Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Mar 2021
Randomized Controlled TrialUltrasound-Guided Pecto-Intercostal Fascial Block for Postoperative Pain Management in Cardiac Surgery: A Prospective, Randomized, Placebo-Controlled Trial.
To explore the effect of pecto-intercostal fascial plane block (PIFB) on postoperative opioid requirements, pain scores, lengths of intensive care unit and hospital stays and incidence of postoperative delirium in cardiac surgical patients. ⋯ Patients who received PIFB with bupivacaine showed a decline in cumulative opioid consumption postoperatively, but this difference between the groups was not statistically significant. Low incidence of complications and improvement in visual analog scale pain scores suggested that the PIFB can be performed safely in this population and warrants additional studies with a larger sample size.
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J. Cardiothorac. Vasc. Anesth. · Mar 2021
ReviewCardioprotective Effect of Anesthetics: Translating Science to Practice.
Cardiovascular diseases are the number one cause of mortality in the world, particularly among the aging population. Major adverse cardiac events are also a major contributor to perioperative complications, affecting 2.6% of noncardiac surgeries and up to 18% of cardiac surgeries. Cardioprotective effects of volatile anesthetics and certain intravenous anesthetics have been well-documented in preclinical studies; however, their clinical application has yielded conflicting results in terms of their efficacy. ⋯ Several recent reviews have focused on mechanistic dissection of anesthetic-mediated cardioprotection. The present review focuses on recent clinical trials investigating the cardioprotective effects of anesthetics in the past five years. In addition to highlighting the main outcomes of these trials, the authors provide their perspectives about the current gap in the field and potential directions for future investigations.
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J. Cardiothorac. Vasc. Anesth. · Mar 2021
Observational StudyMyocardial Injury on Admission as a Risk in Critically Ill COVID-19 Patients: A Retrospective in-ICU Study.
The aim of this study was to investigate the incidence, clinical presentation, cardiovascular (CV) complications, and mortality risk of myocardial injury on admission in critically ill intensive care unit (ICU) inpatients with COVID-19. ⋯ Critically ill patients with COVID-19 had a high risk of CV complications. Myocardial injury on admission may be a common comorbidity and is associated with severity and a high risk of mortality in this population.
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J. Cardiothorac. Vasc. Anesth. · Mar 2021
Preexisting Right Ventricular Diastolic Dysfunction and Postoperative Cardiac Complications in Patients Undergoing Nonemergency Coronary Artery Bypass Surgery.
To evaluate whether the presence of preexisting right ventricular diastolic dysfunction (RVDD) in patients undergoing coronary artery bypass grafting (CABG) is associated with a greater incidence of postoperative cardiac complications. ⋯ Preoperative RVDD, cardiopulmonary bypass, and female sex are independent risk factors for the development of PHF after CABG in coronary artery disease patients. The decreased Et/At ratio was the best echocardiographic marker predicting PHF development after CABG. Nevertheless, the possibility of assessing preoperative diastolic RV function to predict the development of PHF after CABG requires confirmation in additional studies.