Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Aug 2019
ReviewCombined Monitoring-Brain Function Monitoring and Cerebral Oximetry.
Peri-operative brain function monitoring is still seen by most clinicians as complex, difficult to interpret and is therefore adopted very slowly. Current available technology mainly focusses on either a processed parameter based on the electroencephalogram to titrate anesthetics and central acting agents or on cerebral oximetry, a wider term to obtain information on the cerebral oxygen balance. ⋯ However, there is scientific evidence that it is possible to combine measurements in an algorithmic approach that allows to better manage brain function in the surgical setting. Such integrated solutions should be made available to clinicians as they are likely to optimize patient care dependent on a sound health technology assessment.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2019
ReviewNoninvasive Continuous Hemoglobin Monitoring: Role in Cardiovascular Surgery.
Blood transfusions in the operating room are associated with increased morbidity and mortality as well as increased cost. The technology exists for continuous noninvasive hemoglobin monitoring (SpHb), which could allow for the rapid diagnosis and treatment of acute blood loss anemia secondary to surgical bleeding. ⋯ SpHb in the operating room could reduce cost by decreasing lab draws, unnecessary transfusions, and the morbidity associated with blood transfusions. This review examines the accuracy of noninvasive hemoglobin monitoring as well as the role it may play in the operating room.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2019
ReviewReview of the 2017 European Society of Cardiology's Guidelines for the Management of Acute Myocardial Infarction in Patients Presenting with ST-Segment Elevation and Focused Update on Dual Antiplatelet Therapy in Coronary Artery Disease Developed in Collaboration with the European Association for Cardio-Thoracic Surgery.
-
J. Cardiothorac. Vasc. Anesth. · Aug 2019
Observational StudyVon Willebrand Factor-GP1bα Interactions in Venoarterial Extracorporeal Membrane Oxygenation Patients.
Evaluate extracorporeal membrane oxygenation (ECMO) patients' platelet adhesion and aggregation under shear stress and determine whether addition of von Willebrand factor (VWF) concentrate improves platelet function. Also, explore whether reduced platelet adhesion and aggregation is associated with clinical bleeding during ECMO. ⋯ VA ECMO patients have severely impaired platelet function, which improved but did not normalize with VWF concentrate. The data suggest that GP1bα receptor loss of dysfunction also contributes to impaired platelet adhesion and aggregation during ECMO. Based on these findings, clinical bleeding in ECMO patients is unlikely to be correctable with VWF supplementation alone.