Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Sep 2021
Observational StudyThe Effect of Postoperative Fluid Balance on the Occurrence and Progression of Acute Kidney Injury After Cardiac Surgery.
In addition to the association between positive fluid balance (FB) and acute kidney injury (AKI) after cardiac surgery reported by former studies, this study examined the relationship between FB and progressive AKI. ⋯ An exponential increase was found between 24-hour FB and AKI occurrence and a "U"-shape association between 48-hour FB and AKI progression. Both excessively negative and positive accumulative 48-hour FB increased the risk of AKI progression, suggesting cautious monitoring and application of fluid load in clinical practice.
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J. Cardiothorac. Vasc. Anesth. · Sep 2021
Case ReportsNitric Oxide Ventilation Improves Recirculation and Right Ventricular Function During Veno-Venous Extracorporeal Membrane Oxygenation in a COVID-19 Patient.
Patients with coronavirus disease 2019 (COVID-19) are prone to pulmonary artery hypertension (PAH) and right ventricular pressure overload due to severe bilateral infiltrates, high ventilation pressures, persistent hypoxemia, pulmonary fibrosis, and/or pulmonary embolism. In patients on extracorporeal membrane oxygenation (ECMO), this potentially leads to increased recirculation. In the current report, the authors present a case in which continuous inhaled nitric oxide (iNO)-enriched ventilation was effective in terms of PAH and recirculation reduction in a COVID-19 patient on veno-venous ECMO.
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J. Cardiothorac. Vasc. Anesth. · Sep 2021
Efficiency Improvements of Nonoperating Room Cardiac Anesthesia Services.
Scheduling and staffing nonoperating room anesthesia (NORA) cases often require cross-service coordination and can result in significant delays in patient care, resource inefficiencies, and provider dissatisfaction. The objective of the present study was to reduce these delays and case cancellations for patients requiring cardiac anesthesia for their transesophageal echocardiography procedure. ⋯ In the two months after implementing changes to the scheduling process for NORA cases in the echocardiography laboratory, a substantial reduction in average case delay, elimination of long delays lasting more than one hour, and avoidance of case cancellations were observed.