Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Dec 2022
Randomized Controlled TrialComparison Among Ultrasound-Guided Thoracic Paravertebral Block, Erector Spinae Plane Block and Serratus Anterior Plane Block for Analgesia in Thoracotomy for Lung Surgery.
To compare the analgesic efficacy and safety of preoperative, single-shot ultrasound-guided thoracic paravertebral block (TPVB), erector spinae plane block (ESB), and serratus anterior plane block (SAPB) in thoracotomy pain. ⋯ The nerve blocks in decreasing order of analgesic efficacy in relieving post-thoracotomy pain would be ESB, TPVB, and SAPB.
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J. Cardiothorac. Vasc. Anesth. · Dec 2022
ReviewAveir Leadless Pacemaker: Novel Technology With New Anesthetic Implications.
The Aveir VR Leadless Pacemaker (Abbott, Chicago, IL) recently was approved by the US Food and Drug Administration, and joined the Micra (Medtronic, Minneapolis, MN) transcatheter pacing system in the realm of nontransvenous cardiovascular implantable devices. The Aveir VR offers design improvements over its predecessor, the Nanostim (St. ⋯ There are recommendations for the perioperative management of conventional transvenous pacemakers, but leadless pacemakers add a new layer of consideration. Although there have been prior documented experiences with the Micra device, there are enough differences between the Aveir VR and the Micra that it is important to understand what makes the Aveir VR unique if an anesthesiologist were to come across one preoperatively.
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J. Cardiothorac. Vasc. Anesth. · Dec 2022
Decline in Functional Status While on the Waiting List Predicts Worse Survival After Lung Transplantation.
To determine if decreases in the Karnofsky Performance Score (KPS) while on the waitlist predict decreased survival after lung transplantation (LTx). ⋯ Deterioration of KPS on the waiting list for LTx is associated with significantly greater postoperative mortality in patients after LTx. These results should be taken into consideration when allocating organs. Strategies to increase or to prevent a decrease in KPS before LTx should be evaluated.
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J. Cardiothorac. Vasc. Anesth. · Dec 2022
ReviewPerioperative Management of the Patient at HighRisk for Cardiac Surgery-Associated Acute Kidney Injury.
Acute kidney injury (AKI) is one of the most common major complications of cardiac surgery, and is associated with increased morbidity and mortality. Cardiac surgery-associated AKI has a complex, multifactorial etiology, including numerous factors such as primary cardiac dysfunction, hemodynamic derangements of cardiac surgery and cardiopulmonary bypass, and the possibility of a large volume of blood transfusion. ⋯ This narrative review describes the current state of the scientific literature concerning the specific aspects of cardiac surgery-associated AKI, and presents it in a chronological fashion to aid the perioperative clinician in their approach to this high-risk patient group. The evidence was considered for risk prediction models, preoperative optimization, and the intraoperative and postoperative management of cardiac surgery patients to improve renal outcomes.
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J. Cardiothorac. Vasc. Anesth. · Dec 2022
ReviewInfection Control for Perioperative Ultrasonography and Echocardiography.
Ultrasound technology has revolutionized point-of-care diagnostics, decision-making, and the guidance of interventional procedures in Anesthesiology and Perioperative Medicine. Recent literature has highlighted important infection control considerations when performing transesophageal or transthoracic echocardiography, point-of-care ultrasound, and ultrasound-guided procedures. This narrative review focuses on operator precautions and disinfection methods and summarizes key recommendations from the international Echocardiography and Radiology Societies.