Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Dec 2024
Meta AnalysisAssociation of Activated Clotting Time-Guided Anticoagulation with Complications during Extracorporeal Membrane Oxygenation Support: A Systematic Review and Meta-Analysis.
Extracorporeal membrane oxygenation (ECMO) requires systemic anticoagulation to reduce the risk of thromboembolic events. Despite its historic role, activated clotting time (ACT) remains a widely used heparin monitoring method. Systematic evidence on the association of ACT-guided monitoring with hemorrhagic or thromboembolic complications does not exist. ⋯ Even though ACT is a widely used heparin monitoring tool, the evidence on its association with hemorrhagic or thromboembolic events is still controversial and limited. Further studies are essential to elucidate the role of ACT in anticoagulation monitoring during ECMO support.
-
J. Cardiothorac. Vasc. Anesth. · Dec 2024
ReviewRemimazolam Use in Cardiac Anesthesia: A Narrative Review.
Remimazolam, a novel ultra-short-acting intravenous benzodiazepine, has garnered recent attention for its use as a general anesthetic. This narrative review aims to summarize and analyze the available literature on the effects of remimazolam use in cardiac surgical patients, including its effects on hemodynamics, safety in patients with baseline myocardial dysfunction, and impact on postoperative management including time to emergence and extubation. Finally, there is discussion regarding potential drawbacks of adopting remimazolam as a routine anesthetic for cardiac surgery.
-
J. Cardiothorac. Vasc. Anesth. · Dec 2024
Frailty Is Associated With Increased Care Dependence in Patients Following Major Vascular Surgery.
To assess if frailty scoring can predict increased frailty and care dependence requiring a change in living situation in patients with peripheral artery disease (PAD) following major vascular surgery. ⋯ Frail patients with PAD undergoing major vascular surgery are at significant risk of functional decline, necessitating a change in living situation to meet their increased care needs. This increased care dependence persisted 6 months following discharge.
-
J. Cardiothorac. Vasc. Anesth. · Dec 2024
The Pre-ECPR Score: Developing and Validating a Multivariable Prediction Model for Favorable Neurological Outcomes in Patients Undergoing Extracorporeal Cardiopulmonary Resuscitation.
Extracorporeal cardiopulmonary resuscitation (ECPR) can save patients with refractory cardiac arrest; however, according to recent meta-analyses, only 20% of patients achieve favorable outcomes (Modified Rankin Scale 0-3). We aimed to develop and validate an ECPR prediction model to improve patient selection. ⋯ The Pre-ECPR score combines multiple weighted predictors to provide a single balanced probability of favorable outcomes in ECPR patient selection. In cross-validation, it demonstrated significantly more favorable discriminatory performance than that of the ELSO criteria.