Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Randomized Controlled TrialFeasibility and Usefulness of Self-Hypnosis in Patients Undergoing Double-Lung Transplantation During the Pre- and Postoperative Periods: A Randomized Study.
Hypnosis can reduce pain and anxiety in surgical patients. This study aimed to demonstrate that implementing self-hypnosis in the setting of lung transplantation could improve patients' pain and quality of life. ⋯ Implementation of self-hypnosis is possible, but the study failed to demonstrate an improvement in patients' experience, perhaps due to the variable compliance with the technique.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
External Validation of the ACTA-PORT Transfusion Risk Score in Older Cardiac Surgery Patients at Risk of Frailty.
Accurate preoperative transfusion risk stratification may serve to better manage older patients undergoing cardiac surgery. Therefore, the aim of the present study was to externally validate the existing Association of Cardiothoracic Anesthetists perioperative risk of blood transfusion (ACTA-PORT) score in a population ≥70 years of age scheduled for cardiac surgery. Furthermore, the study authors investigated the additional prognostic value of individual frailty variables to this transfusion risk score. ⋯ External validation of the original ACTA-PORT score showed good discrimination and moderate calibration in older patients at risk of frailty undergoing cardiac surgery. Updating the original ACTA-PORT improved the predictive performance. Careful evaluation of additional frailty domains did not add prognostic value to the ACTA-PORT score.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Observational StudyProspective Observational Trial of a Nonocclusive Dilatation Balloon in the Management of Tracheal Stenosis.
Tracheal stenosis is a debilitating condition that often presents as an emergency and is challenging to treat. Dilatation may avoid tracheostomy or costly tracheal resection and reconstruction. Traditional dilators cause complete occlusion, preventing oxygenation and ventilation, limiting the safe duration of dilatation, and increasing the risk of hypoxic injury or barotrauma. The study authors here assessed an innovative nonocclusive tracheal dilatation balloon, which may improve patient safety by allowing continuous gas exchange. ⋯ The authors report the first human trial of the device, in which continuous conventional ventilation could be provided during all tracheal balloon dilatation procedures. Larger trials are needed to confirm improved patient safety and comparative efficacy.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Observational StudyRenal-Resistive Index and Acute Kidney Injury in Aortic Surgery: An Observational Pilot Study.
Acute kidney injury (AKI) is a common perioperative complication in patients undergoing cardiovascular surgery, increasing mortality, morbidities, and costs. Recently, growing interest has risen in the use of the renal-resistive index (RRI) as a predictor of perioperative AKI. The aim of this study was to evaluate the role of RRI variation to identify postoperative AKI. ⋯ RRI variation could be a useful tool to investigate kidney function in patients undergoing aortic surgery. The %RRI in the perioperative time seems to detect AKI onset early and potentially could enhance renal-protective management within 24 hours after surgery.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Observational StudyUtility of Lung Ultrasound in the Estimation of Extravascular Lung Water in a Pediatric Population-A Prospective Observational Study.
Lung ultrasound (LUS) is a promising bedside modality for the estimation of extravascular lung water index (EVLWI), but has not been validated against objective measures in children. This study aimed to investigate the correlation of LUS B-line scoring with EVLWI, thresholds indicating elevated EVLWI, and its outcome following pediatric cardiac surgery. ⋯ LUS B-line scoring has limited utility in semiquantitative estimation of EVLWI at lower thresholds of EVLWI in pediatric cardiac surgical patients. It may have better discrimination and acceptable sensitivity and specificity at higher thresholds of EVLWI. Contrasting with multiple reports of clinical utility, these results call for wider evaluation of LUS and its clinical modifiers like age, pathology, and pretest probability in estimation of EVLWI.