Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Hemolysis Index, Carboxyhemoglobin, and Methemoglobin for the Early Identification of Patients at Risk for Cardiac Surgery-Associated Acute Kidney Injury.
Hemolysis is a contributor to CS-AKI. Biochemistry analyzers provide a hemolysis index to quantify in vitro hemolysis, a condition that can, for example, affect the accuracy of potassium concentration measurements. We aimed to assess whether the postoperative plasma level of the hemolysis index (HIpostoperative) could aid the early recognition of patients at risk for cardiac surgery-associated acute kidney injury (CS-AKI) and also to evaluate other hemolysis indicators: plasma carboxyhemoglobin (COHbpostoperative) and methemoglobin (MetHbpostoperative). ⋯ Elevated HIpostoperative represents an early alert signal for the development of CS-AKI. Our findings support the incorporation of HIpostoperative, a readily available biomarker, into predictive scores of CS-AKI.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Observational StudyPredictive Performances of ACEF, ACEF II, Updated ACEF II, and EuroSCORE II Risk Scores in Patients Undergoing Isolated Off-pump Coronary Artery Bypass Grafting.
This study evaluated the performances of the age, creatinine, and ejection fraction (ACEF) I and II scores and compare them with that of the European System for Cardiac Operative Risk Evaluation (EuroSCORE) II score in patients who underwent isolated off-pump coronary artery bypass grafting (OPCABG). Additionally, this study was designed to externally validate the performance of the updated ACEF II score. ⋯ ACEF I and II scores are reliable risk stratification models with performances comparable to the EuroSCORE II score in patients undergoing isolated OPCABG. However, the updated ACEF II score failed to demonstrate improved performance.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Outflow Graft Tamponade: An Underrecognized Cause of Obstruction.
Left ventricular assist device (LVAD) outflow graft obstruction can result in severe clinical deterioration. Underlying mechanisms may vary depending on the location. Outflow graft tamponade due to external compression can be under recognized. Management of this complication varies across institutions and a uniform approach has yet to be elucidated. ⋯ Conclusions: Outflow graft tamponade is a form outflow graft obstruction with a variable presentation that can result in significant hemodynamic compromise. It is amenable to both surgical and percutaneous interventions that restore LVAD function.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Incidence and Factors Associated With Burnout Among Cardiac Anesthesiologists in India.
Many previous surveys have demonstrated a high incidence of burnout among anesthesiologists. The current survey was designed to estimate the incidence and understand the factors associated with burnout among cardiac anesthesiologists in India. ⋯ The burden of burnout syndrome is high among Indian anesthesiologists. Risk factors included younger age, inadequate workplace and external support, limited personal time, and contemplation of leaving cardiac anesthesia. There is a need for various stakeholders to be sensitized and institute necessary measures to reduce the burden and impact of burnout.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Observational StudyAssessment of Perioperative Protamine Reactions in Patients With Fish Allergies: A Retrospective Observational Study.
To retrospectively assess the incidence and severity of perioperative protamine reactions in adult patients with documented history of fish allergy. ⋯ The study findings suggest that in patients with a history of fish allergy, cross-reactivity with protamine is unlikely, as anaphylaxis and/or protamine reactions were rare in this patient population in the perioperative environment. Based on these findings, this study does not recommend avoiding protamine solely based on a history of fish allergy when heparin reversal is required during surgery.