Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jul 2022
ReviewPerioperative Presentations of Kounis Syndrome: A Systematic Literature Review.
Kounis syndrome commonly is described as a complex multisystem phenomenon mainly affecting coronary arteries, resulting in coronary vasospasm in the context of an allergic manifestation. This article reviews the literature regarding perioperative presentations of the syndrome. A systematic search in MEDLINE and Embase databases was performed for case reports through June 16, 2021, on Kounis syndrome triggered by medications administered in the perioperative setting. ⋯ Coronary vasospasm is often less frequently recognized as a form of allergic manifestation in the perioperative setting. Many potential triggers, such as antibiotics and neuromuscular blocking agents, are routinely administered during surgery. Awareness of this condition, early diagnosis, and effective management of this condition can lead to good outcomes.
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J. Cardiothorac. Vasc. Anesth. · Jul 2022
ReviewIntraoperative Hypotension-Physiologic Basis and Future Directions.
Intraoperative hypotension (IOH) is a major concern to the anesthesiologist. Its appropriate identification and management require an understanding of the physiology of blood pressure regulation, prudent blood pressure monitoring, and treatment. Even short durations of low mean arterial pressure have been associated with adverse postoperative clinical outcomes. ⋯ This new technology has the potential to reduce duration or even prevent IOH. In the authors' opinion, it is an example of how human-machine interaction will contribute to future advances in medicine. Additional studies should evaluate the effects of its use on postoperative outcomes.
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J. Cardiothorac. Vasc. Anesth. · Jul 2022
Randomized Controlled TrialEffect of Cyclosporine on Cytokine Production in Elective Coronary Artery Bypass Grafting: A Sub-Analysis of the CiPRICS (Cyclosporine to Protect Renal Function in Cardiac Surgery) Study.
The augmented inflammatory response to cardiac surgery is a recognized cause of postoperative acute kidney injury. The present study aimed to investigate the effects of preoperative cyclosporine treatment on cytokine production and delineate factors associated with postoperative kidney impairment. ⋯ Elective coronary artery bypass grafting surgery with cardiopulmonary bypass triggers cytokine activation. This activation was not impacted by preoperative cyclosporine treatment.