Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Observational StudyRetrograde Autologous Priming for Minimally Invasive Mitral Valve Surgery.
Little is known about the safety and clinical utility of retrograde autologous priming (RAP) in patients undergoing minimally invasive mitral valve surgery. The study authors hypothesized that RAP would increase the oxygen delivery index (DO2i) while decreasing red blood cell transfusion requirements compared to valve surgery without RAP. ⋯ In a minimally invasive mitral valve context, RAP was safe and associated with better DO2i, higher hematocrit, and fewer intraoperative and postoperative red blood cell transfusions.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Case ReportsA Call for Real-Time Bispectral Index and Electroencephalogram Monitoring in a Patient Undergoing Aortic Surgery.
A 77-year-old woman underwent replacement of the ascending aorta and aortic valve. Before separation from cardiopulmonary bypass, the pump flow was reduced to 0-to-1.1 L/min/m2 for four minutes at a tympanic temperature of 34.3°C to perform additional sutureing for aorta-graft anastomosis. ⋯ An offline scalogram of intraoperative electroencephalograms obtained from the bispectral index monitor, which was generated by using continuous wavelet transform with complex Morlet wavelets, readily visualized the process of development of cerebral infarction preceding a significant decrease of regional cerebral oxygen saturation during the low-flow period of cardiopulmonary bypass. The present case demonstrated the possible importance of real-time bispectral index and electroencephalogram monitoring in patients undergoing cardiovascular surgery, especially those undergoing high-risk procedures under hypothermic circulatory arrest.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Perioperative Risk Factors for Intensive Care Unit Readmissions and Mortality After Cardiac Surgery.
The aim of this study was to identify perioperative risk factors associated with intensive care unit readmission and in-hospital death after cardiac surgery. ⋯ Preoperative risk assessment is crucial for identifying cardiac surgery patients at risk of ICU readmission and in-hospital death. The potentially modifiable risk factors pinpointed by this study call for the optimization of care before surgery and after ICU discharge.
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J. Cardiothorac. Vasc. Anesth. · Aug 2022
Observational StudySemiquantitative ChestCT Severity Score Predicts Failure of Noninvasive Positive-Pressure Ventilation in Patients Hospitalized for COVID-19 Pneumonia.
Noninvasive positive-pressure ventilation (NPPV) emerged as an efficient tool for treatment of COVID-19 pneumonia. The factors influencing NPPV failure still are elusive. The aim of the study was to investigate the relationships between semiquantitative chest computed tomography (CT) scoring and NPPV failure and mortality in patients with COVID-19. ⋯ The authors reported the common and effective use of NPPV in patients with COVID-19 pneumonia. In the authors' population, a semiquantitative chest CT analysis at hospital admission accurately identified those patients responding poorly to NPPV.