Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jul 2022
Case ReportsUltrasound-Guided Continuous Parasternal Intercostal Block Relieves Postoperative Pain After Open Cardiac Surgery: A Case Series.
Pain after open cardiac surgery can be severe and may persist for several days, potentially developing into chronic postsurgical pain. Herein the authors describe three patients who underwent open cardiac surgery via traditional median sternotomy approach. Postoperative pain was relieved in these patients via a novel, straightforward, ultrasound-guided parasternal intercostal block, peripheral regional anesthetic technique. This plane block, thus, may represent an effective regional anesthetic strategy and a valuable component of a multimodal analgesic approach for patients who have undergone open cardiac surgery with median sternotomy.
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J. Cardiothorac. Vasc. Anesth. · Jul 2022
Observational StudyNon-White Race/Ethnicity and Female Sex Are Associated with Increased Allogeneic Red Blood Cell Transfusion in Cardiac Surgery Patients: 2007-2018.
To evaluate racial and/or ethnic and sex disparities in allogeneic and autologous red blood cell (RBC) transfusions in cardiac surgery. ⋯ These findings highlighted the differences in the rates of allogeneic RBC transfusion for non-White and female patients undergoing cardiac surgery, which is a well-established marker of poorer outcomes.
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J. Cardiothorac. Vasc. Anesth. · Jul 2022
Observational StudyInterventions Triggered During Routine Use of NIRS Cerebral Oxygenation Monitoring in Cardiac Surgical Patients.
The purpose of this study was to determine the incidence and types of interventions triggered during a drop of baseline near-infraredspectroscopy (NIRS) values in consecutive cardiac surgical patients. ⋯ Of the 1,972 patients who met the inclusion criteria, 576 (29.2%) patients showed NIRS deviation of -20% from baseline. Interventions performed during the drop of baseline NIRS values were documented in 285 (14.4%) patients, with a total of 391 interventions. Three hundred fifteen (80%) interventions were triggered by a deviation in NIRS and concomitant changes in standard monitoring parameters. Seventy-six (20%) interventions were triggered by NIRS deviation alone, with no concomitant pathologic deviation in standard monitoring. A total of 279 (71%) interventions were performed on patients who had no recommendation for NIRS monitoring by current national guidelines. Out of these, 30 (7.7%) interventions (1.3% of all patients) were performed based on NIRS monitoring alone. The higher risk deviation group had longer intensive care unit and hospital lengths of stays (one and 15 days) and postoperative delirium when compared with the no-deviation group (zero and 13 days) Conclusions: The authors' data suggested that most interventions triggered during the drop of baseline values during routine use of NIRS would have also been triggered by the concomitant changes in standard monitoring parameters. Routine use of NIRS for all cardiac surgical patients still is debatable and needs to be evaluated in a large prospective trial.
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J. Cardiothorac. Vasc. Anesth. · Jul 2022
Six-Month Quality of Life in COVID-19 Intensive Care Unit Survivors.
Because there is increasing evidence of serious deterioration in long-term quality of life (QoL) in coronavirus 2019 (COVID-19) intensive care unit (ICU) survivors, the authors identified predictors of poor quality of life in these patients. ⋯ In COVID-19 ICU survivors the authors identified treatment with low- molecular-weight heparin as a predictor of improved physical component of QoL at 6 months.