Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · May 2021
Intercostal Blocks with Liposomal Bupivacaine in Thoracic Surgery: A Retrospective Cohort Study.
Assess the efficacy of adding liposomal bupivacaine (LB) to bupivacaine-containing intercostal nerve blocks (ICNBs) to improve analgesia and decrease opioid consumption and hospital length of stay compared with bupivacaine-only ICNBs. ⋯ LB with bupivacaine in ICNBs did not demonstrate superior postoperative analgesia or affect the rate of hospital discharge.
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J. Cardiothorac. Vasc. Anesth. · May 2021
Conventional Ultrafiltration During Elective Cardiac Surgery and Postoperative Acute Kidney Injury.
Conventional ultrafiltration (CUF) during cardiopulmonary bypass (CPB) serves to hemoconcentrate blood volume to avoid allogeneic blood transfusions. Previous studies have determined CUF volumes as a continuous variable are associated with postoperative acute kidney injury (AKI) after cardiac surgery, but optimal weight-indexed volumes that predict AKI have not been described. ⋯ Removal of weight-indexed CUF volumes > 32 mL/kg increased the risk for postoperative AKI development. Importantly, CUF volume removal of any amount did not mitigate allogeneic blood transfusion during elective cardiac surgery. Prospective studies are needed to validate these findings.
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J. Cardiothorac. Vasc. Anesth. · May 2021
Case ReportsPeripheral Cardiopulmonary Bypass in Two Patients With Symptomatic Tracheal Masses: Perioperative Challenges.
Tracheal tumors or masses causing critical airway obstruction require resection for symptom relief. However, the location and extent of these tumors or masses often preclude conventional general anesthesia and tracheal intubation. Peripheral cardiopulmonary bypass often is required before anesthetizing these patients. ⋯ Instead, femoral vein-axillary artery venoarterial bypass was established to avoid Harlequin syndrome. Some of the challenges encountered were the development of Harlequin syndrome with risk of myocardial and cerebral ischemia, type and conduct of extracorporeal bypass, choice of monitoring sites, and provision of regional anesthesia for peripheral extracorporeal cannulations. Management of such patients needs frequent troubleshooting and multidisciplinary coordination for a successful surgical outcome.
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J. Cardiothorac. Vasc. Anesth. · May 2021
Observational StudyA Retrospective Evaluation of Airway Anatomy in Young Children and Implications for One-Lung Ventilation.
One-lung ventilation (OLV) in children remains a niche practice with few studies to guide best practices. The objective of this study was to describe lower airway anatomy relevant to establishment of OLV in young children. ⋯ A more detailed and accurate understanding of pediatric lower airway anatomy may assist the clinician in successfully performing OLV in young children.
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J. Cardiothorac. Vasc. Anesth. · May 2021
Observational StudyPreoperative Electrocardiogram and Perioperative Methods for Predicting New-Onset Atrial Fibrillation During Lung Surgery.
To investigate if preoperative electrocardiogram scores and perioperative surgical methods could predict new-onset atrial fibrillation during lung surgery. ⋯ Preoperative electrocardiogram markers can be used together with surgical methods as strong predictors to identify those patients at a high risk for new-onset atrial fibrillation during lung surgery.