Journal of cardiothoracic and vascular anesthesia最新文献_第7页

Right-to-Left Interatrial Shunt Inversion Using a Percutaneous Left Ventricular Assist Device and Extracorporeal Membrane Oxygenation 使用经皮左心室辅助装置和体外膜氧合技术进行右至左心房间分流反转。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-08-14 DOI: 10.1053/j.jvca.2024.08.012

引用次数: 0

Correlation Between Tissue Doppler Imaging Method (E/e') and Invasive Measurements of Left Ventricular Filling Pressures: A Systematic Review, Meta-Analysis, and Meta-Regression. 组织多普勒成像方法（E/e'）与左心室充盈压侵入性测量之间的相关性：系统回顾、元分析和元回归。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-08-13 DOI: 10.1053/j.jvca.2024.08.014

Daniele Orso, Marta Sabbadin, Giacomo Bacchetti, Gabriele Simeoni, Tiziana Bove

{"title":"Correlation Between Tissue Doppler Imaging Method (E/e') and Invasive Measurements of Left Ventricular Filling Pressures: A Systematic Review, Meta-Analysis, and Meta-Regression.","authors":"Daniele Orso, Marta Sabbadin, Giacomo Bacchetti, Gabriele Simeoni, Tiziana Bove","doi":"10.1053/j.jvca.2024.08.014","DOIUrl":"https://doi.org/10.1053/j.jvca.2024.08.014","url":null,"abstract":"<p><strong>Objectives: </strong>Evaluation of pulmonary capillary wedge pressure (PCWP) through right heart catheterization can indirectly provide an estimation of the filling pressure of the left ventricle. Echocardiography can estimate left ventricular compliance using mitral annular tissue Doppler imaging (TDI). The E/e' ratio refers to the correlation between the peak mitral inflow (E-wave) velocity and early diastolic tissue Doppler mitral annular velocity (e'). The main purpose of this systematic review was to establish the correlation between echocardiographic E/e' ratio and PCWP. The correlation between E/e' and left ventricular end-diastolic pressure (LVEDP) was evaluated as a secondary objective.</p><p><strong>Design: </strong>A systematic review and meta-analysis of observational studies was conducted. The search was based on Medline (PubMed), Scopus, and Web of Science.</p><p><strong>Setting: </strong>Intensive care unit or cardiac intensive care unit.</p><p><strong>Participants: </strong>Adult patients.</p><p><strong>Interventions: </strong>Any study comparing the left ventricular filling pressure obtained by cardiac catheterization (reference) and echocardiographic evaluation, in particular TDI analysis (intervention), were included.</p><p><strong>Measurements and main results: </strong>The pooled analysis included 94 studies from the initially identified 7,304 records. The correlation was 0.48 (95% CI 0.42-0.54, Q = 420.52, I<sup>2</sup> = 84.8%) for PCWP and 0.50 (95% CI 0.38-0.60, Q = 210.91, I<sup>2</sup> = 89.1%) for LVEDP.</p><p><strong>Conclusions: </strong>The E/e' ratio moderately correlated with PCWP/LVEDP. The correlation was stable irrespective of the sites where e' was measured, but each site has its own limitations for specific patient subpopulations. The correlation was weak in patients with heart failure with a preserved ejection fraction.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107809","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

Local Adverse Events Associated with Peripheral Vasoactive Infusion in Children: A Systematic Review with Meta-analysis. 与儿童外周血管输注相关的局部不良事件：带 Meta 分析的系统回顾。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-08-13 DOI: 10.1053/j.jvca.2024.08.020

Jun Takeshita, Atsushi Kawaguchi, Tatsuya Kawasaki, Tadashi Ishihara, Nobuaki Shime

