Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Crossing Boundaries: Utilizing Left-sided Impella for Right Ventricular Mechanical Support and Intraoperative Transesophageal Echocardiogram Considerations.
Right ventricular failure is a leading cause of mortality among patients with various etiologies of cardiogenic shock. This case series outlines an innovative approach to directly unloading the right ventricle with the Impella LD or 5.5 without crossing the tricuspid valve in cases requiring tricuspid valve repair or replacement. ⋯ Left-sided Impella can be used to support the right ventricle in patients who have undergone surgical tricuspid valve procedures. It provides direct right ventricular unloading, does not cross a newly replaced or repaired tricuspid valve, and allows early ambulation.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
The Efficacy and Safety of Angiotensin II for Treatment of Vasoplegia in Critically Ill Patients: A Systematic Review.
To summarize evidence regarding intravenous angiotensin II administration in critical illness and provide an updated understanding of its effects on various organ dysfunction and renin-angiotensin system (RAS) biomarkers. ⋯ Intravenous angiotensin II has been reported in almost 3000 critically ill patients with diverse types of shock. Despite unclear mortality impacts, angiotensin II seems to confer beneficial effects on several organ systems and RAS derangements, without increasing adverse events.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
The Effect of Extracorporeal Membrane Oxygenation on the Pharmacokinetics of Dexmedetomidine Hydrochloride.
Our objective was to explore the effects of extracorporeal membrane oxygenation (ECMO) on the pharmacokinetics of dexmedetomidine hydrochloride via vitro and in vivo experiments DESIGN: A single-center animal investigation. ⋯ The ECMO circuit had an adsorption effect on dexmedetomidine hydrochloride, but this effect was not sufficient to impact the in vivo pharmacokinetics of dexmedetomidine significantly. The effect of ECMO on the pharmacokinetics of dexmedetomidine hydrochloride was not significant.