Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2021
Initial Postoperative Hemoglobin Values Are Independently Associated With One-Year Mortality in Patients Undergoing Double-Lung Transplantation Requiring Intraoperative Transfusion.
To evaluate the association of postoperative hemoglobin values and mortality in patients undergoing double- lung transplantation with intraoperative transfusion. ⋯ Lower postoperative hemoglobin levels in double-lung transplantation recipients were associated with increased mortality during the first year after surgery. Confirmation of these findings in additional investigations could alter patient blood management for double-lung transplantation.
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J. Cardiothorac. Vasc. Anesth. · Oct 2021
Randomized Controlled TrialHigh Versus Normal Blood Pressure Targets in Relation to Right Ventricular Dysfunction After Cardiac Surgery: A Randomized Controlled Trial.
Management of right ventricular (RV) dysfunction is challenging. Current practice predominantly is based on data from experimental and small uncontrolled studies and includes augmentation of blood pressure. However, whether such intervention is effective in the clinical setting of cardiac surgery is unknown. ⋯ In a mixed cardiac surgery population with RV dysfunction, norepinephrine-mediated high blood pressure targets did not result in an increase in PAC-derived RVEF compared with normal blood pressure targets.
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J. Cardiothorac. Vasc. Anesth. · Oct 2021
Case ReportsCOVID 19: A Stressor for Both the Patient and the Anesthesiologist.
The coronavirus disease 2019 pandemic has created not only widespread morbidity and mortality, but a myriad of social, financial, and psychological stressors. In this setting, the medical community has seen a substantial increase in the incidences of cardiac morbidity and mortality, and, therefore, anesthesiologists should expect a higher incidence in the perioperative period. In this E-Challenge, the authors present a patient in whom an acute cardiac decompensation occurred secondary to an unanticipated difficult intubation, with an unexpected echocardiographic finding.
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J. Cardiothorac. Vasc. Anesth. · Oct 2021
Pulmonary Complications in Esophagectomy Based on Intraoperative Fluid Rate: A Single-Center Study.
Esophagectomy is associated with significant morbidity and mortality. The authors assessed the relationship between intraoperative fluid (IOF) administration and postoperative pulmonary outcomes in patients undergoing a transthoracic, transhiatal, or tri-incisional esophagectomy. ⋯ Increased IOF administration during esophagectomy may be associated with worse postoperative pulmonary complications, specifically ARDS. Future well-powered studies are warranted, including randomized, controlled trials comparing liberal versus restrictive fluid administration in this surgical population.