Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Mar 2020
Meta AnalysisEffect of Dexmedetomidine on Cardiac Surgery-Associated Acute Kidney Injury: A Meta-Analysis With Trial Sequential Analysis of Randomized Controlled Trials.
Cardiac surgery-associated acute kidney injury (CS-AKI) is associated with high mortality rates. This study aimed to determine the effects of perioperative dexmedetomidine (DEX) administration on CS-AKI in adult patients. ⋯ Perioperative DEX administration provided protective effects against CS-AKI, especially when initiated before and during surgery in elderly patients.
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J. Cardiothorac. Vasc. Anesth. · Mar 2020
Multicenter StudyTransesophageal Echocardiography, Acute Kidney Injury, and Length of Hospitalization Among Adults Undergoing Coronary Artery Bypass Graft Surgery.
To test the association between transesophageal echocardiography (TEE) and incidence of acute kidney injury and length of hospitalization among United States adults undergoing isolated coronary artery bypass graft (CABG) surgery. ⋯ TEE monitoring in CABG surgery was not associated with a lower incidence of acute kidney injury or decreased length of hospitalization. These findings highlight the importance of additional work to study the clinical effectiveness of TEE in CABG surgery.
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J. Cardiothorac. Vasc. Anesth. · Mar 2020
Observational StudyPerioperative Changes of Right Ventricular Function in Cardiac Surgical Patients Assessed by Myocardial Deformation Analysis and 3-Dimensional Echocardiography.
To test the hypothesis that longitudinal strain of the right ventricle (RV) is significantly reduced in patients undergoing cardiac surgery with extracorporeal circulation and cardioplegic cardiac arrest at the end of surgery, whereas RV ejection fraction remains unchanged. ⋯ In patients undergoing coronary artery bypass grafting with cardioplegic cardiac arrest, the longitudinal contraction of the RV lateral and inferior wall, the RV outflow tract, and the interventricular septum is impaired at the end of surgery. This impairment is compensated by an increase in circumferential contraction without changes in RV ejection fraction.
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J. Cardiothorac. Vasc. Anesth. · Mar 2020
Preoperative Blood Pressure Complexity Indices as a Marker for Frailty in Patients Undergoing Cardiac Surgery.
Frailty, a state of decreased physiological reserve, increases the risk of adverse outcomes. There is no standard tool for frailty during perioperative period. Autonomic dysfunction, an underlying process in frailty, could result in hemodynamic fluctuations. Complexity, the physiological adaptability of a system can quantify these fluctuations. The authors hypothesized that complexity could be a marker for frailty and explored their relationship in cardiac surgical patients. ⋯ Preoperative BP complexity indices correlate and predict frailty. Impaired autonomic control is the underlying mechanism to explain this finding. A simple automated measure of preoperative BP complexity in the surgeon's office has the potential to reliably assess frailty.