发布求助
文献互助 智能选刊 最新文献

Cardiac Anesthesia: A Problem-Based Learning Approach最新文献

筛选
英文 中文
Anesthetic Management for Patients With Left Ventricular Assist Devices Undergoing Noncardiac Surgery 非心脏手术中使用左心室辅助装置患者的麻醉管理
Cardiac Anesthesia: A Problem-Based Learning Approach Pub Date : 2019-04-01 DOI: 10.1093/MED/9780190884512.003.0015
A. Kleiman, Christopher Spencer, J. Huffmyer
{"title":"Anesthetic Management for Patients With Left Ventricular Assist Devices Undergoing Noncardiac Surgery","authors":"A. Kleiman, Christopher Spencer, J. Huffmyer","doi":"10.1093/MED/9780190884512.003.0015","DOIUrl":"https://doi.org/10.1093/MED/9780190884512.003.0015","url":null,"abstract":"The incidence and prevalence of chronic heart failure is increasing in the United States, and end-stage heart failure is associated with high mortality. While medical management is often the first-line treatment of heart failure, mechanical circulatory support and ventricular assist device therapies are being increasingly employed to improve symptoms and end-organ dysfunction from heart failure. Patients with left ventricular assist devices (LVADs) are not only surviving with their disease, but also thriving as a result of LVAD support, and many return to normal activities of daily life. Thus, these patients present to hospitals for noncardiac surgeries, both elective and urgent, with increasing frequency. This chapter explores some commonly used ventricular assist devices, the altered physiology that accompanies LVAD therapy with continuous flow devices, as well as some of the anesthetic considerations that are vital for patients presenting for both elective and urgent surgeries.","PeriodicalId":103017,"journal":{"name":"Cardiac Anesthesia: A Problem-Based Learning Approach","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122967079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anesthesia for Cardiac Transplantation 心脏移植的麻醉
Cardiac Anesthesia: A Problem-Based Learning Approach Pub Date : 2019-04-01 DOI: 10.1093/MED/9780190884512.003.0026
Stefan A. Lombaard, Heather Reed, Samantha Arzillo
{"title":"Anesthesia for Cardiac Transplantation","authors":"Stefan A. Lombaard, Heather Reed, Samantha Arzillo","doi":"10.1093/MED/9780190884512.003.0026","DOIUrl":"https://doi.org/10.1093/MED/9780190884512.003.0026","url":null,"abstract":"Heart transplantation is indicated when other treatment options for patients with heart failure are no longer effective or when a heart transplant would improve survival. There are currently a variety of treatment options for these patients; the options range from medical therapy to full mechanical support. Heart transplantation remains the definitive therapy for end-stage heart failure. This discussion focuses on the management of a patient who presents for a heart transplant as well as some of the challenging clinical issues that may present during this period. Anesthetic induction agents may depress cardiovascular function and result in cardiovascular collapse. Drugs should be chosen that have limited hemodynamic effects.","PeriodicalId":103017,"journal":{"name":"Cardiac Anesthesia: A Problem-Based Learning Approach","volume":"206 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115913948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Electrophysiology Procedures 电生理学方法
Cardiac Anesthesia: A Problem-Based Learning Approach Pub Date : 2019-04-01 DOI: 10.1093/med/9780190884512.003.0021
Andrew A Disque, K. Patel
{"title":"Electrophysiology Procedures","authors":"Andrew A Disque, K. Patel","doi":"10.1093/med/9780190884512.003.0021","DOIUrl":"https://doi.org/10.1093/med/9780190884512.003.0021","url":null,"abstract":"Cardiac arrhythmias are a common cause of patient morbidity and mortality. Modern electrophysiology (EP) procedures, including placement of permanent pacemakers and implantable cardioverter-defibrillators and catheter ablation of cardiac arrhythmias, have been shown to reduce mortality and improve quality of life and symptoms. These procedures can also reduce the need for antiarrhythmic medications and hence reduce side effects related to these medicines. The procedures performed in the EP laboratory can be protracted and painful and therefore frequently require the assistance of an anesthesia team for patient comfort. Additionally, this patient population often presents with complicated comorbid conditions and hemodynamic instability. Frequently, the anesthetic management can be complicated and difficult, requiring a thorough understanding of these patients and the procedures they choose to undergo.","PeriodicalId":103017,"journal":{"name":"Cardiac Anesthesia: A Problem-Based Learning Approach","volume":"122 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114557640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Percutaneous Mitral Valve Procedures 经皮二尖瓣手术
Cardiac Anesthesia: A Problem-Based Learning Approach Pub Date : 2019-04-01 DOI: 10.1093/MED/9780190884512.003.0020
Sheela Pai Cole
