Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Nov 2022
Observational StudyImpact of Hospital Practice and Staffing Differences on Transesophageal Echocardiography Use in Cardiac Valve or Coronary Artery Bypass Graft Surgery.
To identify and quantify the predictors of intraoperative transesophageal echocardiography (TEE) use among the patients undergoing cardiac valve or isolated coronary artery bypass graft (CABG) surgery. ⋯ Hospital practice was the strongest predictor for TEE use overall. In isolated CABG surgery, hospitals with anesthesiologist TEE staffing were a primary predictor for TEE use.
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J. Cardiothorac. Vasc. Anesth. · Nov 2022
Risk Factors and Consequences of Late-Onset Hyperlactatemia After Cardiac Surgery With Cardiopulmonary Bypass: A Single-Center Retrospective Study.
Mechanisms and consequences of late-onset hyperlactatemia after cardiac surgery remain unclear. The aim of this study was to identify risk factors and outcomes of late hyperlactatemia, defined as a lactate value ≥3 mmol/L developing in the intensive care unit (ICU) after not being elevated on admission after cardiac surgery with cardiopulmonary bypass. ⋯ The strongest risk factors associated with late-onset hyperlactatemia in the authors' population were afternoon surgery and H6 bleeding >300 mL. Poor postoperative outcomes were more frequent in patients with late hyperlactatemia, even in the absence of early hyperlactatemia or severe obvious condition.
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J. Cardiothorac. Vasc. Anesth. · Nov 2022
Extubation Failure in Infants with Modified Blalock-Taussig Shunt: The Incidence, Predictors, and Outcomes.
Infants with congenital heart diseases often require mechanical ventilation and a prolonged intensive care unit (ICU) stay due to complex cardiopulmonary complications. The primary objective of the study was to determine the incidence and predictors of tracheal extubation failure in infants undergoing modified Blalock-Taussig shunt (MBTS). The secondary objective was to evaluate if extubation failure was associated with increased mortality and longer ICU and hospital stays. ⋯ The incidence rate of extubation failure after placement of MBTS was 18.5%. Preoperative mechanical ventilation, diaphragmatic paralysis, the need for escalation of the inotropic score, and systolic blood pressure ≤50th percentile could be considered predictors of extubation failure in these infants.
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J. Cardiothorac. Vasc. Anesth. · Nov 2022
Acute Kidney Injury With a Miniaturized Extracorporeal Circuit for Neonatal Cardiopulmonary Bypass.
The objectives of this study were to evaluate the incidence and to identify risk factors for acute kidney injury (AKI) in neonates undergoing cardiopulmonary bypass (CPB) with a miniaturized bloodless primed extracorporeal circuit. ⋯ With a miniaturized CPB circuit and bloodless priming, the AKI incidence was well within the range consistent with previously reported studies from other institutions.