Journal of cardiothoracic and vascular anesthesia最新文献_第10页

Practice Advisory for Postoperative Pain Management of Thoracic Surgical Patients: A Report from the Society of Cardiovascular Anesthesiologists.

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-12-12 DOI: 10.1053/j.jvca.2024.12.004

Benu Makkad, Timothy Lee Heinke, Raiyah Sheriffdeen, Marie-Louise Meng, Bessie Kachulis, Michael Conrad Grant, Wanda Maria Popescu, Jessica Louise Brodt, Diana Khatib, Christopher L Wu, Miklos D Kertai, Bruce Allen Bollen

引用次数: 0

(Dis)continuation of Beta-blockers after Myocardial Infarction: The AβYSS Trial Examined. 心肌梗死后β受体阻滞剂的停用：AβYSS试验检验

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-12-12 DOI: 10.1053/j.jvca.2024.12.011

Shashank Shekhar, Seshasayee Narasimhan, Harish Ramakrishna

引用次数: 0

Personalizing Permissive Hypercapnia in Acute Severe Respiratory Failure. 急性严重呼吸衰竭患者容许性高碳酸血症的个体化治疗。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-12-11 DOI: 10.1053/j.jvca.2024.12.005

Vasileios Zochios, Hakeem Yusuff, Matthieu Schmidt

引用次数: 0

Unilateral Pulmonary Edema-Another Layer of Complexity Before Extubation After Minimally Invasive Cardiac Surgery and a Call for Predictive Risk Scores. 单侧肺水肿——微创心脏手术拔管前的另一层复杂性和对预测性风险评分的呼吁。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-12-10 DOI: 10.1053/j.jvca.2024.12.014

Jordan Holloway, Melissa Lee, Michael Essandoh

引用次数: 0

Efficacy of Quantra-Qplus System for Rapid Diagnosis and Treatment of Hypofibrinogenemia and Thrombocytopenia After Cardiopulmonary Bypass. Quantra-Qplus系统对体外循环术后低纤维蛋白原血症和血小板减少症的快速诊断和治疗效果。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-12-09 DOI: 10.1053/j.jvca.2024.12.009

Hiroaki Suzuki, Hironaga Ogawa, Seiko Endo, Takero Arai

{"title":"Efficacy of Quantra-Qplus System for Rapid Diagnosis and Treatment of Hypofibrinogenemia and Thrombocytopenia After Cardiopulmonary Bypass.","authors":"Hiroaki Suzuki, Hironaga Ogawa, Seiko Endo, Takero Arai","doi":"10.1053/j.jvca.2024.12.009","DOIUrl":"https://doi.org/10.1053/j.jvca.2024.12.009","url":null,"abstract":"Objectives: To assess whether the Quantra-Qplus can provide the cutoff values for predicting transfusion thresholds after cardiopulmonary bypass.Design: Prospective observational study.Setting: Single-center university hospital.Participants: Adult patients undergoing cardiac surgery.Interventions: The Quantra-Qplus and conventional laboratory coagulation test were performed.Measurements and main results: We enrolled 50 adult patients, and collected blood samples at 4 times (preoperative, during cardiopulmonary bypass, after protamine administration, and at the end of surgery). We obtained the values of the Quantra-Qplus (fibrinogen contribution to clot stiffness [FCS] and platelet contribution to clot stiffness [PCS]) and the values of conventional laboratory coagulation test (fibrinogen concentration and platelet count). To determine the cutoff values for FCS and PCS predicting blood transfusion thresholds at after protamine, receiver operating characteristic curve, area under the curve (AUC) with 95% confidence intervals (95% CIs), and Youden index were used. The cutoff value of FCS for predicting a fibrinogen concentration of less than 150 mg/dL was 0.95 hPa (AUC = 0.94; 95% CI, 0.86-1.00), and PCS for predicting a platelet count of less than 50,000/mm3 was 7.05 hPa (AUC = 0.97; 95% CI, 0.92-1.00) at after protamine administration. The cutoff values of FCS and PC varied during cardiac surgery.Conclusions: Our study provides potential cutoff values of FCS and PCS to guide fibrinogen administration or platelet transfusion in cardiac surgery patients after protamine administration. These cutoff values might vary during surgery, and different cutoff values for predicting transfusion thresholds during cardiac surgery might apply.","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927243","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}

