Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
Randomized Controlled Trial Multicenter Study Comparative StudyComparison of Inhalational and Intravenous Anesthesia Induction on Electroencephalogram and Cerebral Perfusion in Children With Congenital Heart Disease: A Secondary Analysis of a Randomized Controlled Trial.
The effects of anesthetics on electroencephalograms and cerebral perfusion remain understudied in children with congenital heart disease. With regard to this, we compared inhalational anesthesia induction and intravenous anesthesia induction. ⋯ The administration of sevoflurane for anesthesia induction results in more burst suppression, while also demonstrating superior cerebral perfusion when compared with the use of intravenous medications for anesthesia induction.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
ReviewRemimazolam in Cardiac Anesthesia: Analysis of Recent Data.
Interest in remimazolam has surged in recent years, thanks to its advantageous pharmacologic profile. This ultra-short-acting benzodiazepine is noted for its rapid onset and termination of action, organ-independent elimination, availability of a reversal agent, and excellent hemodynamic stability. Although the use of remimazolam has been explored in various anesthesia settings and procedures, data on its application in cardiovascular anesthesia and catheterization laboratory procedures remain limited. ⋯ The analysis shows that remimazolam offers anesthesia without significant hemodynamic instability and a reduced need for vasopressors, with an incidence of perioperative adverse events comparable to that of other agents. These findings are relevant for both the induction and maintenance of general anesthesia in catheterization laboratory procedures and general anesthesia in elective cardiac surgery. Although further research is needed to fully understand remimazolam's role in cardiovascular anesthesia, its favorable hemodynamic and safety profile suggests that it is a promising option for cardiac anesthesiologists in both the catheterization laboratory and the operating room.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
Ultrafiltration During Cardiac Surgery Requiring Cardiopulmonary Bypass and Its Effect on Acute Kidney Injury.
To explore whether ultrafiltration (UF) volume adjusted for weight is associated with an increased risk of acute kidney injury (AKI) after cardiopulmonary bypass (CPB) in cardiac surgery patients. ⋯ This study suggests that conventional UF is a potential risk factor for AKI incidence following surgery with CPB. The results demonstrate an association between higher weight-adjusted ultrafiltration volume and a higher incidence of AKI. Future studies should incorporate a multicenter, prospective approach to test the generalizability of the present findings and validate modified ultrafiltration strategies that use hemodynamic variables to determine fluid removal volume.
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J. Cardiothorac. Vasc. Anesth. · Jan 2025
The Hemodynamic Effects of Protamine in Pediatric Patients Undergoing Pulmonary Artery Reconstruction and Unifocalization Surgery: A Pilot StudyHemodynamic Effects of Protamine in Children.
To determine protamine administration increases pulmonary artery pressures (PAPs) in patients undergoing unifocalization or pulmonary artery reconstruction surgeries. ⋯ Protamine administration led to a small increase in PAP after separation from cardiopulmonary bypass in patients undergoing pulmonary artery reconstruction or unifocalization surgeries. Calcium coadministration did not lead to a greater increase in PAP.