Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2022
Review Case ReportsLate Diagnosis of a Large Extrapleural Hematoma in a Patient With Stanford Type B Aortic Dissection: A Case Report and Review of Literature.
Acute aortic dissection is a rare but catastrophic condition. When the dissection extends through the adventitia, blood can extravasate into the extrapleural or intrapleural spaces, causing an extrapleural hematoma or hemothorax. The early recognition of extrapleural hematoma and distinguishing it from hemothorax is critical because the management of those two entities is different. ⋯ Without clear radiographic diagnostic features of extrapleural hematoma, unsuccessful drainage of hematoma after insertion of a chest tube may suggest an extrapleural hematoma or a clotted hemothorax. If patients continue to have circulatory or respiratory compromises, prompt surgical exploration should be considered. It is important for clinicians to be aware of extrapleural hematoma in complicated acute aortic dissection, especially when chest tube drainage of an apparent hemothorax is unsuccessful.
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J. Cardiothorac. Vasc. Anesth. · Apr 2022
ReviewScoring Systems for Risk Stratification in Patients Undergoing Cardiac Surgery.
Cardiac surgery is associated with significant mortality rates. Careful selection of surgical candidates is, therefore, vital to optimize morbidity and mortality outcomes. Risk scores can be used to inform this decision-making process. ⋯ There are many other scoring systems in existence; however, no perfect scoring system exists, therefore, additional research is needed as clinicians strive toward a more idealized risk stratification model. The purpose of this review is to discuss the advantages and limitations of some of the most commonly used risk stratification systems and use this to determine what an ideal scoring system might look like. This includes not only the generalizability of available scores but also their ease of use and predictive power.
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Up to one-third of all patients admitted to intensive care units carry a diagnosis of shock. The use of angiotensin II is becoming widespread in all forms of shock, including cardiogenic, after the U. ⋯ Food and Drug Administration's (FDA's) initial approval for vasoplegic shock in 2017. Here, the authors review the literature on angiotensin II's mechanism of action, benefits, and future therapeutic opportunities.
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J. Cardiothorac. Vasc. Anesth. · Apr 2022
ReviewThe Year in Cardiothoracic and Vascular Anesthesia: Selected Highlights from 2021.
This special article is the fourteenth in an annual series for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the Editor-in-Chief, Dr. Kaplan, and the editorial board for the opportunity to continue this series; namely, the research highlights of the past year in the specialty of cardiothoracic and vascular anesthesiology. ⋯ The fourth and final theme is an update in heart failure, with discussion of diverse aspects of this area. The themes selected for this fourteenth special article are only a few of the diverse advances in the specialty during 2021. These highlights will inform the reader of key updates on a variety of topics, leading to improvement of perioperative outcomes for patients with cardiothoracic and vascular disease.
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J. Cardiothorac. Vasc. Anesth. · Apr 2022
Multicenter Study Observational StudyThe Association Between Acute Kidney Injury and Mortality After Coronary Artery Bypass Grafting Was Similar in Women and Men.
To assess sex differences in short- and long-term mortality in patients who develop acute kidney injury (AKI) after coronary artery bypass grafting (CABG). ⋯ AKI after CABG was associated with a similar increase in 90-day and long-term mortality in both women and men.