Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Jul 2020
Socioeconomic Disparities in Carotid Revascularization Procedures.
Several studies have demonstrated healthcare disparities in postoperative outcomes after carotid endarterectomy and carotid artery stenting, including increased hospital mortality, postoperative stroke, and readmission rates. The objective of the present study was to examine the intersectionality between race/ethnicity, insurance status, and postoperative outcomes in carotid procedures. ⋯ These results suggest that disparities in postoperative outcomes after carotid artery procedures are associated with race but not with primary insurance status. Multiple contributing factors exist, including racial inequities in prevalence of comorbidities, health literacy, and procedure type performed.
-
J. Cardiothorac. Vasc. Anesth. · Jul 2020
Standards and Best Practice for Acute Normovolemic Hemodilution: Evidence-based Consensus Recommendations.
To develop a standardized approach to the implementation and performance of acute normovolemic hemodilution (ANH) in order to reduce the incidence of bleeding and allogeneic blood transfusion in high-risk surgical bleeding-related cardiac surgery with cardiopulmonary bypass (CPB). ⋯ Consensus was reached on 6 conditions in which ANH would or would not be acceptable, showing that development of a standardized approach for the use of ANH in high-risk surgical bleeding and allogeneic blood transfusion is clearly possible. The recommendations developed by this expert panel may help guide the management and inclusion of ANH as an evidence and consensus-based blood conservation modality.
-
J. Cardiothorac. Vasc. Anesth. · Jul 2020
A Focused Transesophageal Echocardiography Protocol for Intraoperative Management During Orthotopic Liver Transplantation.
The value of a simplified, focused intraoperative transesophageal echocardiography (TEE) protocol in patients undergoing liver transplantation (LT) is unknown. We sought to create and assess a 5-view LT TEE examination focused on 5 prespecified common causes of hypotension during LT. ⋯ In a retrospective cohort study, a simplified LT TEE protocol would have detected 92% of prespecified TEE findings. Management changes occurred in 94% of those patients, while changes rarely occurred in patients with other TEE findings. A focused LT TEE protocol may diagnose critical pathology adequately and guide management during LT when standard monitors are insufficient.
-
J. Cardiothorac. Vasc. Anesth. · Jul 2020
Observational StudyWhose Voices Are Heard? Speaker Gender Representation at the Society of Cardiovascular Anesthesiologists Annual Meeting.
Gender disparities in academic medicine continue to be prevalent despite significant advances in the number of women entering medicine over the last decades. The purpose of the present study was to investigate gender representation of speakers at Society of Cardiovascular Anesthesiologists (SCA) Annual Scientific Sessions meetings from 2015 to 2018. ⋯ Between 2015 and 2018, the majority of lectures at the SCA annual meetings were given by men, with women consistently giving 22% to 25% of individual lectures. When all sessions were combined, there was a statistically significant difference in the expected versus observed proportion of women in speaking slots.