Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2011
Case ReportsThe management and outcome of documented intraoperative heart rate-related electrocardiographic changes.
The authors analyzed surgical cases in which electrocardiographic (ECG) signs of cardiac ischemia were noted to be precipitated by increases in heart rate (ie, heart rate-related ECG changes [REC]). The authors aimed to find REC incidence, specificity for coronary artery disease (CAD), and the outcome associated with different management strategies. ⋯ This incidence of reported REC was much lower than the previously reported incidence of ischemia-related ECG changes, suggesting that the largest proportion of events go unnoticed. In many patients, subsequent cardiology workup did not confirm the existence of clinically significant CAD.
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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.
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J. Cardiothorac. Vasc. Anesth. · Oct 2011
Scholarly productivity of united states academic cardiothoracic anesthesiologists: influence of fellowship accreditation and transesophageal echocardiographic credentials on h-index and other citation bibliometrics.
The h-index allows the evaluation of scholarly output in academics, but this bibliometric statistic has not been applied extensively to measure productivity in anesthesiology. The authors tested the hypothesis that the h-index is dependent on academic rank, American College of Graduate Medical Education (ACGME) accreditation of the training program, and National Board of Echocardiography credentials in perioperative transesophageal echocardiography (TEE) in United States academic cardiothoracic anesthesiologists. ⋯ The results show that the h-index increases progressively with academic rank and is dependent on fellowship program accreditation status but not transesophageal echocardiographic credentials in United States academic cardiothoracic anesthesiologists.