引用次数: 0

Impact of Inflammation After Cardiac Surgery on 30-Day Mortality and Machine Learning Risk Prediction. 心脏手术后炎症对30天死亡率和机器学习风险预测的影响。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-12-09 DOI: 10.1053/j.jvca.2024.12.013

Enrico Squiccimarro, Roberto Lorusso, Antonio Consiglio, Cataldo Labriola, Renard G Haumann, Felice Piancone, Giuseppe Speziale, Richard P Whitlock, Domenico Paparella

{"title":"Impact of Inflammation After Cardiac Surgery on 30-Day Mortality and Machine Learning Risk Prediction.","authors":"Enrico Squiccimarro, Roberto Lorusso, Antonio Consiglio, Cataldo Labriola, Renard G Haumann, Felice Piancone, Giuseppe Speziale, Richard P Whitlock, Domenico Paparella","doi":"10.1053/j.jvca.2024.12.013","DOIUrl":"https://doi.org/10.1053/j.jvca.2024.12.013","url":null,"abstract":"Objectives: To investigate the impact of systemic inflammatory response syndrome (SIRS) on 30-day mortality following cardiac surgery and develop a machine learning model to predict SIRS.Design: Retrospective cohort study.Setting: Single tertiary care hospital.Participants: Patients who underwent elective or urgent cardiac surgery with cardiopulmonary bypass (CPB) from 2016 to 2020 (N = 1,908).Interventions: Mixed cardiac surgery operations were performed on CPB. Data analysis was made of preoperative, intraoperative, and postoperative variables without direct interventions.Measurements and main results: SIRS, defined using American College of Chest Physicians/Society of Critical Care Medicine parameters, was assessed on the first postoperative day. The primary outcome was 30-day mortality. SIRS incidence was 28.7%, with SIRS-positive patients showing higher 30-day mortality (12.2% v 1.5%, p < 0.001). A multivariate logistic model identified predictors of SIRS. Propensity score matching balanced 483 patient pairs. SIRS was associated with increased mortality (OR 2.77; 95% CI 1.40-5.47, p = 0.003). Machine learning models to predict SIRS were developed. The baseline risk model achieved an area under the curve of 0.77 ± 0.04 in cross-validation and 0.73 (95% CI 0.70-0.85) on the test set, while the procedure-adjusted risk model showed improved performance with an area under the curve of 0.81 ± 0.02 in cross-validation and 0.82 (95% CI 0.76-0.85) on the test set.Conclusions: SIRS is significantly associated with increased 30-day mortality following cardiac surgery. Machine learning models effectively predict SIRS, paving the way for future investigations on potential targeted interventions that may mitigate adverse outcomes.","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894761","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}

引用次数: 0

Mechanical Circulatory Support for Acute Myocardial Infarction Cardiogenic Shock: Review and Recent Updates. 急性心肌梗死心源性休克的机械循环支持：回顾和最新进展。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-12-08 DOI: 10.1053/j.jvca.2024.12.007

Jay S Saggu, Troy G Seelhammer, Sarvie Esmaeilzadeh, John A Roberts, Misty A Radosevich, Juan G Ripoll, Juan C Diaz Soto, Patrick M Wieruszewski, J Kyle K Bohman, Erica Wittwer, Chinyere Archie, Lakshmi Nemani, Christoph G S Nabzdyk

{"title":"Mechanical Circulatory Support for Acute Myocardial Infarction Cardiogenic Shock: Review and Recent Updates.","authors":"Jay S Saggu, Troy G Seelhammer, Sarvie Esmaeilzadeh, John A Roberts, Misty A Radosevich, Juan G Ripoll, Juan C Diaz Soto, Patrick M Wieruszewski, J Kyle K Bohman, Erica Wittwer, Chinyere Archie, Lakshmi Nemani, Christoph G S Nabzdyk","doi":"10.1053/j.jvca.2024.12.007","DOIUrl":"https://doi.org/10.1053/j.jvca.2024.12.007","url":null,"abstract":"Cardiogenic shock (CS) in acute myocardial infarction (AMI) is a life-threatening syndrome characterized by systemic hypoperfusion that can quickly progress to multiorgan failure and death. Various devices and configurations of mechanical circulatory support (MCS) exist to support patients, each with unique pathophysiological characteristics. The Intra-aortic balloon pump can improve coronary perfusion, decrease afterload, and indirectly augment cardiac output. TandemHeart, a percutaneous ventricular assist device, can decrease left ventricular preload and directly augment cardiac output. Neither the intra-aortic balloon pump nor the percutaneous ventricular assist device has been shown to decrease mortality in the revascularization era. Venoarterial extracorporeal membrane oxygenation can offer complete cardiopulmonary support; however, it has not been shown to decrease mortality. Recent studies have indicated that microaxial flow pumps, such as Abiomed's Impella family of devices, can decrease mortality in the AMI-CS population. Managing AMI-CS requires careful clinical assessment, as no single MCS device is universally effective, and device-related complications are common. While venoarterial extracorporeal membrane oxygenation provides complete support, it has not demonstrated a mortality benefit in major trials and carries significant risks. In contrast, microaxial flow pumps have shown a mortality benefit but with higher complication rates. Ongoing research and advancements aim to refine MCS strategies, improve device safety, and enhance patient outcomes.","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914803","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}

