Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Effect of Initial Anticoagulation Targets on Bleeding and Thrombotic Complications for Patients With Acute Respiratory Distress Syndrome Receiving Extracorporeal Membrane Oxygenation.
To evaluate the effect of anticoagulation targets and intensity on bleeding events, thrombotic events, and transfusion requirements in patients with acute respiratory distress syndrome (ARDS) receiving venovenous extracorporeal membrane oxygenation (ECMO) and continuous-infusion heparin. ⋯ Anticoagulation protocols standardizing aPTT goals to <50 or 40-to-50 seconds may be a reasonable strategy for patients receiving venovenous ECMO for ARDS. More restrictive hemoglobin transfusion thresholds, in combination with lower aPTT targets, may be associated with a reduction in transfusion requirements.
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Race and Outcomes in Patients with Congenital Cardiac Disease in an Enhanced Recovery Program.
Disparities in perioperative outcomes exist. In addition to patient and socioeconomic factors, racial disparities in outcome measures may be related to issues at the provider and institutional levels. Recognizing a potential role of standardized care in mitigating provider bias, this study aims to compare the perioperative sedation and pain management and consequent outcomes in Enhanced Recovery After Surgery (ERAS) cardiac patients of different races undergoing congenital heart surgery at a single quaternary children's hospital. ⋯ Racial disparity in perioperative management and outcomes in patients with standardized ERAS protocols does not exist at the authors' institution. Future comparative studies of ERAS noncardiac patients may provide additional information on the role of standardization in reducing implicit bias.
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Retraining an Artificial Intelligence Algorithm to Calculate Left Ventricular Ejection Fraction in Pediatrics.
Identifying patients with low left ventricular ejection fraction (LVEF) and monitoring LVEF responses to treatment are important clinical goals. Can a deep-learning algorithm predict pediatric LVEF within clinically acceptable error? ⋯ The fine-tuned model calculates LVEF in a range of pediatric patients within clinically acceptable error. Potential advantages include reducing operator error in LVEF calculation and supporting independent LVEF assessment by inexperienced users.