Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Apr 2023
ReviewRemedē Systems: Transvenous Pacing of the Phrenic Nerve.
The remedē System (ZOLL Medical, Minnetonka, MN; Fig 1), which was approved by the Food and Drug Administration in October of 2017, is a transvenous device that stimulates the phrenic nerve for the treatment of central sleep apnea, which is often associated with heart failure and atrial fibrillation. Given the similarity in implantation procedure to pacemakers and implantable cardioverter/defibrillators, the remedē System implantation often occurs in the electrophysiology laboratory. Despite the transvenous nature and close proximity to cardiac structures on radiographic imaging, the remedē System does not have any cardiac pacing function/antiarrhythmia therapies, and it is important for an anesthesiologist to be able to recognize and manage such a device if they were to come across one preoperatively.
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To investigate the independent association of platelet transfusion with hospital mortality and key relevant clinical outcomes in cardiac surgery. ⋯ Platelet transfusion was not associated with hospital mortality, but it was associated with decreased odds of suspected infection and with shorter ICU and hospital stays.
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J. Cardiothorac. Vasc. Anesth. · Apr 2023
Noninvasive Assessment With Transthoracic Echocardiography in End-Stage Heart Failure.
Heart failure is a common cardiac condition that carries a substantial risk of morbidity and mortality despite advances in management. Echocardiography plays a central role in its diagnosis, elucidation of mechanisms, and detailed hemodynamic analysis. In this E-Challenge, the authors review a few transthoracic echocardiographic findings that yield insights into the hemodynamics.