Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2017
Observational StudyA Novel Automated Somatosensory Evoked Potential (SSEP) Monitoring Device for Detection of Intraoperative Peripheral Nerve Injury in Cardiac Surgery: A Clinical Feasibility Study.
Peripheral nerve injury (PNI) is a common and potentially devastating complication in cardiac surgery. Somatosensory evoked potential (SSEP) monitoring is one of the modalities for PNI; however, its application is limited by complicated logistics. This study aimed to assess the feasibility of using a novel, automated SSEP device (EPAD; SafeOp Surgical, Hunt Valley, MD) for detection of intraoperative PNI during cardiac surgery. ⋯ The EPAD automated SSEP device is a viable option for detecting PNI during cardiac surgery. A high incidence of intraoperative peripheral nerve compromise and a 6.1% incidence of postoperative peripheral neuropathy were observed. This study reports the clinical feasibility of using the EPAD automated SSEP device; additional studies are required to evaluate the diagnostic test accuracy and the outcome benefit of routine SSEP monitoring in cardiac surgical patients.
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J. Cardiothorac. Vasc. Anesth. · Aug 2017
Observational StudyImpact of Left Heart Bypass on Arterial Oxygenation During One-Lung Ventilation for Thoracic Aortic Surgery.
The aim of this study was to reveal the mechanism of improved arterial oxygenation by measuring the changes in oxygenation before and after initiation of left heart bypass (LHB) during one-lung ventilation (OLV) for thoracic aortic surgery. ⋯ The improved arterial oxygenation during OLV in patients who underwent thoracic aortic surgery using LHB can be attributed to the insertion of an inflow cannula via the left pulmonary vein into the left atrium before LHB.
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J. Cardiothorac. Vasc. Anesth. · Aug 2017
Cardioprotection by Remote Ischemic Preconditioning is Blocked in the Aged Rat Heart in Vivo.
In animal studies, remote ischemic preconditioning (RIPC) is a powerful tool to protect the heart from ischemia and reperfusion injury. Unfortunately, this effect was not seen consistently in recent large clinical trials. Aging was shown to be a confounding factor for the effect of direct preconditioning in experimental studies, but whether aging also can influence the effect of RIPC and thus be responsible for the contradictory clinical effect is unknown. The aim of this study was to investigate whether the cardioprotective effect of RIPC was abolished by aging. ⋯ The results of the authors' study showed that cardioprotection induced by remote ischemic preconditioning was blocked in the aged rat heart.