Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Case ReportsA Call for Real-Time Bispectral Index and Electroencephalogram Monitoring in a Patient Undergoing Aortic Surgery.
A 77-year-old woman underwent replacement of the ascending aorta and aortic valve. Before separation from cardiopulmonary bypass, the pump flow was reduced to 0-to-1.1 L/min/m2 for four minutes at a tympanic temperature of 34.3°C to perform additional sutureing for aorta-graft anastomosis. ⋯ An offline scalogram of intraoperative electroencephalograms obtained from the bispectral index monitor, which was generated by using continuous wavelet transform with complex Morlet wavelets, readily visualized the process of development of cerebral infarction preceding a significant decrease of regional cerebral oxygen saturation during the low-flow period of cardiopulmonary bypass. The present case demonstrated the possible importance of real-time bispectral index and electroencephalogram monitoring in patients undergoing cardiovascular surgery, especially those undergoing high-risk procedures under hypothermic circulatory arrest.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
ReviewIntraoperative Renal Replacement Therapy: Practical Information for Anesthesiologists.
Previous publications regarding perioperative renal replacement therapy (RRT) have focused on the general care of the RRT-dependent patient and provided a broad overview of the various RRT modalities. The goal of this review article is to provide anesthesiologists with specific practical information regarding the possible intraoperative advantages and limitations of each modality, mandatory equipment to institute intraoperative therapy, and background knowledge necessary to communicate effectively with nephrologists and/or support staff regarding the intraoperative RRT goals.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Observational StudyIdentifying Patients at High Risk of Chronic Pain After Video-Assisted Thoracoscopic Surgery Using Thermal Quantitative Sensory Testing.
To examine whether perioperative thermal quantitative sensory testing could be used to identify patients at high risk of chronic pain after video-assisted thoracoscopic surgery (VATS). ⋯ Chronic pain after VATS is typically neuropathic. The change in perioperative CPT at the incision site may help to identify patients at higher risk of chronic pain after VATS.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
ReviewEchocardiography and Management for Cardiac Trauma.
Trauma is the number one cause of death among Americans between the ages of 1 and 46, costing >$670 billion a year. Blunt and penetrating trauma can lead to cardiac and aortic injuries, with the incidence of death varying upon the location of the damage. ⋯ This review article aims to analyze the pathophysiology of cardiac injuries in patients with trauma and the role of echocardiography for the accurate diagnosis of cardiac injury in trauma. This review, additionally, will offer a patient-centered, team-based, early management plan with a treatment algorithm to help improve the quality of care among these patients with cardiac trauma.