Journal of cardiothoracic and vascular anesthesia最新文献

{"title":"Reevaluating the Clinical Interpretation of Ultrafiltration Volume and Acute Kidney Injury Risk Following Cardiopulmonary Bypass: Causality, Confounding, or Context?","authors":"Melike Korkmaz Toker, Eylem Yasar","doi":"10.1053/j.jvca.2025.06.008","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.06.008","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560236","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":"An Argument for Artificial Intelligence.","authors":"M Haseeb Zubair, Vanja Tolj, Frederick C Cobey","doi":"10.1053/j.jvca.2025.05.055","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.055","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608456","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":"Con: Speckle Tracking Echocardiographic Strain Analysis of the Right Ventricle After Left Ventricular Mechanical Support.","authors":"Govind Pandompatam","doi":"10.1053/j.jvca.2025.06.002","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.06.002","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496727","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":"A Valve-like Subaortic Membrane Diagnosed on Intraoperative Transesophageal Echocardiography in a Case of Subaortic Ventricular Septal Defect.","authors":"Udit Khajuria, Saravana Babu Ms, Subin Sukesan, Varghese T Panicker","doi":"10.1053/j.jvca.2025.06.003","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.06.003","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505815","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":"Prophylactic Intravenous Tranexamic Acid in Thoracic Surgery: A Matched-pair Analysis From the German Thoracic Registry.","authors":"Mark Schieren, Stephane Collaud, Luis Bonberg, Jesko Welters, Frank Wappler, Jérôme Defosse","doi":"10.1053/j.jvca.2025.06.005","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.06.005","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effect of prophylactic intravenous tranexamic acid (TXA) on bleeding complications, thromboembolic events, and hospital stay in patients undergoing thoracic surgery.</p><p><strong>Design: </strong>Retrospective matched-pair analysis of registry data.</p><p><strong>Setting: </strong>German Thorax Registry data from multiple thoracic surgery centers across Germany.</p><p><strong>Participants: </strong>A total of 1,034 adult patients undergoing thoracic surgical procedures, matched 1:1 (517 received intravenous TXA, 517 did not).</p><p><strong>Interventions: </strong>Administration of prophylactic intravenous TXA prior to thoracic surgery.</p><p><strong>Measurements and main results: </strong>Postoperative bleeding complications, including reoperations for bleeding and transfusion requirements, did not differ significantly between groups. However, thromboembolic complications were significantly less frequent in the TXA group (1.0% v 5.1%). Cardiac complications were also less frequent in the TXA group. No significant differences were observed in overall complication rates or length of hospital stay.</p><p><strong>Conclusions: </strong>Prophylactic intravenous TXA did not reduce bleeding complications in thoracic surgery but was associated with a lower incidence of thromboembolic and cardiac events. While no definitive conclusions can be made about the efficacy of TXA in reducing bleeding complications, the study offers insights into its potential role in reducing thromboembolic and cardiac complications. A well-powered, randomized controlled trial is needed to confirm these results.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564833","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":"Modified Measurement of Tricuspid Annular Plane Systolic Excursion for Assessing Right Ventricular Function During Cardiac Surgery.","authors":"Kaili Ye, Yejun Zhao, Xiaofeng Hu, Xiaoxia Zhou","doi":"10.1053/j.jvca.2025.06.001","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.06.001","url":null,"abstract":"<p><p>Precise and prompt identification of right ventricular (RV) dysfunction is critical in cardiac surgery. Tricuspid annular plane systolic excursion (TAPSE) has been widely used as a simple, rapid, and repeatable index for assessing RV function. However, the current measurement of TAPSE is based mainly on M-mode ultrasound and is used predominantly in transthoracic echocardiography (TTE). Owing to differences in imaging views and the angle dependence of M-mode ultrasound, directly applying TAPSE measurement from TTE to transesophageal echocardiography (TEE) is not advisable. Therefore, exploring a modified TAPSE measurement method suitable for TEE is of great value for obtaining more accurate TAPSE values and informing subsequent clinical decision making. This review summarizes and discusses in detail the research progress on modified TAPSE in TEE as reported in the literature. By systematically reviewing relevant studies, it aims to provide new methods and insights for cardiac subspecialist anesthesiologists. Modified measurement methods will enable them to more accurately use TAPSE to assess RV function during perioperative TEE. This not only will help optimize clinical decision making, but also will provide an important basis for predicting patients' clinical outcomes.