Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Fast-Track Failure After Cardiac Surgery: Risk Factors and Outcome With Long-Term Follow-Up.
An important cornerstone of the Enhanced Recovery After Cardiac Surgery initiative is a fast-track cardiac anesthesia management protocol. Fast-track failure has been described to have a detrimental impact on immediate postoperative outcomes. The authors here evaluated risk factors for short- and long-term effects of fast-track failure. ⋯ Fast-track failure is associated with increases in morbidity and long-term mortality, but remains difficult to predict.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Safety of Ultrasound-Guided Transversus Thoracis Plane Block in Pediatric Cardiac Surgery: A Retrospective Cohort Study.
Ultrasound-guided fascial plane blocks are associated with good postoperative analgesia after pediatric cardiac surgery, with improved safety profile. To the best of the authors' knowledge, this study was the first with the primary aim of assessing the safety profile of transversus thoracis plane (TTP) block in pediatric patients who underwent open cardiac surgery. ⋯ The above complications were noted in patients who received TTP block, and further prospective studies with more patients are required to comment on its safety.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Association Between Exogenous Nitric Oxide Given During Cardiopulmonary Bypass and the Incidence of Postoperative Kidney Injury in Children.
To compare the incidence and severity of acute kidney injury (AKI) after cardiac surgery with cardiopulmonary bypass and the administration of exogenous nitric oxide in children. ⋯ This single-center, retrospective, cohort study found no change in the incidence and severity of postoperative AKI after the administration of nitric oxide into the cardiopulmonary bypass circuit in children.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Is an Acute Perioperative Increase in Creatinine Production Rate a Potential Mechanism for an Early Creatinine-Based Signal of Renal Injury After Cardiac Surgery?
Previous studies report a creatinine-based signal of injury within hours after cardiac surgery, which is sooner than expected based on creatinine kinetic modelling. A plausible mechanism for such an early signal has not been established, but might be explained by an acute perioperative increase in creatinine production rate (Crprod-rate). The authors sought to test the hypothesis that perioperative Crprod-rate increases from baseline in patients undergoing cardiac surgery. ⋯ Perioperative Crprod-rate increased from baseline in patients undergoing cardiac surgery. This may represent a mechanism for an earlier creatinine-based signal of renal injury than previously thought possible.