Annals of cardiac anaesthesia
-
A significant incidence of Posterior Vessel Wall Puncture (PVWP) was reported during ultrasound guidance (USG) for internal jugular vein (IJV) catheterization. We studied a new technique of USGIJV cannulation to minimize or avoid PVWP, thereby decreasing overall complication rate, irrespective of the operators' experience level. ⋯ The "proximal pen-holding method" for real-time USG-IJV cannulation helped in avoiding PVWP with lesser complication rate and greater performer's ease.
-
Takotsubo cardiomyopathy (TCM) is characterized by transient ventricular dysfunction in the absence of obstructive coronary artery disease that may be triggered by an acute medical illness or intense physical or emotional stress. TCM is often confused with acute myocardial infarction given the similar electrocardiographic changes, cardiac enzymes, hemodynamic perturbations, and myocardial wall motion abnormalities. ⋯ Despite the large body of literature, there still seems to be an overall paucity in our understanding of the etiopathogenesis, clinical characteristics, natural history, and management of this syndrome, especially in the perioperative setting. This narrative review seeks to present and synthesize the most recent literature on TCM and to identify gaps in current knowledge which can become the basis for future research.
-
Comparative Study Observational Study
Comparison of full outline of unresponsiveness score and Glasgow Coma Scale in Medical Intensive Care Unit.
The Glasgow Coma Scale (GCS) is the most commonly used scale, and Full Outline of Unresponsiveness (FOUR) score is new validated coma scale as an alternative to GCS in the evaluation of the level of consciousness. ⋯ Both FOUR score and GCS are valuable scales for predicting outcomes in patients are admitted to the MICU; however, the FOUR score showed better discrimination and calibration than GCS, so it is superior to GCS in predicting outcomes in this patients population.
-
Comparative Study
Terlipressin versus norepinephrine to prevent milrinone-induced systemic vascular hypotension in cardiac surgery patient with pulmonary hypertension.
Milrinone at inotropic doses requires the addition of a vasoconstrictive drug. We hypothesized that terlipressin use could selectively recover the systemic vascular hypotension induced by milrinone without increasing the pulmonary vascular resistance (PVR) and mean pulmonary artery pressure (MPAP) as norepinephrine in cardiac surgery patients. ⋯ The use of terlipressin after milrinone will reverse systemic hypotension with lesser effect on the pulmonary artery pressure.
-
Randomized Controlled Trial Comparative Study
A comparative study of safety and efficacy of ultrasound-guided infra-clavicular axillary vein cannulation versus ultrasound-guided internal jugular vein cannulation in adult cardiac surgical patients.
Ultrasound (US)-guided internal jugular vein (IJV) cannulation is a widely accepted standard procedure. The axillary vein (AV) in comparison to the subclavian vein is easily visualized, but its cannulation is not extensively studied in cardiac patients. ⋯ The study shows that the US-guided AV cannulation may serve as an effective alternative to the IJV cannulation in cardiac surgery.