{"title":"Percutaneous Mitral Valve Procedures","authors":"Sheela Pai Cole","doi":"10.1093/MED/9780190884512.003.0020","DOIUrl":"https://doi.org/10.1093/MED/9780190884512.003.0020","url":null,"abstract":"As the population ages, more patients are presenting with symptomatic mitral valve disease that requires risk-prohibitive cardiac surgery. In the last decade, advances in valve technology have generated valves that can be inserted via a minimally invasive percutaneous approach. Nonetheless, patients must fulfill specific criteria in order to be considered for a percutaneous mitral intervention. From an anesthesiologist’s perspective, these cases are unique as they require both a detailed understanding of complex patient physiology and the need to be planned as fast-track procedures. Echocardiography is the cornerstone to success for these procedures, and typically a separate team of echocardiographers may be involved in the conduct of the case. This review discusses patient selection, complications of the procedure, and perioperative considerations for this technique.","PeriodicalId":103017,"journal":{"name":"Cardiac Anesthesia: A Problem-Based Learning Approach","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127452755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pulmonary Thromboendarterectomy 肺Thromboendarterectomy
Cardiac Anesthesia: A Problem-Based Learning Approach Pub Date : 2019-04-01 DOI: 10.1093/med/9780190884512.003.0010
Michael Ross, D. Banks
{"title":"Pulmonary Thromboendarterectomy","authors":"Michael Ross, D. Banks","doi":"10.1093/med/9780190884512.003.0010","DOIUrl":"https://doi.org/10.1093/med/9780190884512.003.0010","url":null,"abstract":"Chronic thromboembolic pulmonary hypertension (CTEPH) is an important and often underappreciated cause of severe pulmonary hypertension. The disease is a result of incomplete resolution or recurrent pulmonary emboli. It is imperative to identify patients with CTEPH because it is one of the only causes of pulmonary hypertension that is curable. The treatment of choice is pulmonary thromboendarterectomy. The procedure involves removing any chronic thrombotic material and removing the intimal layer of the vasculature. Patients with CTEPH can be particularly challenging to manage in the perioperative setting and often present to the operating room with significant right heart dysfunction, severely elevated pulmonary vascular resistance, and reduced cardiac output.1 Increased knowledge about the unique disease and procedure can aid in optimizing the management of these patients in the perioperative period.2\u0000","PeriodicalId":103017,"journal":{"name":"Cardiac Anesthesia: A Problem-Based Learning Approach","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126543960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transfusion Dilemma/Coagulation TEG 输血困境/凝血TEG
Cardiac Anesthesia: A Problem-Based Learning Approach Pub Date : 2019-04-01 DOI: 10.1093/MED/9780190884512.003.0009
L. Duce, Amanda Frantz
{"title":"Transfusion Dilemma/Coagulation TEG","authors":"L. Duce, Amanda Frantz","doi":"10.1093/MED/9780190884512.003.0009","DOIUrl":"https://doi.org/10.1093/MED/9780190884512.003.0009","url":null,"abstract":"The healthcare team is presented with a unique challenge when providing bloodless surgery to patients of the Jehovah’s Witness faith who refuse allogenic transfusions based on religious beliefs. The Jehovah’s Witness faith interprets New and Old Testament passages of the Bible, including Genesis 9:4, as God commanding against “eating blood,” thus preventing believers from receiving transfusions of blood products. When it comes to complex cardiac surgery, where blood loss and coagulopathy are common, the physician and patient must establish a plan for blood conservation and optimization of hemoglobin preoperatively. Knowledge of management options during the preoperative period as well as treatment options for blood loss is imperative to honor patient autonomy and avoid ethical dilemmas.","PeriodicalId":103017,"journal":{"name":"Cardiac Anesthesia: A Problem-Based Learning Approach","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125131722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Robotic CABG 机器人搭桥术
Cardiac Anesthesia: A Problem-Based Learning Approach Pub Date : 2019-04-01 DOI: 10.1093/med/9780190884512.003.0006
R. Dhawan
{"title":"Robotic CABG","authors":"R. Dhawan","doi":"10.1093/med/9780190884512.003.0006","DOIUrl":"https://doi.org/10.1093/med/9780190884512.003.0006","url":null,"abstract":"Technological advances and increased experience in robotic coronary artery bypass surgery in the last 15 years have expanded and changed the field. Totally endoscopic coronary artery bypass surgery has become more prevalent and innovative. These cardiac cases require proficiency in skills such as management of one-lung ventilation, insertion of specialized catheters, intraoperative monitoring, and transesophageal echocardiography. Anesthesiologists must be familiar with different methods of lung isolation, including management of episodes of hypoxemia, hypercarbia, and sequelae of increased pulmonary vascular resistance during lung isolation. Procedures with arrested heart on cardiopulmonary bypass require expertise in insertion of a percutaneous coronary sinus catheter for administration of retrograde cardioplegia, in addition to insertion of a pulmonary artery vent for left ventricular decompression. Transesophageal echocardiography is essential for placement of specialized cannulas for cardiopulmonary bypass, such as the endoaortic occlusion balloon clamp and remote access perfusion lines. In certain cases, anesthetic technique should facilitate intraoperative extubation and management of postoperative pain.","PeriodicalId":103017,"journal":{"name":"Cardiac Anesthesia: A Problem-Based Learning Approach","volume":"42 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132393921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Robotic Thoracic Surgery 机器人胸外科手术
