Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Nov 2022
Analgesic Effects of a Novel Combination of Regional Anesthesia After Pediatric Cardiac Surgery: A Retrospective Cohort Study.
The objective of this study was to determine whether the use of regional anesthesia in children undergoing congenital heart surgery was associated with differences in outcomes when compared to surgeon-delivered local anesthetic wound infiltration. ⋯ Bilateral PIFBs and a unilateral RSB on the side ipsilateral to the chest tube is a novel analgesic technique for sternotomy in pediatric patients. In this retrospective study, these interventions were associated with decreases in postoperative opioid use, pain scores, and hospital length of stay without prolonging time under GA.
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J. Cardiothorac. Vasc. Anesth. · Nov 2022
Observational StudyTiming, Threshold, and Duration of Intraoperative Hypotension in Cardiac Surgery: Their Associations With Postoperative Delirium.
To study the timing, threshold, and duration of intraoperative hypotension (IOH) associated with the risk of postoperative delirium (POD). ⋯ A longer cumulative duration of IOH with the threshold between <60 and <75 mmHg that occurred after CPB was independently associated with the risk of POD.
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J. Cardiothorac. Vasc. Anesth. · Nov 2022
Observational StudyPreoperative Liver Stiffness is Associated With Hospital Length of Stay After Cardiac Surgery.
Risk assessment models for cardiac surgery do not account for the degrees of liver dysfunction. Ultrasound shear-wave elastography measures liver stiffness (LSM), a quantitative measurement related to fibrosis, congestion, and inflammation. The authors hypothesized that preoperative liver stiffness would be associated with hospital length of stay after cardiac surgery. ⋯ A preoperative LSM ≥9.5 kPa was associated with a significantly longer postoperative hospital length of stay. This association appeared independent of preoperative comorbidities commonly associated with coronary disease. Preoperative liver stiffness is a novel risk metric that is associated with the postoperative hospital length of stay after cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Nov 2022
Association of Preoperative Pulse Pressure and Oxygen Delivery Index During Cardiopulmonary Bypass With Postoperative Acute Kidney Injury.
To investigate if oxygen delivery index during cardiopulmonary bypass (DO2I) was more strongly associated with acute kidney injury (AKI), the higher the patient's preoperative pulse pressure (PP). ⋯ A lower DO2I during cardiopulmonary bypass appeared more strongly associated with a higher likelihood of developing AKI, the higher the patient's preoperative pulse pressure.