Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jan 2024
Observational StudyAssociation of Preoperative Renal-Resistive Index With Long-term Renal and Cardiovascular Outcomes After Cardiac Surgery.
To investigate the association of elevated preoperative renal-resistive index (RRI) with persistent renal dysfunction, major adverse kidney events (MAKE), and major adverse cardiovascular events (MACE) after cardiac surgery. ⋯ Elevated preoperative RRI is associated with persistent renal dysfunction, MAKE, and MACE after cardiac surgery. Preoperative RRI may be used for long-term risk assessment in patients undergoing cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Jan 2024
Medical Malpractice Claims Related to Performance of Transesophageal Echocardiography by Anesthesiologists.
More than 300,000 adults have cardiac surgery in the United States annually, and most undergo intraoperative transesophageal echocardiography (TEE). This patient population is often older with multiple comorbidities, increasing their risk for complications for even routine procedures. ⋯ Esophageal injury accounted for most of the suits, and only 2 were related to diagnosis. Most expert reviews deemed the care provided by the anesthesiologist to be appropriate.
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J. Cardiothorac. Vasc. Anesth. · Jan 2024
Modification of Respiratory Drive and Lung Stress by Level of Support Pressure and ECMO Sweep Gas Flow in Patients With Severe COVID-19-Associated Acute Respiratory Distress Syndrome: an Exploratory Retrospective Analysis.
Patients with severe acute respiratory distress syndrome (ARDS) often exhibit an unusually strong respiratory drive, which predisposes them to effort-induced lung injury. Careful titration of support pressure via the ventilator and carbon dioxide removal via extracorporeal membrane oxygenation (ECMO) may attenuate respiratory drive and lung stress. ⋯ In patients with CARDS on pressure support ventilation, even moderate support pressure may lead to overassistance during assisted ventilation, which is only reflected by advanced monitoring of respiratory mechanics. Modifying carbon dioxide removal via the extracorporeal system profoundly affects respiratory effort and mechanics. Spontaneously breathing patients with CARDS may benefit from consequent carbon dioxide removal.
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J. Cardiothorac. Vasc. Anesth. · Jan 2024
Observational StudyPhase Angle as a Reliable Biomarker of Frailty to Predict Postoperative Outcomes in Patients Undergoing Off-Pump Coronary Artery Grafting: A Prospective Observational Study.
To elucidate the association between phase angle (PA) and a composite adverse outcome in patients requiring off-pump coronary artery bypass grafting (OPCAB). ⋯ Low PA as an indicator of frailty is associated with adverse postoperative outcomes after OPCAB. Low PA may be employed as a noninvasive and practical tool for the prediction of prognosis in patients with coronary artery disease.