Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Oct 2020
Observational StudyRescue Echocardiography/Ultrasonography in the Management of Combined Cardiac Surgical and Medical Patients in a Cardiac Intensive Care Unit.
Rescue point-of-care ultrasound (r-POCUS) in critical care medicine has revolutionized the management of critically ill patients with hemodynamic instability. However, clinical studies on its use among high-risk cardiac patients still are limited. The authors aimed to assess the utility of r-POCUS for managing high-risk cardiac patients in a mixed cardiac-surgical and cardiac-medical intensive care unit (ICU) in a quaternary care hospital by reviewing the indications and findings of r-POCUS and subsequent effect on patient management. ⋯ In this retrospective study, r-POCUS performed by attending intensivists resulted in diverse findings and was associated with rapid changes in clinical management of patients in a high-acuity, mixed cardiac-surgical and cardiac-medical ICU.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2020
Observational StudyPerioperative Low Tetraiodothyronine Levels and Adverse Outcomes After Heart Transplantation: A Retrospective, Observational Study.
Thyroid dysfunction has been shown to be associated with increased all-cause mortality and severity of chronic heart failure in critical illness and severe cardiac diseases. The present study was conducted to ascertain the relationship between perioperative free triiodothyronine and free tetraiodothyronine (fT4) levels and postoperative adverse outcomes after heart transplantation (HTX). ⋯ The perioperative fT4 level could be a prognostic marker of adverse outcomes in HTX. The authors suggest appropriate perioperative monitoring of fT4 levels. Additional research is warranted to examine the optimal timing, dosage, and method of replacement.
-
J. Cardiothorac. Vasc. Anesth. · Oct 2020
Assessment of Resident Performance During the Cardiac Anesthesia Rotation: Application of the House Officer Clinical Assessment in Cardiac Anesthesiology.
The assessment of clinical skills was created that evaluates House Officer performance within 13 clinical domains during the Cardiac Anesthesiology rotation to provide an assessment and evaluation process for residents while performing a cardiac anesthetic. ⋯ The House Officer Clinical Assessment in Cardiac Anesthesiology allows for a more objective assessment of performance for specific portions of the case and allows for improved feedback on performance. Aspects of the evaluation tool and where residents correlate with the Anesthesiology Milestones for residency are discussed, as well as the ability to determine sufficient proficiency with knowledge and skills over the use of subjective rank to determine competency.