Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2011
Multimodal brain monitoring reduces major neurologic complications in cardiac surgery.
Although adverse neurologic outcomes are common complications of cardiac surgery, intraoperative brain monitoring has not received adequate attention. The aim of the present study was to evaluate the effectiveness of multimodal brain monitoring in the prevention of major brain injury and reducing the duration of mechanical ventilation, intensive care unit, and postoperative hospital stays after cardiac surgery. ⋯ This preliminary study suggests that multimodal brain monitoring can reduce the incidence of neurologic complications as well as hospital costs associated with post-cardiac surgery patient care. Furthermore, intraoperative brain monitoring provides useful information about brain functioning, blood flow velocity, and metabolism, which may guide the anesthesiologist during surgery.
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J. Cardiothorac. Vasc. Anesth. · Dec 2011
Predictors of duration of unconsciousness in patients with coma after cardiac surgery.
To describe clinical and brain imaging characteristics of patients who recovered and did not recover consciousness from a coma after cardiac surgery and to investigate predictors of the duration of unconsciousness in those patients who ultimately recovered consciousness. ⋯ In patients who ultimately recovered consciousness after being in a coma for at least 24 hours after cardiac surgery and have no abnormality on a brain CT scan, elevated preoperative serum creatinine, urgent cardiac surgery, and lower postoperative hemoglobin were correlated with an increased duration of unconsciousness.
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J. Cardiothorac. Vasc. Anesth. · Dec 2011
Outcomes after rigid bronchoscopy in children with suspected or confirmed foreign body aspiration: a retrospective study.
To identify the determinants of immediate outcome after rigid bronchoscopy for suspected or confirmed foreign body (FB) aspiration. The outcome may be affected by the duration of bronchoscopy, the type of FB, the time between inhalation and removal of the FB, and the type of anesthetic induction. Arterial desaturation, bronco-laryngospasm, and the need for tracheal reintubation as complications were investigated. ⋯ Reducing the bronchoscopy time may not be an option, but an awareness of the risk of complications may prompt a more intense postanesthesia monitoring strategy.
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The authors sought to provide a snapshot of contemporary thoracic anesthetic practice in the United Kingdom and Ireland. ⋯ The authors hope this survey both provides interest and serves as a useful resource reflecting the current practice of thoracic anesthesia.