Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Randomized Controlled TrialThe Effects of Targeted Changes in Systemic Blood Flow and Mean Arterial Pressure on Urine Oximetry During Cardiopulmonary Bypass.
Poor medullary oxygenation is implicated in the evolution of acute kidney injury. The authors sought to determine if increasing systemic flow and mean arterial pressure could improve urine oxygen tension (PuO2) measured in the bladder, a surrogate of kidney medullary oxygenation, in patients undergoing on-pump cardiac surgery. ⋯ PuO2 was higher when systemic flow and MAP were increased during CPB. These findings suggest that PuO2 is responsive to changes in hemodynamics and that higher flow and pressure may improve medullary oxygenation.
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Observational StudyLeft Ventricular Ejection Fraction Correlation With Stroke Volume as Estimated by Doppler Echocardiography in Cardiogenic Shock: A Retrospective Observational Study.
Echocardiography is the main tool for cardiac assessment and helps to guide management in patients admitted to the intensive care unit (ICU) with cardiogenic shock (CS). Left ventricular ejection fraction (LVEF) is a commonly used echocardiographic surrogate for left ventricular (LV) systolic function. In this hypothesis-generating study, the authors investigated the correlation between LVEF and stroke volume (SV)/SV index (SVI) estimated by Doppler echocardiography in patients admitted to the ICU with CS and reduced LVEF. ⋯ There is a weak correlation between LVEF and SV or SVI estimated by Doppler echocardiography in patients admitted to the ICU with STEMI complicated by CS and reduced LVEF. Visually estimated LVEF correlated slightly better with Doppler SV compared to modified Simpson's LVEF.
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Pain Trajectories After Valve Surgeries Performed via Midline Sternotomy Versus Mini-Thoracotomy.
Controlling moderate-to-severe pain remains a major challenge after cardiothoracic surgery. Several outcomes have been compared extensively after valve surgery performed via midline sternotomy versus mini-thoracotomy, but postoperative pain (POP) was not adequately examined. Therefore, the authors tested the hypothesis that there is no difference in POP trajectories in patients undergoing valve surgery via midline sternotomy versus mini-thoracotomy. ⋯ Midline sternotomies are associated with higher odds of having an acute worsening or stationary versus a rapidly improving pain trajectory compared to mini-thoracotomies. Therefore, the choice of incision may play an important role in determining POP trajectory after valve surgery.
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
A Survey of the Congenital Cardiac Anesthesia Society on the Use and Clinical Application of Near- Infrared Tissue Oximetry in Pediatric Cardiac Surgery.
To better understand the patterns of use and the perceived utility of tissue oximetry in pediatric cardiac surgery. ⋯ Near-infrared spectroscopy-based tissue oximetry frequently used was by CCAS members, but with significant variations in clinical application.
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J. Cardiothorac. Vasc. Anesth. · Sep 2022
Interobserver Variation in Echocardiographic Measurements and Grading of Tricuspid Regurgitation Based on a Novel Web-Based Assessment Environment.
The primary aim of this study was to assess interobserver variability in grading tricuspid regurgitation (TR) severity. The authors' secondary goals were to delineate which transesophageal echocardiographic (TEE) parameters best correlate with severity and how consistent the participants were at grading severity. ⋯ The interobserver variation in quantifying TEE parameters for TR is high, suggesting these may be difficult to measure reliably in a busy perioperative setting. Of the parameters assessed, VC and PISA radius had the highest interobserver agreement and the highest correlation with severity.