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484388","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":"Heparin Resistance: Definition, Risk Factors, and Therapeutic Approaches.","authors":"Daniel Bolliger, Gabor Erdoes, Eckhard Mauermann","doi":"10.1053/j.jvca.2025.05.057","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.057","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496729","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":"Artificial Intelligence-Driven Prediction of Acute Kidney Injury Following Acute Type A Aortic Dissection Surgery in a Chinese Population.","authors":"Zheyuan Chen, Xuran Lu, Maomao Liu, Yan Yu, Li Yu, Sihao Cheng, Zhihui Zhu, Yongqiang Lai, Nan Liu","doi":"10.1053/j.jvca.2025.05.047","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.047","url":null,"abstract":"<p><strong>Objectives: </strong>To develop and validate machine learning (ML) models for predicting acute kidney injury (AKI) following acute type A aortic dissection (ATAAD) surgery.</p><p><strong>Design: </strong>A retrospective single-center study.</p><p><strong>Setting: </strong>Beijing Anzhen Hospital (November 2018 to October 2023).</p><p><strong>Participants: </strong>1350 patients with ATAAD.</p><p><strong>Interventions: </strong>Predictive models have been developed using various ML algorithms to estimate the risk of postoperative AKI.</p><p><strong>Measurements and main results: </strong>Patients were randomly divided into training (85%) and testing (15%) sets. Seven ML algorithms-Gradient Boosting Machine (GBM), LightGBM, Random Forest (RF), K-Nearest Neighbors (KNN), Multi-Layer Perceptron Neural Network (MLP-NN), Naive Bayes (NB), and Logistic Regression (LR)-were evaluated. Model performance was assessed using SHapley Additive exPlanations (SHAP) analysis. A web-based application was developed using the optimal model. Postoperative AKI occurred in 586 patients (43.4%). The constructed models-GBM, LightGBM, RF, KNN, MLP-NN, NB, and LR-achieved areas under the receiver operating characteristic curves of 0.849 (95% CI 0.798-0.902), 0.874 (95% CI 0.831-0.918), 0.800 (95% CI 0.737-0.855), 0.672 (95% CI 0.598-0.739), 0.529 (95% CI 0.486-0.574), 0.833 (95% CI 0.775-0.886), and 0.866 (95% CI 0.810-0.912), respectively, in the testing set. Among these, the LightGBM model surpassed others in predictive accuracy, calibration, and clinical utility.</p><p><strong>Conclusion: </strong>ML models, particularly LightGBM, accurately predict postoperative AKI risk in ATAAD patients, offering a promising tool to enhance perioperative management and patient outcomes.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528063","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":"Impact of Cardiopulmonary Bypass Duration on the Renal Effects of Amino Acids Infusion in Cardiac Surgery Patients.","authors":"Domenico Pontillo, Lisa Q Rong, Alessandro Pruna, Antonio Pisano, Fabrizio Monaco, Andrea Bruni, Martina Baiardo Redaelli, Lian Kah Ti, Alessandro Belletti, Nikola Bradic, Cristiano Massaro, Gaia Barucco, Cristina Viscido, Rosario Losiggio, Francesco Federici, Marilena Marmiere, Simona Silvetti, Cristiano Marchetti, Monica Carmosino, Marco Manazza, Federico Mattia Oliva, Andrea Cortegiani, Fabio Guarracino, Marco Ranucci, Gianluca Paternoster, Giovanni Landoni, Alberto Zangrillo, Mario F L Gaudino, Rinaldo Bellomo","doi":"10.1053/j.jvca.2025.05.050","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.050","url":null,"abstract":"<p><strong>Objective: </strong>To test whether the duration of cardiopulmonary bypass (CPB) affects the nephroprotective effect of amino acids (AA) infusion in decreasing the occurrence of acute kidney injury (AKI) among cardiac surgery patients.</p><p><strong>Design: </strong>A post hoc study of the PROTECTION multicenter randomized double-blind placebo-controlled trial aiming to assess the effect of CPB duration on the differential impact of AA infusion on both the absolute and relative risk reduction in AKI incidence by comparing medians of CPB duration and CPB duration as a continuous variable.</p><p><strong>Setting: </strong>International, multicenter.</p><p><strong>Participants: </strong>The entire population of the PROTECTION trial, comprising 3511 adult patients undergoing cardiac surgery with CPB.</p><p><strong>Interventions: </strong>Intravenous AA infusion at a dosage of 2 g/kg/day, up to a maximum of 100 g/day.</p><p><strong>Measurements and main results: </strong>Compared with patients with CPB duration above the median (prolonged [P]-CPB group), patients with CPB duration below the median (brief [B]-CPB group) had a significantly lower incidence of AKI (23% [n/N =391/1716] vs 36% [n/N = 617/1723]; relative risk [RR], 0.64; 95% confidence interval [CI], 0.57-0.71; p <0.001). However, in the P-CPB group, AA infusion achieved an 8% absolute risk reduction (32% vs 40%) and a 0.79 RR reduction (95% CI, 0.70-0.90; p < 0.001; number needed to treat, 14). Moreover, AA also decreased the occurrence of AKI stage 3 (2.2% [n = 19] vs 5.0% [n = 43]; RR, 0.45; 95% CI, 0.26-0.76; p < 0.001) with a >95% probability of this effect being significantly greater in the P-CPB group compared to the B-CPB group.</p><p><strong>Conclusions: </strong>Cardiac surgery patients with prolonged CPB exposure had a significantly higher incidence of AKI. Notably, the P-CPB group received a greater benefit from AA therapy with an absolute risk and relative risk reduction of both any and severe AKI compared with the B-CPB group. Patients with prolonged CPB may be the specific targets of future studies.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505817","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":"Caution in Extrapolating in Vitro Heparin-Protamine Titration Data to Clinical Use.","authors":"Jonathan Rickmeyer, Min U Jang, Amir L Butt, Kenichi A Tanaka","doi":"10.1053/j.jvca.2025.05.060","DOIUrl":"https://doi.org/10.1053/j.jvca.2025.05.060","url":null,"abstract":"","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484387","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}