Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2023
Review Meta AnalysisEffects of Dexmedetomidine on Brain and Inflammatory Outcomes In Pediatric Cardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Dexmedetomidine use decreases adverse neurocognitive outcomes in adults undergoing cardiovascular surgery, but its effect has been unclear in children with congenital heart disease. ⋯ The authors' findings support the effect of dexmedetomidine on reductions in brain markers among children who undergo cardiac surgery. Further studies would be needed to elucidate its clinically meaningful effects using cognitive functions in the long term, and its effects among children who undergo more complex cardiac surgeries.
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J. Cardiothorac. Vasc. Anesth. · Jun 2023
ReviewAnesthetic Management of Patients With Kartagener Syndrome: A Systematic Review of 99 Cases.
KARTAGENER SYNDROME (KS) is characterized by the triad of chronic sinusitis, bronchiectasis, and situs inversus. The mirrored anatomy and respiratory infections in patients with KS patients pose great challenges for anesthetic management. The aim of this review is to summarize published cases with the hope of helping anesthesiologists perform anesthesia in patients with KS more safely. ⋯ For nonthoracic surgery, an endotracheal tube was the most commonly used airway device. For thoracic surgery, a double-lumen tube was the most commonly used airway device. The intraoperative process was uneventful in most patients, and most patients recovered smoothly in the postoperative course.
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J. Cardiothorac. Vasc. Anesth. · Jun 2023
Randomized Controlled TrialLevosimendan or Milrinone for Ventricular Septal Defect Repair With Pulmonary Arterial Hypertension.
Both milrinone and levosimendan have been used in patients undergoing surgical closure of ventricular septal defects (VSD) with pulmonary artery hypertension (PAH); however, the evidence base for their use is limited. In the present study, the authors sought to compare the role of levosimendan and milrinone in the prevention of low-cardiac-output syndrome in the early postoperative period. ⋯ In patients undergoing surgical repair for VSD with PAH, levosimendan does not confer any additional benefit compared to milrinone. Both milrinone and levosimendan appear to be safe in this cohort.
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J. Cardiothorac. Vasc. Anesth. · Jun 2023
Editorial Comment Randomized Controlled TrialMethylprednisolone for Cardiac Surgery in Infants: Findings From a Large-scale, Randomized, Controlled Trial.
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J. Cardiothorac. Vasc. Anesth. · Jun 2023
Observational StudyCoagulation Tests and Bleeding Classification After Cardiopulmonary Bypass: A Prospective Study.
No recent prospective studies have analyzed the accuracy of standard coagulation tests and thromboelastography (TEG) to identify patients with excessive microvascular bleeding following cardiopulmonary bypass (CPB). The aim of this study was to assess the value of coagulation profile tests, as well as TEG, for the classification of microvascular bleeding after CPB. ⋯ Standard coagulation tests and individual components of TEG in isolation agree poorly with the visual classification of microvascular bleeding after CPB. The PT-INR and platelet count performed best but had low accuracy. Further work is warranted to identify better testing strategies to guide perioperative transfusion decisions in cardiac surgical patients.