Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Multicenter Study
Effect of iloprost inhalation on postoperative outcome in high-risk cardiac surgical patients: a prospective randomized-controlled multicentre trial (ILOCARD).
Perioperative right ventricular (RV) failure due to pressure overload from pulmonary hypertension (PH) worsens postoperative outcomes after cardiac surgery. Inhaled iloprost is a potent pulmonary vasodilator improving RV performance, ameliorating myocardial and pulmonary ischemia-reperfusion injury and attenuating inflammation. We hypothesized that the prophylactic inhalation of iloprost would reduce postoperative ventilation times after cardiac surgery. ⋯ The prophylactic inhalation of iloprost did not meaningfully improve the outcome in high-risk cardiac surgical patients.
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Observational Study
Anatomical evaluation of the extent of spread in the erector spinae plane block: a cadaveric study.
The erector spinae plane (ESP) block is an interfascial analgesic technique first described as an alternative for pain control at the thoracic level. The objective of this observational study was to determine the anatomical spread of dye following a T7 ESP block in a cadaveric model. ⋯ The results suggest that the ESP block reaches a wide range of the posterior rami of spinal nerves without diffusion into the paravertebral space or involvement of the anterior rami.
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Altered perioperative glycemic control may contribute to the development of renal dysfunction in cardiac surgery patients. Nevertheless, whether it is intraoperative hyperglycemia or increased glucose variability that affects postoperative outcomes is not yet clear. The aim of this study was to assess the association of intraoperative glucose concentration and variability with acute kidney injury (AKI) after cardiac surgery. ⋯ Intraoperative glucose variability, but not the average glucose concentration itself, may be a risk factor for AKI after cardiac surgery.