Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Multicenter StudyAssociation Between Gabapentinoids and Postoperative Pulmonary Complications in Patients Undergoing Thoracic Surgery.
Perioperative gabapentinoids in general surgery have been associated with an increased risk of postoperative pulmonary complications (PPCs), while resulting in equivocal pain relief. This study's aim was to examine the utilization of gabapentinoids in thoracic surgery to determine the association of gabapentinoids with PPCs and perioperative opioid utilization. ⋯ Perioperative gabapentinoid administration in elective thoracic surgery may be associated with a higher risk of PPCs and no opioid-sparing effect.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
ReviewThree-Dimensional Printing of Patient-Specific Heart Valves: Separating Facts From Fiction and Myth From Reality.
The development of prosthetic heart valves by Dr. Charles Hufnagel in 1952 was a major clinical innovation; however, it was not an ideal solution. Mechanical prosthetic heart valves are rigid, immunogenic, require anticoagulation, do not grow with the patient, and have a finite life.1 An ideal prosthetic valve should overcome all these limitations. ⋯ However, due to the disruptive nature of this technology, often there are commercially-motivated claims of originality and overstatement of the scope and applicability of 3D printing. It often is difficult to separate fact from fiction and myth from reality. In this manuscript, the authors have reviewed the historic perspective, status of the basic techniques of organogenesis with specific reference to heart valves, and their potential.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Randomized Controlled TrialEffects of Landiolol on Macrocirculatory Parameters and Left and Right Ventricular Performances Following Cardiac Surgery: A Randomized Controlled Trial.
Postoperative atrial fibrillation (POAF) is a major complication after cardiac surgery, and an early postoperative introduction of beta-blockers is recommended to reduce its incidence. Landiolol, a new intravenous short-acting beta-1 blocker, could present a useful and safe macrohemodynamic profile after cardiac surgery. Detailed metabolic and hemodynamic effects of landiolol on cardiac performance, however, remain poorly documented. The authors aimed to investigate the dose-dependent hemodynamic and metabolic effects of landiolol in that specific setting. ⋯ Infusion of landiolol in the range of 0.5-to-10 μg/kg/min during the early postoperative period presents a good macrohemodynamic safety profile in cardiac surgical patients and could be useful to prevent POAF.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Randomized Controlled TrialThe Effect of Erector Spinae Plane Block and Combined Deep and Superficial Serratus Anterior Plane Block on Acute Pain After Video-Assisted Thoracoscopic Surgery: A Randomized Controlled Study.
The study aimed to compare the analgesic effects of erector spinae plane block (ESPB) and a combination of the deep and superficial serratus anterior plane block (C-SAPB) methods in patients who underwent video-assisted thoracoscopic surgery (VATS). ⋯ Patients who underwent VATS receiving ESPB or C-SAPB had similar pain scores, opioid consumption, and side effects during the first postoperative 24 hours. At the same time, the fact that the duration of the block procedure was similar in both groups showed that multisite serratus anterior plane block can be an effective alternative method in analgesic treatment after VATS, considering that it easily can be applied. The authors here think that C-SAPB can be a good alternative to ESPB because the outcomes of both applications are similar, and C-SAPB easily can be seen and applied with ultrasound.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Case ReportsUninterrupted Continuation of VV-ECMO Without Anticoagulation for 44 Days in COVID-19 ARDS: A Precarious Quandary.
Venovenous extracorporeal membrane oxygenation (VV-ECMO) has become a mainstay treatment modality for a select patient population who do not respond to conventional medical therapy suffering from severe acute respiratory distress syndrome (ARDS) due to COVID-19. This therapy necessitates the utilization of anticoagulation, whether unfractionated heparin or bivalirudin, to prevent thrombotic complications. ⋯ Herein, the authors report a case of a successful outcome in a COVID-19 ARDS patient who suffered an acute hemorrhagic complication leading to pre-emptive termination of systemic anticoagulation. The authors believe this to be one of the first such cases in the literature.