Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Sep 2023
Evaluating the Utility of Portal Vein Pulsatility Index for Detecting Fluid Unresponsiveness in the Intensive Care Unit.
The primary aim of the authors' study was to evaluate the capacity of the portal vein pulsatility index (PVP) to detect fluid unresponsiveness in patients admitted to intensive care. ⋯ Although PVP has limited value as the sole indicator for fluid management decisions, it can be used as a stopping rule or combined with other diagnostic tests to improve the accuracy of fluid responsiveness assessment.
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J. Cardiothorac. Vasc. Anesth. · Sep 2023
Observational StudyAssociation Between Risk of Stroke and Delirium After Cardiac Surgery and a New Electroencephalogram Index of Interhemispheric Similarity.
Neurologic complications after surgery (stroke, delirium) remain a major concern despite advancements in surgical and anesthetic techniques. The authors aimed to evaluate whether a novel index of interhemispheric similarity, the lateral interconnection ratio (LIR), between 2 prefrontal electroencephalogram (EEG) channels could be associated with stroke and delirium following cardiac surgery. ⋯ After improvement of SNR, it might be of value to further study the index decrease as an indication for risk for brain injury after surgery. The timing of decrease (after CPB or end of surgery) may provide hints regarding the injury pathophysiology and its onset.
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J. Cardiothorac. Vasc. Anesth. · Sep 2023
Cardiac Surgery in Jehovah's Witnesses: 329 Consecutive Cases.
This study aimed to describe the outcome of Jehovah's Witnesses (JWs) undergoing cardiac surgery at the authors' center. ⋯ This study demonstrated that cardiac surgery in JWs is safe when adhering to a strict perioperative patient blood management protocol.
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J. Cardiothorac. Vasc. Anesth. · Sep 2023
Perioperative Risk Assessment in Children With Congenital Heart Disease Undergoing Noncardiac Procedures.
To risk-stratify children with congenital heart disease undergoing noncardiac surgery or diagnostic procedures for perioperative cardiopulmonary complications using the authors' established institutional guidelines. ⋯ A robust model for severe perioperative complications was developed within the authors' institutional clinical guidelines, identifying 5 predictors for perioperative cardiac arrest or death. The usual markers of critical illness were not found to be predictive of a moderate perioperative complication, regardless of the level of anesthesiologist training, suggesting that many of these children with congenital heart disease undergoing noncardiac procedures can be treated by a general pediatric anesthesiologist rather than a pediatric cardiac anesthesiologist within an institution that has or can establish clinical guidelines for these children.