Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Feb 2025
Perioperative Stroke Following Implantation of Left Ventricular Assist Device: A Retrospective Cohort Study.
Stroke is common following left ventricular assist device (LVAD) implantation, although comprehensive data on perioperative strokes in this uncommon population is lacking. The current study aim was to characterize the presentation, features, and outcomes of perioperative cerebrovascular ischemia post-LVAD implantation at the authors' institution. ⋯ LVAD patients carry a high risk of perioperative stroke. They experience delayed recognition and diagnosis, limited intervention, and poor outcomes. Frequent neurological assessment and a low threshold for neuroimaging are prudent.
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J. Cardiothorac. Vasc. Anesth. · Feb 2025
Intraoperative Methadone in Adult Cardiac Surgical Patients and Risks for Postoperative QTc Prolongation.
To evaluate the effect of intraoperative intravenous methadone within a standardized enhanced recovery after cardiac surgery pathway on the perioperative corrected QT interval (QTc). ⋯ A single intraoperative intravenous methadone dose did not prolong the QTc significantly or increase the incidence of arrhythmias and may be safe in adult cardiac surgical patients.
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J. Cardiothorac. Vasc. Anesth. · Feb 2025
Randomized Controlled TrialThe Potential Role of Albumin in Reducing Cardiac Surgery-Associated Acute Kidney Injury: A Randomized Controlled Trial.
Cardiac surgery-associated acute kidney injury (CSA-AKI) is a common complication with high morbidity and mortality. This study was designed to determine whether adding human albumin to the cardiopulmonary bypass (CPB) priming solution reduces the incidence of CSA-AKI. ⋯ Adding albumin to the CPB priming solution did not decrease the incidence of CSA-AKI in patients with normal preoperative renal function. These findings suggest that albumin might benefit patients with impaired renal function, warranting further investigation.
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J. Cardiothorac. Vasc. Anesth. · Feb 2025
ReviewPrognostic Impact of Anemia and Blood Transfusions on Cardiovascular Outcomes in Patients Undergoing Vascular Surgery: A Scoping Review.
Prior studies suggest an association of anemia and blood transfusion with increased morbidity and mortality in patients undergoing cardiac surgery. However, the impact of perioperative anemia and blood transfusion on clinical outcomes in patients undergoing major vascular surgery has been poorly defined yet. The primary objectives of this scoping review were to determine the extent of the evidence base that links anemia and blood transfusions to mortality and cardiovascular outcomes in patients undergoing major vascular surgery, and identify recurring themes or gaps in the literature to guide future research. ⋯ The weight of the evidence suggests that anemia carries a substantial burden of cardiovascular complications, mortality, and multiorgan complications, resulting in increased health care costs. Peripheral and endovascular aortic surgery are affected deeply by the impact of anemia. Anemia itself stands out as a crucial predictor for requiring transfusions. In turn, the effect of transfusion of blood products is associated with worse outcomes and complications.