Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2022
Review Meta AnalysisBispectral Index (BIS) Monitoring and Postoperative Delirium in Elderly Patients Undergoing Surgery: A Systematic Review and Meta-Analysis With Trial Sequential Analysis.
To examine the effect of bispectral index (BIS)-guided anesthesia on the incidence of postoperative delirium (POD) in elderly patients undergoing surgery. ⋯ The authors' meta-analysis demonstrated that BIS-guided anesthesia was not associated with a reduced incidence of POD, but it was associated with a reduced incidence of POCD and improved recovery parameters.
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J. Cardiothorac. Vasc. Anesth. · Dec 2022
Randomized Controlled Trial Multicenter StudyUse of a Video Laryngoscope to Reduce Complications of Transesophageal Echocardiography Probe Insertion: A Multicenter Randomized Study.
The objective of this multicenter study was to test the hypothesis of whether the use of a video laryngoscope (VL) reduces complications related to transesophageal echocardiography (TEE) probe insertion. ⋯ The use of VL was associated with a lesser incidence of injury compared to the conventional technique, and its use for this purpose is recommended. The use of VL for probe insertion resulted in fewer attempts compared with the conventional technique. Significant variations do exist in the relation between the esophageal inlet and the larynx, and direct visualization with VL may contribute to better safety.
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J. Cardiothorac. Vasc. Anesth. · Dec 2022
Decline in Functional Status While on the Waiting List Predicts Worse Survival After Lung Transplantation.
To determine if decreases in the Karnofsky Performance Score (KPS) while on the waitlist predict decreased survival after lung transplantation (LTx). ⋯ Deterioration of KPS on the waiting list for LTx is associated with significantly greater postoperative mortality in patients after LTx. These results should be taken into consideration when allocating organs. Strategies to increase or to prevent a decrease in KPS before LTx should be evaluated.
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J. Cardiothorac. Vasc. Anesth. · Dec 2022
Randomized Controlled TrialUsing Music for the Prevention of Delirium in Patients After Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial.
The aim was to evaluate the effect of music on preventing delirium after coronary artery bypass grafting, to analyze vital signs and blood gas parameters, and to determine risk factors affecting delirium. ⋯ Twelve participants who were delirium-positive were in the control group, and there were 3 in the case group, which suggested a statistically significant effect of music in preventing delirium (p = 0.016). The mean age of patients was 64.7 ± 7.9 years old in the control group and 62.2 ± 7.5 years old in the case group. There was a significant difference among the control and case groups in terms of the surgery time; surgery time in the control group was significantly lower than in the case group (242.4 ± 42.3 v 261.6 ± 48.9, respectively; p = 0.03 < 0.05). Blood pressure and heart rate in the case group were lower, similar to the respiratory rate and venous blood gas parameters; Blood pressure differences were not statistically significant (p > 0.05); CONCLUSION: Relaxation music, including bird, water, and wind, significantly prevents delirium after coronary artery bypass grafting.
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J. Cardiothorac. Vasc. Anesth. · Dec 2022
ReviewPerioperative Anesthetic Management of the Pregnant Patient With Congenital Heart Disease Undergoing Cardiac Intervention: A Systematic Review.
Maternal congenital heart disease is increasingly prevalent, and has been associated with a significantly increased risk of maternal, obstetric, and neonatal complications. For patients with CHD who require cardiac interventions during pregnancy, there is little evidence-based guidance with regard to optimal perioperative management. The periprocedural management of pregnant patients with congenital heart disease requires extensive planning and a multidisciplinary teams-based approach. Anesthesia providers must not only be facile in the management of adult congenital heart disease, but cognizant of the normal, but significant, physiologic changes of pregnancy.