Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Mar 2020
Randomized Controlled TrialSustained High-dose Thiamine Supplementation in High-risk Cardiac Patients Undergoing Cardiopulmonary Bypass: A Pilot Feasibility Study (The APPLY trial).
To test the feasibility and investigate possible cardiovascular effects of a sustained high-dose intravenous thiamine protocol in patients undergoing combined valvular and coronary artery bypass graft surgery. ⋯ A double-blind trial of sustained high-dose intravenous thiamine supplementation in higher-risk cardiac surgery patients was feasible and appeared to be safe. However, such treatment did not demonstrate evidence of biological or physiological effects.
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J. Cardiothorac. Vasc. Anesth. · Mar 2020
ReviewAssessment of Spinal Cord Ischemia With Near-Infrared Spectroscopy: Myth or Reality?
Non-invasive near-infrared spectroscopy is gaining popularity in the detection of spinal cord ischemia following aortic aneurysm repair. However, practical recommendations are lacking. This review focuses on the physiological and anatomical background, as well as on the clinical implementations of near-infrared spectroscopy as a tool for monitoring ischemia of the spinal cord. Clinical recommendations based on the currently available evidence are rendered.
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J. Cardiothorac. Vasc. Anesth. · Mar 2020
ReviewThrombocytosis: Perioperative Considerations for Patients Undergoing Cardiac Surgery.
Thrombocytosis is an uncommon yet important laboratory abnormality with significant considerations for patients undergoing cardiac surgery. The etiology of thrombocytosis can be categorized by those related to reactive processes; acquired platelet disorders (ie, myeloproliferative neoplasms, hematologic malignancies); or inherited platelet disorders (ie, hereditary thrombocythemia). A foundational understanding of the normal physiologic function of platelets and the abnormalities associated with each of these disorders is critical when considering implications and optimization to prevent perioperative complications. This review systematically outlines the platelet disorders that cause thrombocytosis with an emphasis on how the disorder affects normal physiologic processes, summarizes the literature related to the disorder, and the describes the implications and recommendations for patients undergoing cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Mar 2020
Randomized Controlled TrialIntraoperative Ketamine for Analgesia Post-Coronary Artery Bypass Surgery: A Randomized, Controlled, Double-Blind Clinical Trial.
To determine whether the administration of ketamine during coronary artery bypass grafting (CABG) surgery leads to a reduction in the quantity of opioids required over the first 48 hours after surgery. ⋯ The administration of ketamine during CABG surgery did not result in reduced opioid consumption or pain scores postoperatively.
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J. Cardiothorac. Vasc. Anesth. · Mar 2020
ReviewReview and Update: Hematologic Malignancies and Adult Cardiac Surgery.
As treatments for hematologic malignancies continue to advance, many patients with active disease and many more in remission will present for cardiac surgical procedures. Radiation and chemotherapeutic therapies for hematologic malignancies often result in cardiopulmonary injury. ⋯ However, short- and long-term mortality has been found to be acceptable. This review will distinguish the important points of characterizing, understanding, and managing hematologic malignancies in the cardiac surgical patient.