Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Electrocardiographic Features and Outcome: Correlations in 124 Hospitalized Patients With COVID-19 and Cardiovascular Events.
Electrocardiographic (ECG) changes have been associated with coronavirus disease 2019 (COVID-19) severity. However, the progression of ECG findings in patients with COVID-19 has not been studied. The purpose of this study was to describe ECG features at different stages of COVID-19 cardiovascular (CV) events and to examine the effects of specific ECG parameters and cardiac-related biomarkers on clinical outcomes in COVID-19. ⋯ In hospitalized patients with COVID-19 and CV events, ECGs at various stages of COVID-19 hospitalization showed significantly different features with dissimilar clinical outcome correlations.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
ReviewBlunt Trauma to the Heart: A Review of Pathophysiology and Current Management.
Blunt cardiac injury (BCI), defined as an injury to the heart from blunt force trauma, ranges from minor to life-threatening. The majority of BCIs are due to motor vehicle accidents; however, injuries caused by falls, blasts, and sports-related injuries also can be sources of BCI. A significant proportion of patients with BCI do not survive long enough to receive medical care, succumbing to their injuries at the scene of the accident. ⋯ Close communication with the surgical team and access to blood products for potentially massive transfusion also play key roles in maintaining hemodynamic stability. With proper surgical and anesthetic care, survival in cases involving urgent cardiac repair can reach 66%-to-75%. This narrative review focuses on the types of cardiac injuries that are caused by blunt chest trauma, the modalities and techniques currently used to diagnose BCI, and the perioperative management of injuries that require surgical correction.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
ReviewFour Decades of Randomized Clinical Trials Influencing Mortality in Critically Ill and Perioperative Patients.
Randomized clinical trials (RCTs) represent the highest level of scientific evidence. The aim of this review was to map and summarize the main characteristics and publication trends of RCTs with a statistically significant effect on mortality in critically ill and perioperative patients. ⋯ In the largest contemporary RCTs database of interventions significantly influencing mortality, the authors found an increase in scientific production. United States, China, France, Italy, and the United Kingdom contributed with 172 (51%) RCTs over 40 years. Only 20% of the studies were multinational collaborations, though this percentage increased over time. The presence of women as first authors was 1 out of 8 RCTs.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
ReviewNear-Infrared Spectroscopy (NIRS) for Cerebral and Tissue Oximetry: Analysis of Evolving Applications.
THE USE OF NEAR-INFRARED SPECTROSCOPY (NIRS) has increased significantly worldwide in the past decade. This technology, first described more than 40 years ago, is based on the fact that near-infrared light is able to penetrate biologic tissue and can obtain real-time, noninvasive information on tissue oxygenation and metabolism. ⋯ Near-infrared spectroscopy has progressed beyond assessment of brain oxygenation to monitor local tissue and muscle oxygenation and perfusion. This review analyzes the published data and provides the clinician a comprehensive account of the perioperative utility of NIRS in cardiac, vascular and thoracic surgery, as well as its increasing role in tissue/muscle oxygenation monitoring.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Multicenter StudyPostoperative Pulmonary Complications After Cardiac Surgery: The VENICE International Cohort Study.
Postoperative pulmonary complications (PPC) remain a main issue after cardiac surgery. The objective was to report the incidence and identify risk factors of PPC after cardiac surgery. ⋯ Both individual risk factors and ventilatory settings were shown to explain the high level of PPCs. These findings require further investigations to assess a bundle strategy for optimal ventilation strategy to decrease PPC incidence.