Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2019
Randomized Controlled Trial Multicenter StudyDouble-Blind, Randomized, Placebo-Controlled Trial Comparing the Effects of Antithrombin Versus Placebo on the Coagulation System in Infants with Low Antithrombin Undergoing Congenital Cardiac Surgery.
To determine whether precardiopulmonary bypass (CPB) normalization of antithrombin levels in infants to 100% improves heparin sensitivity and anticoagulation during CPB and has beneficial effects into the postoperative period. ⋯ Supplementation of antithrombin in infants with low antithrombin levels improves heparin sensitivity and anticoagulation during CPB without increased rates of bleeding or adverse events. Beneficial effects may be seen into the postoperative period, reflected by significantly less postoperative bleeding and exposure to blood products and reduced generation of D-dimers.
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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
Multicenter StudyAssociation Between Ethnicity and Postoperative Hyperglycemia in a Southeast Asian Population Undergoing Cardiac Surgery.
Postoperative hyperglycemia is a known risk factor for adverse outcomes following cardiac surgery. Therefore, the authors investigated the association between ethnicity and postoperative hyperglycemia in a Southeast Asian multiethnic population undergoing cardiac surgery. ⋯ The authors' findings demonstrated Indian ethnicity as an independent risk factor of postoperative hyperglycemia, likely due to insulin resistance and exaggerated hyperglycemic stress response, emphasizing the need for ethnic-based data unique to each population group.
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J. Cardiothorac. Vasc. Anesth. · Feb 2019
Multicenter StudySafety of Fibrinogen Concentrate and Cryoprecipitate in Cardiovascular Surgery: Multicenter Database Study.
To investigate whether administering fibrinogen concentrate or cryoprecipitate is associated with increased postoperative thromboembolic events and improved mortality in patients undergoing thoracic aortic surgery. ⋯ Administering fibrinogen concentrate or cryoprecipitate was associated with neither thromboembolic events nor 30-day mortality in patients undergoing thoracic aortic surgery. Administering fibrinogen concentrate or cryoprecipitate is safe and does not appear to increase thromboembolic events and mortality in thoracic aortic surgery patients.