Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Sep 2023
ReviewA Narrative Review of Clinical Decision Support Systems for Perioperative Bleeding Management in Cardiac Surgery.
Bleeding complications in patients undergoing cardiac surgery are common. The clinician must assimilate multiple sources of monitoring information, make rational decisions on the etiology of the bleeding, and then formulate a treatment strategy. Clinical decision support systems that acquire this information and present the data in an easily usable format may be useful tools to guide the physician in optimizing treatment strategies through adherence to evidence-based best practice guidelines. The authors present a narrative review of the literature and discuss how clinical decision support systems may be useful to the clinician.
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J. Cardiothorac. Vasc. Anesth. · Sep 2023
Randomized Controlled TrialAssociation Between Postoperative Delirium and Long-Term Subjective Cognitive Decline in Older Patients Undergoing Cardiac Surgery: A Secondary Analysis of the Minimizing Intensive Care Unit Neurological Dysfunction with Dexmedetomidine-Induced Sleep Trial.
This study aimed to evaluate whether a measure of subjective cognitive decline (SCD), the Patient-Reported Outcomes Measurement Information System (PROMIS) Applied Cognition-Abilities questionnaire, was associated with postoperative delirium. It was hypothesized that delirium during the surgical hospitalization would be associated with a decrease in subjective cognition up to 6 months after cardiac surgery. ⋯ In this cohort of older patients undergoing cardiac surgery, in-hospital delirium was associated with SCD up to 180 days after surgery. This finding suggested that measures of SCD may enable population-level insights into the burden of cognitive decline associated with postoperative delirium.
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J. Cardiothorac. Vasc. Anesth. · Sep 2023
ReviewNovel Three-Dimensionally Printed Ultrasound Probe Simulator and Heart Model for Transthoracic Echocardiography Education.
Simulation-based training is an essential component in the education of transthoracic echocardiography (TTE). Nevertheless, current TTE teaching methods may be subject to certain limitations. Hence, the authors in this study aimed to invent a novel TTE training system employing three-dimensional (3D) printing technology to teach the basic principles and psychomotor skills of TTE imaging more intuitively and understandably. ⋯ The probe simulator incorporates a linear laser generator to enable the visualization of the projection of the ultrasound scan plane in a 3D space. By using the probe simulator in conjunction with the sliceable heart model or other commercially available anatomic models, trainees can attain a more comprehensive understanding of probe motion and related scan planes in TTE. Notably, the 3D-printed models are portable and low-cost, suggesting their potential utility in various clinical scenarios, particularly for just-in-time training.