Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Jun 2020
ReviewViral Myocarditis-Incidence, Diagnosis and Management.
Viral myocarditis has an incidence rate of 10 to 22 per 100,000 individuals. The presentation pattern of viral myocarditis can range from nonspecific symptoms of fatigue and shortness of breath to more aggressive symptoms that mimic acute coronary syndrome. ⋯ As a result of these 3 possibilities, the diagnosis, prognosis, and treatment of viral myocarditis can be extremely unpredictable and challenging for the clinician. Herein, the incidence, etiology, definition and classification, clinical manifestation, diagnosis, pathogenesis, prognosis, and treatment of viral myocarditis are reviewed, and how acute clinical care teams might differentiate between viral myocarditis and other acute cardiac conditions is discussed.
-
J. Cardiothorac. Vasc. Anesth. · Jun 2020
ReviewTrials Focusing on Prevention and Treatment of Delirium After Cardiac Surgery: A systematic Review of Randomized Evidence.
Delirium after cardiac surgery is associated with adverse outcomes, including prolonged hospital stay, prolonged intensive care unit stay, and increased mortality. Effective preventive interventions and treatments still are largely unknown. ⋯ In the present systematic review of 56 randomized controlled trials that examined 38 interventions, the authors found that dexmedetomidine was the most frequently studied agent and that it might reduce the occurrence of delirium after cardiac surgery.
-
J. Cardiothorac. Vasc. Anesth. · Jun 2020
ReviewDeep Sternal Wound Infection: Diagnosis, Treatment and Prevention.
Deep sternal wound infection (DSWI) is a rare but potentially devastating complication of median sternotomy performed in cardiac surgery. The incidence of DSWI is reported to be between 0.2% and 3%. ⋯ Management of DSWI can be complex and may require a multidisciplinary team approach involving infectious disease specialists, microbiologists, as well as cardiothoracic and plastic surgeons. Early detection, appropriate antibiotic treatment, aggressive surgical debridement, and use of regional muscle flaps have significantly improved treatment outcomes.
-
J. Cardiothorac. Vasc. Anesth. · Jun 2020
Randomized Controlled TrialDoes Intraoperative Cell Salvage Reduce Postoperative Infection Rates in Cardiac Surgery?
Primary outcome was the risk for infections after cell salvage in cardiac surgery. ⋯ Cell salvage was directly associated with higher infection rates, but this direct effect was almost completely eliminated by its indirect protective effect through reduced allogeneic blood transfusion.
-
J. Cardiothorac. Vasc. Anesth. · Jun 2020
Observational StudyEfficacy of Early Goal-Directed Renal Replacement Therapy for the Treatment of Acute Kidney Injury After Heart Transplantation: A Single-Center 10-Year Experience.
Acute kidney injury (AKI) after heart transplantation is a common and serious complication. The present study aimed to evaluate the efficacy of early goal-directed renal replacement therapy (GDRRT) for the treatment of AKI after heart transplantation. ⋯ For heart transplantation recipients with AKI, EGDRRT can reduce the in-hospital mortality and the length of intensive care unit and hospital stays, improve the complete renal recovery rate, and reduce the cost of RRT.