引用次数: 0

Role of del Nido Cardioplegia Solution in Prolonged Aortic Cross-clamp Cardiac Surgery: A Prospective Study. del Nido停搏液在延长主动脉交叉钳心脏手术中的作用：一项前瞻性研究。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-12-07 DOI: 10.1053/j.jvca.2024.12.006

Sun Lin, Zhou Xiaoyu, Xu Lingfeng, Chang Xin, Guo Zhen

{"title":"Role of del Nido Cardioplegia Solution in Prolonged Aortic Cross-clamp Cardiac Surgery: A Prospective Study.","authors":"Sun Lin, Zhou Xiaoyu, Xu Lingfeng, Chang Xin, Guo Zhen","doi":"10.1053/j.jvca.2024.12.006","DOIUrl":"https://doi.org/10.1053/j.jvca.2024.12.006","url":null,"abstract":"Objectives: The myocardial-protective effect of del Nido cardioplegia solution was evaluated in adult patients undergoing prolonged aortic cross-clamping during cardiac surgery.Design: Prospective cohort.Setting: Single-center tertiary academic medical center.Participants: A total of 462 patients scheduled for cardiac surgery under cardiopulmonary bypass with an expected aortic cross-clamp time >120 minutes between January 2020 and January 2024 were enrolled.Interventions: Patients with an expected aortic cross-clamp time >120 minutes were randomly assigned to low- and high-risk del Nido and Buckberg groups, with 112 patients in each group. Serum levels of cardiac troponin T and creatine kinase-MB were measured at 1, 24, and 48 hours after operation. The occurrence of atrial fibrillation within 48 hours postoperatively and other intraoperative and postoperative parameters were recorded.Results: No significant differences were observed in preoperative parameters between the groups. The level of cardiac troponin T was significantly higher in the low-risk del Nido group than in the Buckberg group at 24 hours postoperatively (p < 0.05). However, no significant differences were observed in cardiac troponin T or creatine kinase-MB levels at the other time points. The incidence of postoperative atrial fibrillation in the Buckberg group at 48 hours was significantly higher than the del Nido group in both the low- and high-risk groups (p < 0.05).Conclusions: The incidence of postoperative atrial fibrillation at 48 hours was significantly lower in the del Nido group than in the Buckberg group. del Nido cardioplegia solution can be safely used for high-risk patients undergoing prolonged aortic cross-clamping.","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894763","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}

引用次数: 0

Transesophageal Echocardiography Imaging of Iatrogenic Pulmonary Vein Stenosis After Left Atrial Reduction Plasty. 经食管超声心动图诊断左房缩小成形术后医源性肺静脉狭窄。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-12-07 DOI: 10.1053/j.jvca.2024.12.008

Kohei Noto, Junichi Saito, Hirotaka Kinoshita, Tetsuya Kushikata, Kazuyoshi Hirota

引用次数: 0

A Novel Configuration of Venovenous Modified Ultrafiltration for Bivalirudin Removal After HeartMate3 Insertion. 一种新型的静脉-静脉修饰超滤技术用于心脏mate3插入后的比伐鲁定去除。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-12-07 DOI: 10.1053/j.jvca.2024.12.002

Madison I Goldberger, Negmeldeen Mamoun, Zachary Fitch, Desiree Bonadonna, Jacob Schroder, Ian Welsby

引用次数: 0