Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Observational StudyEffect of Body Mass Index on the Clinical Outcomes of Adult Patients Treated With Venoarterial ECMO for Cardiogenic Shock.
Current guidelines consider obesity to be a relative contraindication to venoarterial extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock. The authors investigated the effect of body mass index (BMI) on clinical outcomes in patients treated with VA-ECMO for cardiogenic shock. ⋯ The results suggested that BMI alone should not be considered an exclusion criterion for VA-ECMO. The unfavorable trend observed in underweight patients could be the result of malnutrition.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Dental Strain on Maxillary Incisors During Tracheal Intubation With Double-Lumen Tubes and Different Laryngoscopy Techniques - A Blinded Mannequin Study.
To quantify dental forces during double-lumen tube intubations with different laryngoscopy techniques. ⋯ Although hyperangulated videolaryngoscopes improve dental strain, clinicians also should consider the time to intubation, which is shortest with nonhyperangulated videoblades, when choosing a laryngoscopy technique on an individual patient basis.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Observational StudyCentral Venous Catheter Tip Malposition After Internal Jugular Vein Cannulation in Pediatric Patients With Congenital Heart Disease.
The primary objective of the study was to identify the incidence of catheter tip malposition as determined by postoperative radiography after central venous cannulation by right and left internal jugular venous routes in pediatric cardiac surgical patients. The secondary objective was to determine the relative risk of malposition between the 2 approaches into specific major thoracic veins other than the right superior vena cava. ⋯ The incidence of a malposition of a central venous catheter tip after either right or left internal jugular vein approach was ascertained. The relative risk of a malposition occurring with the left internal jugular approach was higher, and the most common site of malposition was in the right subclavian vein.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Observational StudyAnticoagulation Strategies in Critically Ill Patients With SARS-CoV-2 Infection: The Role of Direct Thrombin Inhibitors.
To compare heparin-based anticoagulation and bivalirudin-based anticoagulation within the context of critically ill patients with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. ⋯ Although heparin is the most used anticoagulant in the intensive care setting, bivalirudin-based anticoagulation was safe and effective in a cohort of critically ill patients with SARS-CoV-2. Bivalirudin may be given full consideration as an anticoagulation strategy for critically ill patients with SARS-CoV-2, especially in those with thrombocytopenia and on extracorporeal support.