Journal of cardiothoracic and vascular anesthesia最新文献

{"title":"Articles to Appear in Future Issues","authors":"","doi":"10.1053/S1053-0770(25)00419-7","DOIUrl":"10.1053/S1053-0770(25)00419-7","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":"39 7","pages":"Page xiv"},"PeriodicalIF":2.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing the Future With the 'Protected Noncardiac Surgery' Paradigm: Is Temporary Mechanical Circulatory Support the Missing Link to Expanding Surgical Eligibility?","authors":"Samuele Bugo, Viviana Teresa Agosta, Alice Bottussi, Jacopo D'Andria Ursoleo, Fabrizio Monaco","doi":"10.1053/j.jvca.2025.05.002","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.002","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144179963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Continuous Erector Spinae Plane Block Reduces Hospital Length of Stay After Minimally Invasive Cardiac Surgery: Preliminary Meta-Analytic Insights.","authors":"Burhan Dost, Yunus Emre Karapinar, Mirac Selcen Ozkal Yalin, Alessandro De Cassai","doi":"10.1053/j.jvca.2025.05.024","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.024","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Efficacy and Safety of Two Analgesic Regimens After Cardiac Surgery: Slow Release and Breakthrough Tapentadol versus Slow Release and Breakthrough Oxycodone.","authors":"Robert Wojnar, Seo Hyeon Jeong, Mohammad Asghari-Jafarabadi, Steve Philpot","doi":"10.1053/j.jvca.2025.05.032","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.032","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the analgesic outcome of two oral opioid regimens after cardiac surgery.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>A single tertiary-care facility.</p><p><strong>Participants: </strong>Opioid-naïve adult patients following cardiac surgery via a sternotomy.</p><p><strong>Interventions: </strong>Patients received 1 of 2 regimens after extubation, an oxycodone protocol or a tapentadol protocol. Each protocol contained at least 3 doses of a slow-release oral formulation with immediate-release doses of the same opioid for breakthrough analgesia. Both protocols included regular paracetamol. Other analgesia for refractory pain was as directed by the physician.</p><p><strong>Measurements and main results: </strong>Daily worst pain score was documented at rest and on movement in patients prescribed the oxycodone protocol and those prescribed the tapentadol protocol for 7 days after extubation. There was no significant difference between the tapentadol and oxycodone groups in worst pain at rest (odds ratio [OR] 1.77; 95% confidence interval [CI], 0.56-5.65; p = 0.334) or worst pain on movement (OR, 3.23; 95% CI, 0.85-12.32; p = 0.086) over the first 7 days post extubation. Despite a rapid de-escalation of opioids, the documented worst pain at rest and on movement by day 7, decreased by 96% in the tapentadol group and by 94% in the oxycodone group.</p><p><strong>Conclusions: </strong>This retrospective cohort study demonstrates that tapentadol compared to oxycodone is an effective alternative for managing pain after cardiac surgery performed via sternotomy.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can Sodium-glucose Cotransporter Inhibitors Alter the Life Cycle of Aortic Stenosis?","authors":"Nadim Choudhury, Ellen Richter, Abimbola Faloye","doi":"10.1053/j.jvca.2025.05.026","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.026","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal Membrane Oxygenation for Vasoplegia: Walking Before Running.","authors":"Jamel Ortoleva, Dominic V Pisano, Patrick M Wieruszewski","doi":"10.1053/j.jvca.2025.05.030","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.030","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Right Ventricular Function and Echocardiographic Pressure-Volume Loops: Overview and Perioperative Clinical Implications.","authors":"Usman Ahmed, Feroze Mahmood, Alina Nicoara, Vahid Kiarad","doi":"10.1053/j.jvca.2025.05.019","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.019","url":null,"abstract":"<p><p>Right ventricular (RV) mechanics have critical roles in cardiovascular physiology, yet their assessment remains challenging owing to the right ventricle's complex geometry and unique interaction with the pulmonary vascular system. This review explores RV structural, functional, and physiologic considerations, emphasizing their interplay with pulmonary hypertension (PH), heart failure, and perioperative outcomes. Traditional pressure- and volume-centric methods of RV evaluation, including echocardiography and right heart catheterization, often fail to provide comprehensive, load-independent measures of RV function. The integration of these measures for pressure-volume (PV) loop analysis has emerged as a valuable tool, offering insights into RV contractility, compliance, and ventriculoarterial coupling. This review highlights advances in intraoperative and noninvasive PV loop methodologies, including echocardiography-derived techniques and integration with catheter-based pressure measurements. These approaches enable detailed assessment of RV function, enhancing prognostic capabilities in such conditions as PH, heart failure with preserved ejection fraction, and postsurgical interventions like left ventricular assist device implantation and valve replacement. Despite the potential of RV PV loop analysis, its clinical adoption has been limited by technical complexities, cost, and the need for specialized expertise. This underscores the importance of standardizing PV loop acquisition techniques and validating surrogate markers, such as tricuspid annular plane systolic excursion/pulmonary artery systolic pressure ratio, to improve accessibility and utility. By providing a comprehensive overview of current and emerging methods for RV assessment, this review aims to foster a deeper understanding of RV mechanics, driving innovation in diagnostic, therapeutic, and prognostic strategies for cardiac surgeries.