Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Jul 2022
Meta AnalysisThe Use of Cerebral Oximetry in Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
The evidence on the use of cerebral oximetry during surgery to minimize postoperative neurologic complications remains uncertain in the literature. The present authors aimed to assess the value of cerebral oximetry in the prevention of postoperative cognitive dysfunction, postoperative delirium, and postoperative stroke in adults undergoing surgery. ⋯ Adult patients with cerebral oximetry monitoring were associated with a significant reduction of postoperative cognitive dysfunction. However, given the low certainty of evidence and substantial heterogeneity, more randomized controlled trials using standardized assessment tools for postoperative cognitive dysfunction and interventions of correcting cerebral desaturation are warranted to improve the certainty of evidence and homogeneity.
-
J. Cardiothorac. Vasc. Anesth. · Jul 2022
ReviewThree-Dimensional Transesophageal Echocardiography Simulator: New Learning Tool for Advanced Imaging Techniques.
The use of intraoperative three-dimensional (3D) transesophageal echocardiography (TEE) has grown exponentially in recent years. Three-dimensional TEE technology has evolved to allow for real-time display of 3D images and, thus, has become the standard of care for the evaluation of cardiac anatomy and function. Its use has provided a new dimension of clinical insight when managing patients for cardiac surgery or structural heart interventions. ⋯ This training is essential, as the skill set involved in acquiring 3D data sets differs from that of two-dimensional (2D) TEE and requires users to be able to appreciate how 3D anatomic display differs from that of tomographic cross-sectional 2D imaging. This added skill set requires mental reconstruction and spatial reorientation to appreciate the added elevational dimension in frustum-based imaging and is best achieved in a simulation environment rather than the busy operating room. In this review article, the authors evaluate the functionality of a 3D TEE simulator and how simulators such as this can establish preclinical proficiency in novices in the expanding area of advanced 3D TEE imaging.
-
J. Cardiothorac. Vasc. Anesth. · Jul 2022
Continuous Noninvasive Blood Pressure Monitoring of Beat-By-Beat Blood Pressure and Heart Rate Using Caretaker Compared With Invasive Arterial Catheter in the Intensive Care Unit.
To examine the accuracy of noninvasively-derived peripheral arterial blood pressure (BP) by the Caretaker device (CT) against invasively measured arterial BP and the fidelity of heart rate variability by CT compared with electrocardiogram (ECG)-derived data. ⋯ This study validated the noninvasive tracking of BP using the CT device, and the pulse decomposition analysis approach is possible within the guidelines of the standard.