Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jul 2022
Meta AnalysisRole of Hypothermia in Adult Cardiac Surgery Patients: A Systematic Review and Meta-analysis.
To review studies that assessed systemic hypothermia as an organ protection strategy in adults undergoing cardiac surgery with cardiopulmonary bypass. ⋯ The existing evidence for an organ-protective effect of hypothermia in adult cardiac surgery is of low quality and inconsistent.
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J. Cardiothorac. Vasc. Anesth. · Jul 2022
ReviewContrast-Enhanced Echocardiography Application in Patients Supported by Extracorporeal Membrane Oxygenation (ECMO): A Narrative Review.
Extracorporeal membrane oxygenation (ECMO) is a lifesaving intervention increasingly used to support patients with severe respiratory and cardiac dysfunction. Echocardiography is an important tool, aiding implantation and monitoring during ECMO therapy, but often its use is limited by poor acoustic windows. ⋯ In this article the authors review the literature addressing the use of contrast-enhanced echocardiography (CEE) in ECMO-supported patients. The authors discuss the role of CEE in guiding implantation of ECMO, cardiac assessment and diagnosis of complications during ECMO therapy, as well as the safety of ultrasound-enhancing agents in this cohort of patients.
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J. Cardiothorac. Vasc. Anesth. · Jul 2022
ReviewPerioperative Presentations of Kounis Syndrome: A Systematic Literature Review.
Kounis syndrome commonly is described as a complex multisystem phenomenon mainly affecting coronary arteries, resulting in coronary vasospasm in the context of an allergic manifestation. This article reviews the literature regarding perioperative presentations of the syndrome. A systematic search in MEDLINE and Embase databases was performed for case reports through June 16, 2021, on Kounis syndrome triggered by medications administered in the perioperative setting. ⋯ Coronary vasospasm is often less frequently recognized as a form of allergic manifestation in the perioperative setting. Many potential triggers, such as antibiotics and neuromuscular blocking agents, are routinely administered during surgery. Awareness of this condition, early diagnosis, and effective management of this condition can lead to good outcomes.
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J. Cardiothorac. Vasc. Anesth. · Jul 2022
ReviewIntraoperative Hypotension-Physiologic Basis and Future Directions.
Intraoperative hypotension (IOH) is a major concern to the anesthesiologist. Its appropriate identification and management require an understanding of the physiology of blood pressure regulation, prudent blood pressure monitoring, and treatment. Even short durations of low mean arterial pressure have been associated with adverse postoperative clinical outcomes. ⋯ This new technology has the potential to reduce duration or even prevent IOH. In the authors' opinion, it is an example of how human-machine interaction will contribute to future advances in medicine. Additional studies should evaluate the effects of its use on postoperative outcomes.
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J. Cardiothorac. Vasc. Anesth. · Jul 2022
A Comparative Study of Multiple Electrode Aggregometry Technologies in Cardiac Surgery: Different Values, Same Clinical Relevance.
The assessment of platelet function in cardiac surgery patients who recently received dual-antiplatelet therapy is considered in the existing guidelines. Among available devices, Multiplate (MP) and ROTEM Platelet (RP) are both based on electrical impedance. This study aimed to determine the agreement between MP and RP in cardiac surgery patients under dual-antiplatelet therapy discontinued before surgery. Secondarily, it compared the ability of the MP and RP in predicting postoperative bleeding and the need for platelet transfusion. ⋯ Both technologies seemed to offer potential benefits in the surgical approach to patients who preoperatively received antiplatelet drugs. However, the results of these tests are not interchangeable, and different cut-off values should be applied.