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep Parasternal Intercostal Plane Blocks and Their Role in a Cardiac Fast-Track Program.","authors":"Amir Zabida, Karen Foley, Cristopher Araya Gonzalez, Santiago Chaverra, Margarita Otalora Esteban, Kirubanand Senniappan, Paola Vidal Díaz, Juan Camilo Segura-Salguero, Bilal Ansari, Michael Kahn, Vivek Rao, George Djaiani","doi":"10.1053/j.jvca.2025.05.018","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.018","url":null,"abstract":"<p><strong>Objectives: </strong>To determine if deep parasternal intercostal plane (DPIP) blocks are associated with reduced opioid consumption and a subsequent reduction in postoperative delirium after cardiac surgery.</p><p><strong>Design: </strong>A retrospective observational study.</p><p><strong>Setting: </strong>A single-center tertiary care hospital.</p><p><strong>Participants: </strong>Three hundred and eight adult patients who underwent cardiac surgery with median sternotomy between March 2021 and February 2023.</p><p><strong>Interventions: </strong>DPIP blocks are performed after chest closure in the operating room under sterile conditions and with real-time ultrasound guidance. The control group did not receive DPIP blocks.</p><p><strong>Measurements and main results: </strong>Median [range] postoperative hydromorphone consumption at 12 hours was 0.8 [0-2.6] mg vs. 1.2 [0-2.6] mg, p = 0.0004, and at 24 hours was 0.4 [0-3.2] mg versus 0.6 [0-3.4] mg, p = 0.007 in the DPIP and control groups, respectively. Predictors of reduced hydromorphone requirements included the presence of DPIP blocks, use of a dexmedetomidine infusion, and absence of composite comorbidities. Postoperative delirium was present in 17 (11%) and 23 (14.9%) patients in the DPIP block and control groups respectively (odds ratio 0.76; 95% confidence interval 0.38-1.53, p = 0.45). The median [IQR] time to extubation was 135 [65, 274] minutes versus 196.5 [74, 420] minutes in the DPIP and control groups, respectively, p = 0.04. There was no difference with respect to major morbidity and mortality between the two groups.</p><p><strong>Conclusions: </strong>DPIP blocks were associated with decreased perioperative opioid consumption, and earlier tracheal extubation after cardiac surgery. DPIP blocks may be incorporated within the fast-track cardiac anesthesia pathways; however, alternative strategies need to be further explored to reduce postoperative delirium after cardiac surgery.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal Membrane Oxygenation in the Awake or Extubated Patient.","authors":"Giuseppe Cuttone, Luigi La Via, Giovanni Misseri, Gennaro Martucci, Massimiliano Sorbello, Nicolò Patroniti, Federico Pappalardo","doi":"10.1053/j.jvca.2025.05.021","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.021","url":null,"abstract":"<p><p>Extracorporeal membrane oxygenation (ECMO) traditionally has been used under deep sedation and mechanical ventilation. However, recent advancements have led to the development of awake ECMO strategies, allowing patients to remain conscious. This comprehensive review explores the evolving landscape of awake ECMO, from its historical context to current practices and future directions. We examine the rationale behind awake ECMO, including potential benefits such as preserved muscle strength, reduced sedation-related complications, and improved patient engagement in care. The review details key considerations in patient selection, emphasizing the importance of careful physiologic, psychological, and social assessment to identify suitable candidates for awake ECMO. Technical aspects of awake ECMO implementation are discussed, including cannulation strategies, circuit management, and the integration of extracorporeal support with spontaneous breathing. The unique challenges in managing awake ECMO patients are highlighted, addressing issues such as pain control, anxiety management, and early mobilization protocols. The review synthesizes current evidence on outcomes associated with awake ECMO, focusing in particular on its application as a bridge to lung transplantation and in acute respiratory failure. Although early data suggest promising results in selected populations, the need remains for more robust, large-scale studies to definitively establish the efficacy and safety of awake ECMO across various clinical scenarios. Emerging technologies and future directions in awake ECMO are explored, including the development of more compact and portable systems, advanced monitoring tools, and novel approaches to patient-ECMO interaction. Finally, the importance of specialized training programs and the potential for dedicated awake ECMO units within specialized centers are examined.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moderate Aortic Stenosis: Can We Predict Who Will Benefit from Intervention?","authors":"J Brad Meers, Matthew M Townsley","doi":"10.1053/j.jvca.2025.05.017","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.017","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}