Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2024
Randomized Controlled TrialAnalgesic Effect and Sleep Quality of Low-Dose Dexmedetomidine in Cardiac Surgical Patients After Ultrafast-Track Extubation: A Randomized Clinical Trial.
To compare the analgesic and sleep quality effects of dexmedetomidine infusion versus placebo in patients undergoing cardiac surgery with ultra-fast track extubation. ⋯ Sedation with low-dose dexmedetomidine infusion for ultra-fast track extubation following cardiac surgery enhances sleep duration and quality.
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J. Cardiothorac. Vasc. Anesth. · Oct 2024
Randomized Controlled TrialEffect of Ciprofol on Left Ventricular Myocardial Strain and Myocardial Work in Children Undergoing Cardiac Surgery: A Single-center Double-blind Randomized Noninferiority Study.
The current work was designed to compare the effects of ciprofol and propofol on left ventricular systolic function and myocardial work by noninvasive speckle-tracking echocardiography in children undergoing surgical repair of atrial septal or ventricular septal defects. ⋯ Ciprofol did not show different effects on myocardial function and postoperative outcomes from propofol. Further, on the sensitive cardiac systole marker global longitudinal strain, ciprofol demonstrated noninferiority to propofol. Ciprofol might be an alternative solution for cardiac anesthesia in children with congestive heart disease with mild lesion.
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J. Cardiothorac. Vasc. Anesth. · Oct 2024
ReviewTransatlantic Educational Network: An Innovation Born of Necessity.
The coronavirus disease 2019 pandemic brought about many changes in the delivery of healthcare, graduate medical education, and collaborative efforts across academic medicine. While there was a temporary disruption in the fluid delivery of services, longer-term benefits emerged with the leveraging of innovative technology and multicenter collaborations. These new opportunities led 14 centers in the United States and Europe to develop a novel, remote, and collaborative educational effort in cardiovascular and thoracic anesthesiology, known as the Transatlantic Educational Network. This paper describes the initial pilot structure and preimplementation data and provides a rationale for the development and expansion of the pilot program in other areas of anesthesiology.
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J. Cardiothorac. Vasc. Anesth. · Oct 2024
Review Comparative StudyTotal Intravenous Anesthesia Is Preferred Over Volatile Agents in Cardiac Surgery.
The choice of maintenance anesthetic during cardiopulmonary bypass has been a subject of ongoing debate. Systematic reviews on the topic have so far failed to demonstrate a difference between volatile agents and total intravenous anesthesia (TIVA) in terms of mortality, myocardial injury, and neurological outcomes. Studies using animal models and noncardiac surgical populations suggest numerous mechanisms whereby TIVA has been associated with more favorable outcomes. However, even if the different anesthetic methods are assumed to equivalent in terms of patient outcomes in the context of cardiac surgery, additional factors, namely variables of occupational exposure and environmental impact, strongly support the preferred use of TIVA.
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J. Cardiothorac. Vasc. Anesth. · Oct 2024
Multicenter Study Observational StudyContinuous Urine Output-Based Alert Identifies Cardiac Surgery-associated Acute Kidney Injury Earlier Than Serum Creatinine: A Prospective and Retrospective Observational Study.
Acute kidney injury (AKI) is defined and staged by reduced urine output (UO) and increased serum creatinine (SCr). UO is typically measured manually and documented in the electronic health record, making early and reliable detection of oliguria-based AKI and electronic data extraction challenging. The authors investigated the diagnostic performance of continuous UO, enabled by active drain line clearance-based alerts (Accuryn AKI Alert), compared with AKI stage 2 SCr criteria and their associations with length of stay, need for continuous renal replacement therapy, and 30-day mortality. ⋯ AKI Alert, based on continuous UO and enabled by active drain line clearance, detected AKI stages 1 and 2 before SCr criteria. Early AKI detection allows for early kidney optimization, potentially improving patient outcomes.