled TrialEffect of One-Lung Ventilation on Blood Sevoflurane and Desflurane Concentrations.
To determine the blood sevoflurane and desflurane concentrations during one-lung ventilation (OLV). ⋯ An OLV procedure causes a decrease in the both arterial and venous blood concentrations of sevoflurane and desflurane. This reduction is believed to be due to ventilation-perfusion mismatch.
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J. Cardiothorac. Vasc. Anesth. · Feb 2019
Multicenter StudyMulticenter International Survey on the Clinical Practice of Ultra-Fast-Track Anesthesia with On-Table Extubation in Pediatric Congenital Cardiac Surgery.
To describe global practices for on-table extubation (OTE) in pediatric cardiac anesthesia in European and non-European countries. ⋯ The survey demonstrated that the majority of the approached pediatric cardiac anesthesiologists practice OTE regularly in pediatric cardiac surgery. Frequency of OTE and inclusion criteria vary widely. The observations made in this survey should prompt appropriately powered, randomized controlled clinical trials to examine the effect of OTE on various effectiveness and safety outcomes.
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J. Cardiothorac. Vasc. Anesth. · Feb 2019
Randomized Controlled TrialContinuous Ropivacaine Infusion Offers No Benefit in Treating Postoperative Pain After Cardiac Surgery.
One multimodal pain management method for reducing postoperative opioid need after cardiac surgery is to continuously infuse local anesthetic into a median sternotomy wound. Previous studies have shown contradictory results with this method; therefore, no consensus exists on its effectiveness. The authors tested the effectiveness of continuous 0.2% ropivacaine infusion into a sternotomy wound after cardiac surgery. ⋯ Continuous 0.2% ropivacaine infusions at the median sternotomy wound did not reduce postoperative pain or opioid consumption during the first 48 hours after cardiac surgery. This technique apparently was not beneficial for post-sternotomy pain treatment.
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J. Cardiothorac. Vasc. Anesth. · Feb 2019
Randomized Controlled TrialImpact of Isolyte Versus 0.9% Saline on Postoperative Event of Acute Kidney Injury Assayed by Urinary [TIMP-2] × [IGFBP7] in Patients Undergoing Cardiac Surgery.
Administration of excess chloride in 0.9% normal saline (NS) decreases renal perfusion and glomerular filtration rate, thereby increasing the risk for acute kidney injury (AKI). In this study, the effect of NS versus Isolyte use during cardiac surgery on urinary levels of tissue inhibitor of metalloproteinase 2 and insulin-like growth factor-binding protein 7 [TIMP-2] × [IGFBP7] and postoperative risk of AKI were examined. ⋯ The authors observed no change in urinary [TIMP-] × [IGFBP7] levels in patients receiving NS versus Isolyte during cardiac surgery. Future larger studies in patients at higher risk for AKI are recommended to evaluate the impact of high- versus lower-chloride solutions on the risk of postoperative AKI after cardiac surgery.