Cardiac Anesthesia: A Problem-Based Learning Approach Pub Date : 2019-04-01 DOI: 10.1093/MED/9780190884512.003.0029
D. Stombaugh, A. Dalton
{"title":"Robotic Thoracic Surgery","authors":"D. Stombaugh, A. Dalton","doi":"10.1093/MED/9780190884512.003.0029","DOIUrl":"https://doi.org/10.1093/MED/9780190884512.003.0029","url":null,"abstract":"Minimally invasive thoracic surgery has improved outcomes, including reduced length of postoperative admission, reduced postoperative pain, shorter postoperative stay, reduced wound complications, reduced blood loss, improved cosmesis, and improved equivalent oncological outcomes compared to traditional thoracotomy. Robotic thoracic surgery (RTS) is an improvement on video-assisted thoracoscopic surgery in that it allows the surgeon a greater degree of freedom with instrument movement and better surgical field visualization. Thoracic insufflation and one-lung ventilation both significantly alter and compromise the patient’s baseline cardiopulmonary physiology. Due to this, adequate preoperative workup, deftness at double-lumen endotracheal tube management, and advanced understanding of how RTS affects cardiopulmonary physiology are essential.","PeriodicalId":103017,"journal":{"name":"Cardiac Anesthesia: A Problem-Based Learning Approach","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114626868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fast-Track Recovery 快速恢复
Cardiac Anesthesia: A Problem-Based Learning Approach Pub Date : 2019-04-01 DOI: 10.1093/MED/9780190884512.003.0013
Arturo G. Torres, E. Mcgough
{"title":"Fast-Track Recovery","authors":"Arturo G. Torres, E. Mcgough","doi":"10.1093/MED/9780190884512.003.0013","DOIUrl":"https://doi.org/10.1093/MED/9780190884512.003.0013","url":null,"abstract":"Fast-track cardiac care (FTCC) encompasses the entire spectrum of perioperative care for the cardiothoracic surgical patient. From the preoperative assessment to postoperative care, the main goal is to expedite recovery while minimizing the inherent risks associated with cardiac surgery. The practice of prolonged mechanical ventilation due to high-dose narcotic anesthesia has evolved to early protocolized extubation pathways facilitated by multimodal anesthesia. The goal of the postoperative care phase is focused on reducing or completely bypassing the intensive care unit and ultimately decreasing hospital length of stay. Yet, here is where FTCC seems unable to achieve its goals due to multifactorial barriers. An integral part of successful FTCC is constant reevaluation of the patient through each of the perioperative phases (pre-, intra-, and postoperatively).","PeriodicalId":103017,"journal":{"name":"Cardiac Anesthesia: A Problem-Based Learning Approach","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130224294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cardiac Tamponade 心脏压塞
Cardiac Anesthesia: A Problem-Based Learning Approach Pub Date : 2019-04-01 DOI: 10.1093/med/9780190884512.003.0008
Todd Novak, Silas Hoxie
{"title":"Cardiac Tamponade","authors":"Todd Novak, Silas Hoxie","doi":"10.1093/med/9780190884512.003.0008","DOIUrl":"https://doi.org/10.1093/med/9780190884512.003.0008","url":null,"abstract":"Cardiac tamponade is a life-threatening condition that occurs when accumulating pericardial fluid results in impaired cardiac filling and hemodynamic instability. Most of the clinical features of tamponade are subtle and nonspecific and may not be appreciated until cardiovascular collapse is imminent. Understanding the physiological changes that occur during tamponade are essential for early recognition and intervention. While cardiac tamponade is a clinical diagnosis, echocardiography is the modality of choice in facilitating the prompt identification of extraneous pericardial contents and the determination of the hemodynamic significance. This chapter discusses the presentation, pathophysiology, and echocardiographic signs of tamponade, as well the differential diagnosis and confounding conditions most pertinent to the anesthesiologist. Both medical and surgical management are also addressed, including a review of perioperative and anesthetic techniques.","PeriodicalId":103017,"journal":{"name":"Cardiac Anesthesia: A Problem-Based Learning Approach","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121284999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
首页 上一页 下一页 尾页
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整，为了账户安全，请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们：info@booksci.cn Book学术提供免费学术资源搜索服务，方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号：604180095
Book学术官方微信