Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2018
Observational StudyDisturbances in Oxygen Balance During Cardiopulmonary Bypass: A Risk Factor for Postoperative Delirium.
The aim of this study was to determine risk factors for postoperative delirium after cardiac surgery, specifically associated with the conduct of cardiopulmonary bypass (CPB). ⋯ The influence of the SvO2 level during CPB, fluid balance, and patient age should be recognized as risk factors for postoperative delirium after cardiac surgery in patients 70 years and older.
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J. Cardiothorac. Vasc. Anesth. · Apr 2018
Review Meta AnalysisEffects of Positive Airway Pressure and Mechanical Ventilation of the Lungs During Cardiopulmonary Bypass on Pulmonary Adverse Events After Cardiac Surgery: A Systematic Review and Meta-Analysis.
To investigate whether different ventilation strategies during cardiopulmonary bypass (CPB) can improve outcomes in adult cardiac surgery patients. ⋯ CPAP during CPB improved the alveolar-arterial oxygen gradient difference compared with apnea, but ventilation during CPB did not. Neither CPAP nor ventilation during CPB demonstrated evidence of improving clinical outcomes in low- or intermediate-risk patients for elective cardiac surgery. The findings are inconclusive because of heterogeneity and small sample sizes.
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J. Cardiothorac. Vasc. Anesth. · Apr 2018
Randomized Controlled TrialLower Dose of Sufentanil Does Not Enhance Fast Track Significantly-A Randomized Study.
Adjustment in the doses of opioids has been a focus of interest for achieving better fast-track conditions in cardiac anesthesia, but relatively sparse information exists on the potential effect of psychologic and behavioral factors, such as stress, anxiety, and type of personality, on anesthesia requirements and patient turnover in the cardiac recovery unit (CRU); to the authors' knowledge, this particular focus has not been systematically investigated. In this randomized study, the authors tested the hypothesis that low-dose sufentanil, compared with a standard dose, can improve fast-track parameters and the overall quality of recovery. Opioid requirements related to personality type, pain sensitivity, and preoperative stress and anxiety also were assessed. ⋯ A lower dose of sufentanil, compared with a standard dose, does not enhance fast-track conditions significantly.
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J. Cardiothorac. Vasc. Anesth. · Apr 2018
Randomized Controlled TrialChest Computed Tomography Image for Accurately Predicting the Optimal Insertion Depth of Left-Sided Double-Lumen Tube.
The main objective of this study was to assess the feasibility and accuracy of measuring the distance between the vocal cord and carina using chest computer tomography (CT) as a guide for the intubation of a left-sided double-lumen tube (LDLT). ⋯ This study demonstrated that the method of measuring the distance between the vocal cord and carina according to the chest CT as a guide for the intubation of LDLT is more effective and more accurate than the blind intubation method.