Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Mar 2019
Comparative StudyThoracic Epidurals are Associated With Decreased Opioid Consumption Compared to Surgical Infiltration of Liposomal Bupivacaine Following Video-Assisted Thoracoscopic Surgery for Lobectomy: A Retrospective Cohort Analysis.
Thoracic epidural analgesia (TEA) is considered the gold standard for postoperative pain control in thoracic surgery, however it is associated with the undesirable risks of hypotension urinary retention, and bleeding. Recently, surgical site infiltration with liposomal bupivicaine (LB) has been suggested as a comparable alternative to TEA. The authors compared total opioid consumption in patients who received either TEA or LB undergoing video-assisted thorascopic surgery (VATS) for lobectomy. ⋯ VATs lobectomy patients consumed 43.4% less opioids on POD 0-2 with TEA when compared to surgical site infiltration of LB. Further prospective randomized controlled trials are required to demonstrate superior analgesia of TEA in this surgical population.
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J. Cardiothorac. Vasc. Anesth. · Mar 2019
Letter Review Case ReportsIntraoperative Rescue Transesophageal Echocardiography in a Prone Patient.
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J. Cardiothorac. Vasc. Anesth. · Mar 2019
Clinical TrialThe Effects of Secondhand Smoke Exposure on Postoperative Pain and Ventilation Values During One-Lung Ventilation: A Prospective Clinical Trial.
To investigate the relationships between secondhand smoke (SHS) exposure and oxygenation during one-lung ventilation (OLV) in lobectomy surgery and between SHS exposure and postoperative analgesic consumption. ⋯ The present study demonstrated that during OLV, patients exposed to SHS exhibited significantly lower arterial oxygen pressure compared with nonsmokers. Arterial carbon dioxide values were increased significantly in SHS-exposed patients. Morphine consumption for postoperative analgesia also was increased in patients exposed to SHS compared with that in nonsmokers.
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J. Cardiothorac. Vasc. Anesth. · Mar 2019
Observational StudyRight Ventricular Systolic Performance Determined by 2D Speckle-Tracking Echocardiography and Acute Kidney Injury After Cardiac Surgery.
An association between central venous pressure and acute kidney injury (AKI) has been observed following cardiac surgery, but it is unknown whether this reflects intravascular volume status or impaired right ventricular (RV) myocardial performance. This study was performed to test the hypothesis that decreased RV peak longitudinal strain (PLSS), as measured by 2-dimensional speckle-tracking echocardiography, is associated with AKI following cardiac surgery. ⋯ In this cohort of cardiac surgery patients, speckle-tracking analysis of RV myocardial performance was feasible. Elevated RV systolic pressure associated with AKI, while speckle tracking-derived echocardiography measurements did not.
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J. Cardiothorac. Vasc. Anesth. · Mar 2019
ReviewPreparing for a Fellowship in Adult Cardiothoracic Anesthesiology: Resources and Approaches for the Anesthesiology Trainee.
Adult cardiothoracic anesthesiology (ACTA) is a competitive fellowship. Despite increases in both the number of programs offering cardiothoracic fellowships and the number of residents applying each year, there is little direction or advice for prospective candidates. ⋯ The review examines the qualifications that fellowship programs look for in a candidate, including a discussion on professional behavior, and what an applicant can look for in a program. Finally, there is a brief discussion on post-match preparation.