Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Curriculum for Subspecialty Anesthesia Training in Adult Structural Heart Disease Imaging: A Single-Center Experience.
Intraprocedural transesophageal echocardiography imaging is an integral part of percutaneous structural heart disease (SHD) interventions. The rapid growth in the number, scope, and complexity of SHD interventions has outpaced the efforts to develop training and proficiency standards in periprocedural imaging. At the Beth Israel Deaconess Medical Center in Boston, Massachusetts, the authors have developed a 6-month duration fellowship in interventional echocardiography for SHD to address this issue. ⋯ Their fellowship curriculum follows a multimodal integrative approach to training in SHD imaging, which includes simulation sessions, online modules, deliberate practice in the clinical setting, and interdisciplinary team-based training. In the next several years, there will be an increased need for echocardiographers who are proficient in intraprocedural SHD imaging. In this article, the authors describe their experience with a competency-based curriculum for subspecialty anesthesia training in SHD imaging.
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Patient-Controlled Analgesia After Cardiac Surgery With Median Sternotomy: No Advantages of Hydromorphone When Compared to Morphine.
To compare the efficacy, safety, and side effects of hydromorphone and morphine administered as patient-controlled analgesia (PCA) for postoperative pain therapy after cardiac surgery with median sternotomy. ⋯ There were no significant differences in analgesic efficacy and safety between hydromorphone and morphine when used for postoperative pain therapy with PCA after cardiac surgery with median sternotomy.
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Observational StudyLeft Ventricular Ejection Fraction Correlation With Stroke Volume as Estimated by Doppler Echocardiography in Cardiogenic Shock: A Retrospective Observational Study.
Echocardiography is the main tool for cardiac assessment and helps to guide management in patients admitted to the intensive care unit (ICU) with cardiogenic shock (CS). Left ventricular ejection fraction (LVEF) is a commonly used echocardiographic surrogate for left ventricular (LV) systolic function. In this hypothesis-generating study, the authors investigated the correlation between LVEF and stroke volume (SV)/SV index (SVI) estimated by Doppler echocardiography in patients admitted to the ICU with CS and reduced LVEF. ⋯ There is a weak correlation between LVEF and SV or SVI estimated by Doppler echocardiography in patients admitted to the ICU with STEMI complicated by CS and reduced LVEF. Visually estimated LVEF correlated slightly better with Doppler SV compared to modified Simpson's LVEF.
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
A Survey of the Congenital Cardiac Anesthesia Society on the Use and Clinical Application of Near- Infrared Tissue Oximetry in Pediatric Cardiac Surgery.
To better understand the patterns of use and the perceived utility of tissue oximetry in pediatric cardiac surgery. ⋯ Near-infrared spectroscopy-based tissue oximetry frequently used was by CCAS members, but with significant variations in clinical application.
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Association of Methylene Blue Dosing With Hemodynamic Response for the Treatment of Vasoplegia.
To compare the hemodynamic response of methylene blue dosing regimens (bolus v bolus plus infusion) for the treatment of vasoplegia. ⋯ The addition of a methylene blue continuous infusion did not significantly improve hemodynamic response. Bolus-only dosing of methylene blue may be sufficient for the treatment of vasoplegia after cardiac surgery.