Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jan 2021
ReviewSurgical Closure of Atrial Septal Defects in Young Children-A Review of Anesthesia Care in Sternotomy and Thoracotomy Approaches.
To review and compare the anesthetic management of atrial septal defect (ASD) closures via mini lateral thoracotomy and sternotomy approaches. ⋯ The authors reviewed perioperative pain management strategies used in surgical ASD closures. Different fascial plane blocks were used. This study has paved way to design a randomized control trial to compare various regional techniques for cardiac surgeries and identified opportunities for improved pain assessment scoring in children after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Jan 2021
ReviewTraining and Accreditation Pathways in Critical Care and Perioperative Echocardiography.
In recent years, there has been a dramatic rise in the use of echocardiography in perioperative and critical care medicine. It is now recommended widely as a first-line diagnostic tool when approaching patients in shock, due to its ability to identify shock etiology and response to treatment noninvasively. To match the increasing training demand, and to ensure maintenance of high-quality and reproducible scanning, several accreditation pathways have been developed worldwide. ⋯ Currently, the use of transoesophageal echocardiography remains restricted largely to cardiothoracic anesthesia and critical care; however, its use in the general intensive care setting is growing. This narrative review summarizes the most common training pathways, their curricula, and accreditation requirements. The authors initially focus on echocardiography training in the United Kingdom, and then go on to describe similar international accreditations available in Europe, North America, and Australasia.
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J. Cardiothorac. Vasc. Anesth. · Jan 2021
Randomized Controlled Trial Observational StudyUltrasound-Guided Out-of-Plane Versus In-Plane Radial Artery Cannulation in Adult Cardiac Surgical Patients.
The primary objective was to compare the rate of first-pass radial arterial cannulation using out-of-plane ultrasound guidance with in-plane imaging. The secondary endpoints were a comparison of the number of times the cannula was redirected, the number of attempts, the number of skin punctures, the incidence of hematoma, the time to completion of the cannulation procedure, and the number of failed attempts between the 2 ultrasound imaging techniques. ⋯ In-plane ultrasound guidance appeared to be superior for achieving a higher first-pass success rate more often with minimal redirections and skin punctures compared with out-of-plane ultrasound guidance.