Journal of cardiothoracic and vascular anesthesia
-
J. Cardiothorac. Vasc. Anesth. · Dec 2009
Airway interventions in the cardiac electrophysiology laboratory: a retrospective review.
To quantify the incidence of airway interventions during cardiac electrophysiology laboratory procedures. ⋯ These results suggest that a significant proportion of the authors' patients undergoing cardiac electrophysiology laboratory procedures required deep sedation if not general anesthesia, although a non-general anesthetic was planned. The issue of depth of sedation has implications for patient safety, privileging, and regulatory compliance. Based on the present results, the authors believe sedation for these procedures is best given by anesthesia providers; furthermore, caregivers should be aware that these procedures are likely to require deep sedation if not general anesthesia.
-
J. Cardiothorac. Vasc. Anesth. · Dec 2009
Predictors of prolonged postoperative endotracheal intubation in patients undergoing thoracotomy for lung resection.
The aim of this study was to identify predictors of delayed endotracheal extubation defined as the need for postoperative ventilatory support after open thoracotomy for lung resection. ⋯ Most predictors of delayed postoperative extubation (ie, red blood cell transfusion, higher preoperative serum creatinine, lower preoperative FEV(1), and more extensive lung resection) are difficult to modify in the perioperative period and probably represent greater severity of underlying lung disease and more advanced comorbid conditions. However, thoracic epidural anesthesia and analgesia is a modifiable factor that was associated with reduced odds for postoperative ventilatory support. Thus, the use of epidural analgesia may reduce the need for post-thoracotomy mechanical ventilation.
-
J. Cardiothorac. Vasc. Anesth. · Dec 2009
Meta AnalysisSpinal analgesia in cardiac surgery: a meta-analysis of randomized controlled trials.
Controversial results exist on the effects of spinal analgesia in cardiac surgery. The authors conducted a review of randomized studies to show whether there are any advantages in clinically relevant outcomes using spinal analgesia in patients undergoing cardiac surgery. ⋯ This analysis indicated that spinal analgesia does not improve clinically relevant outcomes in patients undergoing cardiac surgery, discouraging further randomized controlled trials on this topic even if changes in techniques, devices, and drugs could modify the outlook of the comparison between spinal and standard anesthesia in this setting.
-
J. Cardiothorac. Vasc. Anesth. · Dec 2009
Comparative StudyComparison of a new cardiac output ultrasound dilution method with thermodilution technique in adult patients under general anesthesia.
The purpose of this study was to investigate the reliability of cardiac output (CO) measured by a new ultrasound dilution method (COud) in comparison with CO by pulmonary artery thermodilution (COtd) in adult patients undergoing surgery. ⋯ COud measurements agreed well with COtd. The results of this study indicated that COud might be interchangeable with conventional COtd in perioperative adult patients.