Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2022
Does Radial Artery Cannulation Affect the Perfusion of the Dominant Hand in Adult Patients with Normal Modified Allen's Test Undergoing Cardiac Surgeries? Data Derived from the Peripheral Perfusion Index.
This study aimed to evaluate the effect of radial artery cannulation on hand perfusion in patients with normal modified Allen's test undergoing cardiac surgeries using cardiopulmonary bypass (CPB). ⋯ In adult patients undergoing cardiac surgeries using CPB, even with normal modified Allen's test, radial artery cannulation may affect the perfusion of the dominant hand, especially at low arterial blood pressure or low core body temperature. Since the PPI is one of the noninvasive methods used for intraoperative assessment of the peripheral perfusion, the authors recommend the use of the noncannulated hand for this purpose to not misguide this assessment.
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J. Cardiothorac. Vasc. Anesth. · Oct 2022
Case ReportsPerioperative Hemostatic Management of a Newborn With Hereditary Hemophilia A Undergoing Emergent Surgery for Dextro-Transposition of the Great Arteries.
Hemophilia A is an inherited bleeding disorder characterized by a lack of plasma clotting factor VIII (FVIII). In prophylaxis or during surgery, FVIII infusions are necessary to prevent bleeding. The authors describe the perioperative challenges and application of a multidisciplinary hemostatic management approach to a Caucasian male newborn, with antenatal diagnoses of moderate hemophilia A (2 IU/dL) and dextro-transposition of the great arteries requiring arterial switch surgery within the first month of life. ⋯ Successful cardiac surgery, using cardiopulmonary bypass, was performed with continuous infusion of FVIII at 5 IU/kg/h. Thirteen days after surgery, the FVIII antibody screening remained negative and continuous infusion was switched in favor of a daily intravenous bolus treatment to facilitate reconciliation to the center of origin. The authors' multidisciplinary strategy, established antenatally, allowed for successful care in this highly complex and rare situation.
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J. Cardiothorac. Vasc. Anesth. · Oct 2022
Observational StudyThe Elevation of Double-Lumen Tube Cuff Pressure During Lung Surgery: A Single-Center Prospective Observational Study☆,☆.
Excessive tracheal tube cuff pressure can cause postoperative complications; however, the variations in the double-lumen tube cuff pressure in lung surgery have not been investigated. This study aimed to determine the incidence and variations in excess double- lumen tube cuff pressure during one-lung ventilation. ⋯ A high incidence and long duration of excess tracheal and bronchial cuff pressure were observed during one-lung ventilation for lung surgery.