Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2021
Liposomal Bupivacaine Versus Bupivacaine/Epinephrine Intercostal Nerve Block as Part of an Enhanced Recovery After Thoracic Surgery (ERATS) Care Pathway for Robotic Thoracic Surgery.
To examine how postoperative pain control after robotic thoracoscopic surgery varies with liposomal bupivacaine (LipoB) versus 0.5% bupivacaine/1:200,000 epinephrine (Bupi/Epi) intercostal nerve blocks within the context of an enhanced recovery after thoracic surgery (ERATS) protocol. ⋯ As part of an ERATS protocol, infiltration of intercostal spaces and surgical wounds with LipoB for robotic thoracoscopic procedures afforded better postoperative subjective pain control and decreased opioid requirements without an increase in hospital costs as compared with use of Bupi/Epi.
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J. Cardiothorac. Vasc. Anesth. · Aug 2021
Observational StudyCardiac Stress in High-Risk Patients Undergoing Major Endovascular Surgery-Focus on Diastolic Function.
The purpose of this study was to determine the relationship between the changes in diastolic function and their association with cardiac biomarkers in the perioperative period in patients undergoing complex endovascular aortic repair. ⋯ Patients undergoing a branched endovascular aortic repair of a thoracoabdominal aortic aneurysm experience a cardiac insult that manifests with deterioration in diastolic parameters and concomitant increases of troponin and NT-proBNP concentrations. Additional large-scale prospective studies are required to confirm this phenomenon.
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In this report, the clinical evolution of a 72-year-old patient transferred to the surgical intensive care unit after cardiac surgery is described. The presence of a pulsatile Doppler signal of the common femoral vein was noted after surgery. ⋯ The observations seen in peripheral venous flow reinforce the hypothesis that pulsatility of the common femoral vein represents an associated echocardiographic sign of right ventricular dysfunction and may be used to monitor systemic venous congestion. Pulsatility in the venous system may be improved by reducing volume overload and improving right ventricular function.
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J. Cardiothorac. Vasc. Anesth. · Aug 2021
The Use of Artificial Neural Networks to Determine In-Hospital Mortality After Coronary Artery Bypass Surgery.
The aim of this study was to present an artificial neural network (ANN) model for the accurate estimation of in-hospital mortality and to demonstrate the validity of the model with real data and a comparison with conventional multiple linear regression models. ⋯ The ANN model tended to outperform multiple linear regression models in predicting in-hospital mortality among patients who have undergone coronary artery bypass graft surgery. Physicians can make use of this information as an aid in performing treatments and ensuring that more accurate quality of surgical care is achieved.