Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Nov 2024
Altered Microvascular Reactivity During a Skin Thermal Challenge Is Associated With Organ Dysfunction and Slow Recovery After Cardiac Surgery.
To assess microvascular reactivity during a skin thermal challenge early post-cardiac surgery and its association with outcomes. ⋯ Early alterations in microvascular reactivity, evaluated by a skin thermal challenge, are correlated with organ dysfunction. These observations may help in the development of new, simple, noninvasive monitoring systems in postoperative patients.
-
J. Cardiothorac. Vasc. Anesth. · Nov 2024
Current Status of Adult Post-Cardiac Surgery Critical Care in Saudi Arabia.
The field of cardiac surgery in Saudi Arabia has developed significantly over the years, with more advanced procedures being performed for high-risk patients with multiple comorbidities. This poses challenging postoperative management issues requiring multidisciplinary, highly organized expert care in cardiovascular critical care. This survey aimed to describe the current state of postoperative critical care for cardiac surgeries in Saudi Arabia. ⋯ Cardiac surgery intensive care units in Saudi Arabia have varying management structures, care practices, and healthcare provider staffing models, although most of the large-volume centers are adopting the intensivist-led team model of care. Guidelines are needed to standardize practice in all cardiac surgery centers regarding processes and protocols, intensive care unit staffing models, and reporting of outcomes and key performance indicators. Further studies are needed to study cardiac surgery intensive care unit factors related to patient outcomes after cardiac surgery.
-
The Index for Mortality Prediction After Cardiac Transplantation (IMPACT) score is a quantitative risk index that predicts 1-year mortality risk, derived from United Network for Organ Sharing data in which women are underrepresented. The validity of the IMPACT score in 1-year mortality risk after OHT in women is unknown. The objective of this study was to assess differences in score performance by sex. We hypothesized that the IMPACT score is a poor predictor of 1-year mortality risk after orthotopic heart transplantation (OHT) in women. ⋯ The IMPACT score exhibited poor discrimination and calibration in the International Society for Heart and Lung Transplantation 2009-2019 cohort, overall and by sex. There was no difference in 1-year mortality between women and men.
-
J. Cardiothorac. Vasc. Anesth. · Nov 2024
Observational StudyUse of Bioimpedance Spectroscopy for Postoperative Fluid Management in Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass.
To assess whether bioimpedance spectroscopy analysis (BIA) can be used as a tool to guide postoperative fluid management in patients undergoing cardiac surgery. ⋯ BIA measurements in postoperative cardiac surgery patients may be a valuable tool to quantitatively determine fluid status to help guide fluid management in this patient population. Further studies validating the use of BIA for postoperative care in this population are warranted.
-
J. Cardiothorac. Vasc. Anesth. · Nov 2024
The Association Between Renal Desaturation Measured Using Near-Infrared Spectroscopy and Postoperative Acute Kidney Injury: A Systematic Review.
The objective of this systematic review was to clarify the status of near-infrared spectroscopy (NIRS) in monitoring perioperative renal regional tissue oxygen saturation (rSO2) and determine whether there is evidence supporting its use in predicting postoperative acute kidney injury (AKI). ⋯ Renal desaturation may indicate AKI in patients; however, further studies are required to substantiate this relationship. Additional clinical trials are necessary to evaluate normal values and establish the exact threshold of renal rSO2 that signifies a meaningful decline in renal function.