Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jan 2024
ReviewObesity and Extracorporeal Membrane Oxygenation (ECMO): Analysis of Outcomes.
Traditionally, patients with obesity have been deemed ineligible for extracorporeal life support (ELS) therapies such as extracorporeal membrane oxygenation (ECMO), given the association of obesity with chronic health conditions that contribute to increased morbidity and mortality. Nevertheless, a growing body of literature suggests the feasibility, efficacy, and safety of ECMO in the obese population. This review provides an in-depth analysis of the current literature assessing the effects of obesity on outcomes among patients supported with ECMO (venovenous [VV] ECMO in noncoronavirus disease 2019 and coronavirus disease 2019 acute respiratory distress syndrome, venoarterial [VA] ECMO, and combined VV and VA ECMO), offer a possible explanation of the current findings on the basis of the obesity paradox phenomenon, provides a framework for future studies addressing the use of ELS therapies in the obese patient population, and provides guidance from the literature for many of the challenges related to initiating, maintaining, and weaning ELS therapy in patients with obesity.
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J. Cardiothorac. Vasc. Anesth. · Jan 2024
Comparative Study Clinical TrialNew Noninvasive Method for the Assessment of Central Venous Oxygen Saturations in Critically Ill Patients.
To compare noninvasive external jugular vein oxygen saturations (SjvO2) and central venous oxygen saturation (ScvO2) from a blood sample in patients admitted to the intensive care unit. ⋯ Central venous oxygen saturation can be estimated reasonably by the continuous noninvasive measurement of SjvO2 using near-infrared spectroscopy.
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J. Cardiothorac. Vasc. Anesth. · Jan 2024
Medical Malpractice Claims Related to Performance of Transesophageal Echocardiography by Anesthesiologists.
More than 300,000 adults have cardiac surgery in the United States annually, and most undergo intraoperative transesophageal echocardiography (TEE). This patient population is often older with multiple comorbidities, increasing their risk for complications for even routine procedures. ⋯ Esophageal injury accounted for most of the suits, and only 2 were related to diagnosis. Most expert reviews deemed the care provided by the anesthesiologist to be appropriate.