Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2011
Cardiac output determination from endotracheally measured impedance cardiography: clinical evaluation of endotracheal cardiac output monitor.
To evaluate the accuracy, precision, and trending of a new endotracheally sourced impedance cardiography-based cardiac output (CO) monitor (ECOM; ConMed Corp, Irvine, CA). ⋯ ECOM CO shows an acceptable bias with wide limits of agreement and a large percent error when compared with TD CO or TEE CO; however, it shows acceptable trending of CO to both modalities in patients undergoing cardiac surgery. Further studies are required to evaluate ECOM in other patient populations and clinical situations.
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The authors analyze a commercially available software package capable of geometrically reconstructing the mitral valve (MV) dynamically throughout systole. ⋯ This new software, despite its limitations, allows an improved perspective on MV geometry with implications for MV repair and surgical decision making.
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J. Cardiothorac. Vasc. Anesth. · Oct 2011
Anesthesia preparation time is not affected by the experience level of the resident involved during his/her first month of adult cardiac surgery.
This study was designed to answer the question of whether the experience level of the resident on his/her first month of adult cardiothoracic anesthesiology has an impact on operating room efficiency in a large academic medical center. Traditionally, the resident's 1st month of cardiac anesthesia had been reserved for the clinical anesthesia (CA)-2 year of training. This study analyzed the impact on operating room efficiency of moving the 1st month of cardiac anesthesia into the CA-1 year. The authors hypothesized that there would be no difference in anesthesia preparation times (defined as the interval between "in-room" and "anesthesia-ready" times) between CA-1 and CA-2 residents on their 1st month of cardiac anesthesia. ⋯ These findings suggest that operating room efficiency as measured by the anesthesia preparation time may not be affected by the level of the resident on his/her 1st month of adult cardiac anesthesia.
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J. Cardiothorac. Vasc. Anesth. · Oct 2011
Functional hemodynamic parameters do not reflect volume responsiveness in the immediate phase after acute myocardial ischemia and reperfusion.
Functional preload parameters such as stroke-volume variation (SVV) and pulse-pressure variation (PPV) are superior to filling pressures when assessing volume responsiveness in mechanically ventilated patients. This investigation studied their application in the setting of acute myocardial ischemia and reperfusion (I/R). ⋯ SVV and PPV did not reflect volume responsiveness in an experimental model of acute myocardial I/R.