Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Incidence and Factors Associated With Burnout Among Cardiac Anesthesiologists in India.
Many previous surveys have demonstrated a high incidence of burnout among anesthesiologists. The current survey was designed to estimate the incidence and understand the factors associated with burnout among cardiac anesthesiologists in India. ⋯ The burden of burnout syndrome is high among Indian anesthesiologists. Risk factors included younger age, inadequate workplace and external support, limited personal time, and contemplation of leaving cardiac anesthesia. There is a need for various stakeholders to be sensitized and institute necessary measures to reduce the burden and impact of burnout.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Predictors of Postoperative Morphine Milligram Equivalents in Cardiac Surgery.
Given both the short- and long-term deleterious effects of opioids, there has been an increased focused on reducing the use of postoperative opioid analgesia. As patients undergoing cardiac surgery often require high levels opioids postoperatively, understanding risk factors for increased postoperative opioid use may be helpful for the development of patient-specific opioid-sparing pain regimens for this patient population. ⋯ CABG, liver disease, patient-controlled analgesia, younger age, and higher BMI are associated with increased narcotic use after cardiac surgery. Implementation of more aggressive perioperative multimodal opioid-sparing regimens should be considered for these patient groups.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Insights Into Perioperative Hypertension Management in Europe: Results From a Survey Endorsed by the European Association of Cardiothoracic Anaesthesiology and Intensive Care (EACTAIC).
Perioperative blood pressure control is crucial to ensure organ perfusion and avoid adverse events. However, no consensus on blood pressure targets is available. This study was designed to gain insights into current European perioperative hypertension management practices. ⋯ Perioperative SBP targets above 140 mmHg are uncommon among respondents, who predominantly target SBP values between 120 and 140 mmHg. The choice of intravenous antihypertensives is based on their manageability and user experience, and titratable control is the most appreciated characteristic.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
The Pre-ECPR Score: Developing and Validating a Multivariable Prediction Model for Favorable Neurological Outcomes in Patients Undergoing Extracorporeal Cardiopulmonary Resuscitation.
Extracorporeal cardiopulmonary resuscitation (ECPR) can save patients with refractory cardiac arrest; however, according to recent meta-analyses, only 20% of patients achieve favorable outcomes (Modified Rankin Scale 0-3). We aimed to develop and validate an ECPR prediction model to improve patient selection. ⋯ The Pre-ECPR score combines multiple weighted predictors to provide a single balanced probability of favorable outcomes in ECPR patient selection. In cross-validation, it demonstrated significantly more favorable discriminatory performance than that of the ELSO criteria.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
High Postreperfusion Pulmonary Artery Pressure Is Associated With Increased 30-Day Mortality in Liver Transplantation.
To explore the incidence, risk factors, and impact of elevated mean pulmonary artery pressure (mPAP) on 30-day mortality in liver transplantation (LT). ⋯ mPAP is frequently elevated after graft reperfusion during LT, but its influence on clinical outcomes remains unclear. This retrospective study found a 7.3% rate of high PAP following reperfusion in LT, and high postreperfusion PAP was associated with 30-day mortality.