Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2019
Predictive Value of Stress Testing, Revised Cardiac Risk Index, and Functional Status in Patients Undergoing Non Cardiac Surgery.
Patients undergoing noncardiac surgery are at risk for postoperative cardiovascular complications. Literature regarding the ability of the Revised Cardiac Risk Index (RCRI), functional capacity, and stress testing to predict perioperative cardiac events is scarce. The authors examined the association of these parameters with perioperative cardiac events and their additive ability to predict these outcomes. ⋯ In a cohort of patients with predominantly good functional status and intermediate-to-high RCRI scores, addition of a preoperative stress test was of only moderate value in predicting postoperative cardiovascular outcomes compared with a combination of functional class and RCRI.
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J. Cardiothorac. Vasc. Anesth. · Apr 2019
Extracorporeal Membrane Oxygenation Is a Team Sport: Institutional Survival Benefits of a Formalized ECMO Team.
At the authors' institution, prior to 2014, patients requiring care in the peri-extracorporeal membrane oxygenation (ECMO) period were treated by intensivists with specific training in ECMO but worked independently. This isolated form of care was addressed in late 2013 with the formal initiation of an ECMO team. The authors wanted to assess the difference in overall mortality for ECMO patients cared for prior to the initiation of a multidisciplinary team compared to after its establishment. ⋯ Patients cared for after the initiation of an ECMO team showed improved survival compared to patients cared for prior to the creation of the ECMO team.
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J. Cardiothorac. Vasc. Anesth. · Apr 2019
Observational StudyThe Edmonton Frail Scale Improves the Prediction of 30-Day Mortality in Elderly Patients Undergoing Cardiac Surgery: A Prospective Observational Study.
To investigate whether the Edmonton Frail Scale (EFS), a multidimensional frailty assessment tool, improves the prediction of 30-day or in-hospital mortality over the use of the European System for Cardiac Outcome Risk Evaluation (EuroSCORE) II alone. ⋯ The EFS has a good predictive ability for 30-day mortality after cardiac surgery in elderly patients and improves the prediction of 30-day mortality over the use of the EuroSCORE II.
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J. Cardiothorac. Vasc. Anesth. · Apr 2019
The Use of Regional or Local Anesthesia for Carotid Endarterectomies May Reduce Blood Loss and Pulmonary Complications.
Over 150,000 carotid endarterectomy (CEA) procedures are performed each year. Perioperative anesthetic management may be complex due to multiple patient and procedure-related risk factors. The authorsaimed to determine whether the use of general anesthesia (GA), when compared with regional anesthesia (RA), would be associated with reduced perioperative morbidity and mortality in patients undergoing a CEA. ⋯ The use of RA over GA in CEA is associated with decreased risk of postoperative pneumonia and a reduced need for perioperative blood transfusions.