Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Nov 2024
Observational StudySerum Levels of Bupivacaine After Bilateral Ultrasound-Guided Deep Parasternal Intercostal Plane Block in Cardiac Surgery with Median Sternotomy.
To evaluate systemic levels of bupivacaine after bilateral ultrasound-guided deep parasternal intercostal plan (PIP) block in cardiac surgical patients undergoing median sternotomy. ⋯ Bilateral PIP placed at the end of cardiac surgery resulted in low systemic bupivacaine levels. The inclusion of additives shortened Tmax without improving outcome.
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J. Cardiothorac. Vasc. Anesth. · Nov 2024
The Hemodynamic Effects of Bolus Dose Calcium in Patients Undergoing Pulmonary Artery Reconstruction and Unifocalization Surgery: A Pilot Study.
To determine if bolus administration of calcium increases pulmonary artery pressures after unifocalization procedures or pulmonary artery reconstruction surgery. ⋯ Calcium bolus administration led to an increase in pulmonary arterial pressure in patients after pulmonary artery reconstruction or unifocalization surgeries. It may be prudent to avoid bolus administration in this patient population immediately after repair or in patients with right ventricular dysfunction.
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J. Cardiothorac. Vasc. Anesth. · Nov 2024
Norepinephrine Salt Formulations and Risk of Therapeutic Error: Results of a National Survey.
Norepinephrine is available commercially in solution containing its salt (eg, tartrate), but only the base form (ie, norepinephrine base) is active pharmacologically. Unfortunately, the outer label of drug packages frequently reports the dosage of norepinephrine as a salt, which can lead potentially to therapeutic errors when prescribing norepinephrine. We performed a survey to assess the level of awareness of this issue. ⋯ There is significant variability in dosage management of norepinephrine across different hospital units, as well as a lack of knowledge regarding the salt-to-base ratio. Scientific publications (eg, guidelines) should specify whether they are referring to the base or salt form of norepinephrine. The adoption of different labeling and national standards for dilution may decrease the risk of therapeutic errors.
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J. Cardiothorac. Vasc. Anesth. · Nov 2024
The Association Between Renal Desaturation Measured Using Near-Infrared Spectroscopy and Postoperative Acute Kidney Injury: A Systematic Review.
The objective of this systematic review was to clarify the status of near-infrared spectroscopy (NIRS) in monitoring perioperative renal regional tissue oxygen saturation (rSO2) and determine whether there is evidence supporting its use in predicting postoperative acute kidney injury (AKI). ⋯ Renal desaturation may indicate AKI in patients; however, further studies are required to substantiate this relationship. Additional clinical trials are necessary to evaluate normal values and establish the exact threshold of renal rSO2 that signifies a meaningful decline in renal function.
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J. Cardiothorac. Vasc. Anesth. · Nov 2024
Quo Vadis, ECMO? Multidisciplinary Hybrid Extra Corporeal Membrane Oxygenation Rounds During the COVID-19 Pandemic.
The complex care of patients on extracorporeal membrane oxygenation (ECMO) requires a high level of collaboration between multiple medical specialties and allied health professionals. Effective and timely communication between team members is imperative in ensuring patient safety. The COVID-19 pandemic posed unique challenges in the care of patients on ECMO. ⋯ After eight months of rounds, medical care team members were asked to provide feedback regarding the rounds format, strengths, and weaknesses. The most frequently identified strengths were improved multidisciplinary communication and continuity of care. This article demonstrates that hybrid virtual and in-person patient rounds are a feasible way for ECMO programs to improve team communication and overall patient care.