Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Oct 2022
Observational StudyThe Elevation of Double-Lumen Tube Cuff Pressure During Lung Surgery: A Single-Center Prospective Observational Study☆,☆.
Excessive tracheal tube cuff pressure can cause postoperative complications; however, the variations in the double-lumen tube cuff pressure in lung surgery have not been investigated. This study aimed to determine the incidence and variations in excess double- lumen tube cuff pressure during one-lung ventilation. ⋯ A high incidence and long duration of excess tracheal and bronchial cuff pressure were observed during one-lung ventilation for lung surgery.
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J. Cardiothorac. Vasc. Anesth. · Oct 2022
Perioperative Management of Patients With Myasthenia Gravis Undergoing Robotic-Assisted Thymectomy-A Retrospective Analysis and Clinical Evaluation.
Postoperative myasthenic crisis with respiratory failure is a potentially lethal complication, warranting careful perioperative planning and extended postoperative surveillance of patients. Data on the incidence of postoperative respiratory failure and optimal management of patients after robotic-assisted thymectomy are limited. The objective of this study was to evaluate the incidence of respiratory complications and the need for intensive care unit (ICU) capacities after robotic-assisted thymectomy in patients with myasthenia gravis. ⋯ After careful patient selection, planning, and postoperative patient evaluation, robotic-assisted thymectomy can be performed safely without postoperative surveillance in an ICU.
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J. Cardiothorac. Vasc. Anesth. · Oct 2022
Observational StudyComparison of Changes in Thoracic Fluid Content Between On-Pump and Off-Pump CABG by Use of Electrical Cardiometry.
To compare the changes in thoracic fluid content, PaO2/FIO2 ratio, plateau pressure, compliance, and postoperative ventilation duration in off-pump coronary artery bypass grafting (OPCAB) and on-pump coronary artery bypass grafting (ONCAB). ⋯ The change in TFC was greater in the ONCAB group, despite the fact that the fluid balance was higher in the OPCAB group. A higher TFC in ONCAB led to lower PaO2/FIO2 ratio, lower compliance, higher plateau pressures, and longer postoperative ventilation.
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J. Cardiothorac. Vasc. Anesth. · Oct 2022
ReviewThe Intraoperative Assessment of Right Ventricular Function During Cardiac Surgery.
The importance of right ventricular (RV) dysfunction in patients undergoing cardiac surgery is well recognized. There is extensive literature regarding the accurate assessment of RV dysfunction with both echocardiography and hemodynamic data, but the majority of these studies are with transthoracic echocardiography (TTE) and in awake patients. Many of the tools used to assess the RV with TTE are angle-dependent and, therefore, may be inaccurate with transesophageal echocardiography (TEE). ⋯ The purpose of this review is to discuss the intraoperative tools available to the cardiac anesthesiologist for the assessment of RV function. The authors review the available literature surrounding intraoperative RV assessment, from subjective assessment to traditional objective tools that were developed for TTE and newer technology that can be adapted to both TTE and TEE. Future work should focus on whether or not these intraoperative RV assessment tools predict outcome after cardiac surgery.