Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Observational StudyCentral Venous Catheter Tip Malposition After Internal Jugular Vein Cannulation in Pediatric Patients With Congenital Heart Disease.
The primary objective of the study was to identify the incidence of catheter tip malposition as determined by postoperative radiography after central venous cannulation by right and left internal jugular venous routes in pediatric cardiac surgical patients. The secondary objective was to determine the relative risk of malposition between the 2 approaches into specific major thoracic veins other than the right superior vena cava. ⋯ The incidence of a malposition of a central venous catheter tip after either right or left internal jugular vein approach was ascertained. The relative risk of a malposition occurring with the left internal jugular approach was higher, and the most common site of malposition was in the right subclavian vein.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
The Prognostic Role of Early Postoperative Troponin I in Lung Transplantation-A Retrospective 7-Year Analysis.
Postoperative cardiac troponin I concentration is predictive of worsened outcomes in cardiac surgery. Lung transplantation (LT) surgery shares common features with cardiac surgery, but postoperative troponin has yet to be investigated. The authors aimed to evaluate the association between early postoperative troponin concentration and the 1-year mortality after transplantation. ⋯ Early postoperative troponin serum levels were not independently associated with 1-year mortality. Early postoperative troponin I levels were correlated to bilateral LT, the need for ECLS, and intraoperative blood transfusion.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Observational StudyRetrograde Autologous Priming for Minimally Invasive Mitral Valve Surgery.
Little is known about the safety and clinical utility of retrograde autologous priming (RAP) in patients undergoing minimally invasive mitral valve surgery. The study authors hypothesized that RAP would increase the oxygen delivery index (DO2i) while decreasing red blood cell transfusion requirements compared to valve surgery without RAP. ⋯ In a minimally invasive mitral valve context, RAP was safe and associated with better DO2i, higher hematocrit, and fewer intraoperative and postoperative red blood cell transfusions.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Observational StudyVariation of Left Ventricular Outflow Tract Velocity Time Integral at Different Positive End-Expiratory Pressure Levels Can Predict Fluid Responsiveness in Mechanically Ventilated Critically Ill Patients.
To explore whether the variation of left ventricular outflow tract velocity time integral (LVOT VTI) between positive end-expiratory pressure (PEEP) 10 cmH2O and PEEP 0 cmH2O can predict fluid responsiveness in mechanically ventilated critically ill patients. ⋯ Variation of LVOT VTI between PEEP 10 cmH2O and PEEP 0 cmH2O can be used to predict fluid responsiveness in critically ill patients on controlled mechanical ventilation.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Observational StudyUtility of Transfontanelle Ultrasound in Predicting the Fluid Responsiveness in Children After Repair of Congenital Heart Diseases: A Prospective Observational Study.
Postoperative fluid management in children undergoing cardiac surgery requires a balanced optimization. The blood flow velocity variation in the internal carotid artery (ΔICA) measured through transfontanelle ultrasound has been shown to predict fluid responsiveness during cardiac surgery. It may provide an excellent window to study fluid responsiveness in infants during the postoperative period when the intensivist is faced with the challenges of poor echocardiographic window. The authors aimed to observe the correlation between ΔICA measured on transfontanelle ultrasound with the respiratory variability of peak aortic blood flow velocity (ΔVpeak) on transthoracic echocardiography as a marker of fluid responsiveness in infants on mechanical ventilation during the postoperative period after cardiac surgery. ⋯ The ICA variability >9.85% measured via transfontanelle ultrasound is a good predictor of fluid responsiveness in infants, especially those younger than 6 months on mechanical ventilation after cardiac surgery.