Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2018
Historical ArticleHistory of Cardiac Anesthesia in India.
Before the 19th century, the heart was considered as a "no-go" area, although minor and superficial procedures were performed in the early 1800s. It was only in the later part of the century that surgical repair of the wounds of the cardiac chambers was attempted. Cardiac surgery came to India in the mid-20th century and the operations performed were minor and extracardiac. ⋯ The progress was somewhat modest until the 1980s, when it started increasing rapidly and India caught up with the Western world by the turn of century. The progress was seen not only in the clinical field, but also in technology, teaching, and academic fields. This article presents an account of the progress in the field of cardiac anesthesia in India, and highlights the contribution of some of the dedicated anesthesiologists because of whom the specialty has reached the present stature.
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J. Cardiothorac. Vasc. Anesth. · Oct 2018
Review Meta AnalysisContinuous Infusion versus Intermittent Bolus Injection of Furosemide in Critically Ill Patients: A Systematic Review and Meta-analysis.
Fluid overload is a common phenomenon seen in intensive care units (ICUs). However, there is no general consensus on whether continuous or bolus furosemide is safer or more effective in these hemodynamically unstable ICU patients. The aim of this meta-analysis was to examine the clinical outcomes of continuous versus bolus furosemide in a critically ill population in ICUs. ⋯ In this meta-analysis, continuous furosemide was associated with greater diuretic effect in total urine output as compared with bolus. Neither had any differences in mortality and changes of renal function tests. However, a large adequately powered randomized clinical trial is required to fill this knowledge gap.
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J. Cardiothorac. Vasc. Anesth. · Oct 2018
Outcomes After Transcatheter Aortic Valve Replacement: A Propensity Matched Retrospective Cohort Study.
To examine patient acuity and perioperative outcomes in a contemporary cohort of patients undergoing either transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR). ⋯ Patients undergoing TAVR have similar mortality, length of stay, and risk for postoperative complications as do patients undergoing SAVR, but patients undergoing TAVR are less likely to have blood transfused.
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J. Cardiothorac. Vasc. Anesth. · Oct 2018
Randomized Controlled Trial Multicenter StudyEffect of Levosimendan on Renal Outcome in Cardiac Surgery Patients With Chronic Kidney Disease and Perioperative Cardiovascular Dysfunction: A Substudy of a Multicenter Randomized Trial.
Acute kidney injury (AKI) occurs frequently after cardiac surgery. Levosimendan might reduce the incidence of AKI in patients undergoing cardiac surgery. The authors investigated whether levosimendan administration could reduce AKI incidence in a high-risk cardiac surgical population. ⋯ Levosimendan may improve renal outcome in cardiac surgery patients with chronic kidney disease undergoing mitral valve surgery who develop perioperative myocardial dysfunction. Results of this exploratory analysis should be investigated in future properly designed randomized controlled trials.