Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · May 2022
ReviewPreoperative Evaluation and Anesthetic Management of Patients With Liver Cirrhosis Undergoing Cardiac Surgery.
Preoperative evaluation and anesthetic management of patients with liver cirrhosis undergoing cardiac surgery remain a clinical challenge because of its high risk for perioperative complications. This narrative review article summarizes the pathophysiology and anesthetic implication of liver cirrhosis on each organ system. It will help physicians to evaluate surgical candidates, to optimize intraoperative management, and to anticipate complications in liver cirrhosis patients undergoing cardiac surgery. ⋯ Accurately classifying the extent of liver disease, preoperative optimization, and surgical risk communication with the patient are crucial. In addition, all teams involved in the surgery should communicate openly and coordinate in order to ensure optimal care. To reduce perioperative complications, consider using off-pump cardiopulmonary bypass techniques and optimal perfusion modalities to mimic current physiologic conditions.
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J. Cardiothorac. Vasc. Anesth. · May 2022
Observational StudyOne-Year Multidisciplinary Follow-Up of Patients With COVID-19 Requiring Invasive Mechanical Ventilation.
Patients with COVID-19 frequently develop acute respiratory distress syndrome (ARDS) requiring intensive care unit (ICU) admission. Data on long-term survival of these patients are lacking. The authors investigated 1-year survival, quality of life, and functional recovery of patients with COVID-19 ARDS requiring invasive mechanical ventilation. ⋯ All patients who survived the acute phase of COVID-19 and were discharged from the hospital were alive at the 1-year follow up, and the vast majority of them had good overall recovery and quality of life.
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J. Cardiothorac. Vasc. Anesth. · May 2022
Randomized Controlled TrialEffects of Thoracic Epidural Anesthesia on Systemic and Local Inflammatory Responses in Patients Undergoing Lung Cancer Surgery: A Randomized Controlled Trial.
Inflammatory responses play major roles in the development of acute lung injury following lung cancer surgery. The authors tested the hypothesis that thoracic epidural anesthesia (TEA) during surgery could attenuate both systemic and local inflammatory cytokine productions in patients undergoing lung cancer surgery. ⋯ This randomized clinical trial suggested that TEA could attenuate local inflammatory responses in the lungs during lung cancer surgery.
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J. Cardiothorac. Vasc. Anesth. · May 2022
Utility of the CHA2DS2-VASc Score in Prediction of Postoperative Atrial Fibrillation After Coronary Artery Bypass Graft Surgery.
The authors aimed to investigate the role of CHA2DS2-VASc score and its components in prediction of postoperative atrial fibrillation (POAF) after isolated coronary artery bypass graft (CABG) surgery. ⋯ CHA2DS2-VASc score is a useful tool for the prediction of POAF after isolated CABG. However, the risk should be interpreted cautiously, since the risk score's promising effect relies on only several of its components.