{"title":"Local Adverse Events Associated with Peripheral Vasoactive Infusion in Children: A Systematic Review with Meta-analysis.","authors":"Jun Takeshita, Atsushi Kawaguchi, Tatsuya Kawasaki, Tadashi Ishihara, Nobuaki Shime","doi":"10.1053/j.jvca.2024.08.020","DOIUrl":"https://doi.org/10.1053/j.jvca.2024.08.020","url":null,"abstract":"<p><p>Prior meta-analysis suggested a low incidence of local adverse events after infusion of vasoactive agents via a peripheral venous catheter in children. However, the number of included patients was relatively low, and the vasoactive agents used were mostly dopamine. We performed an updated systematic review with meta-analysis using databases of MEDLINE (via PubMed) and Cochrane Central Register of Controlled Trials to explore the safety of infusing vasoactive agents, including epinephrine and norepinephrine, through peripheral venous catheters or intraosseous access in critically ill children. The primary outcome was the occurrence of local adverse events associated with peripheral vasoactive infusion, such as extravasation or infiltration. Twelve observational studies and 1 randomized controlled trial were finally included. The pooled incidence rates of local adverse events associated with infusion of vasoactive agents through peripheral venous catheters or intraosseous access, peripheral venous catheters only, and intraosseous access only were 2.1% (95% confidence interval [CI]: 0.8%-3.9%), 2.3% (95% CI: 1.0%-4.0%), and 1.1% (95% CI: 0.0%-9.8%), respectively. Based on the findings of this meta-analysis, the incidence rate of local adverse events associated with peripheral vasoactive infusion appears to be low. Peripheral infusion of vasoactive agents, including epinephrine and norepinephrine, can be considered when necessary.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125817","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

Overcoming Challenges to Research Success in Cardiothoracic Anesthesiology Fellowship Training 克服心胸麻醉学研究员培训中研究成功所面临的挑战。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-08-13 DOI: 10.1053/j.jvca.2024.08.015

引用次数: 0

Anesthetic Management for Aspiration Thrombectomy Using the Penumbra Indigo System in Pediatric Patients with Congenital Heart Disease 先天性心脏病儿科患者使用 Penumbra Indigo 系统进行吸栓切除术的麻醉管理。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-08-10 DOI: 10.1053/j.jvca.2024.08.005

{"title":"Anesthetic Management for Aspiration Thrombectomy Using the Penumbra Indigo System in Pediatric Patients with Congenital Heart Disease","authors":"","doi":"10.1053/j.jvca.2024.08.005","DOIUrl":"10.1053/j.jvca.2024.08.005","url":null,"abstract":"<div><h3>Objective</h3><div>To describe clinical characteristics and outcomes, including transfusion requirements, in pediatric patients with congenital heart disease undergoing aspiration thrombectomy.</div></div><div><h3>Design</h3><div>Retrospective chart review.</div></div><div><h3>Setting</h3><div>Quaternary academic children's hospital.</div></div><div><h3>Participants</h3><div>Patients aged <18 years with congenital heart disease undergoing aspiration thrombectomy between November 2017 and February 2022.</div></div><div><h3>Measurements and Main Results</h3><div>Thirteen patients underwent mechanical thrombectomy with the Penumbra Indigo System. Their median age was 3.8 years, and median weight was 15.2 kg. Seven patients had palliated single ventricle circulation, and 6 had biventricular circulation. Nine patients had intensive care unit (ICU) admission before the procedure, and 12 required ICU admission after the procedure. Indications for thrombectomy included systemic venous thrombus in 7 patients, pulmonary arterial thrombus in 3 patients, systemic arterial thrombus in 2 patients, and systemic-to-pulmonary shunt occlusion in 1 patient. The median estimated blood loss was 7.7 mL/kg (interquartile range [IQR], 1.4-15.8 mL/kg; range, 0.5-51.5 mL/kg). Seven patients required intraoperative transfusion of packed red blood cells (n = 4), fresh frozen plasma (n = 2), platelets (n = 3), and/or cryoprecipitate (n = 1). In the patients requiring transfusion, the median transfusion volume was 22 mL/kg (IQR, 14.1-59.7 mL/kg, 9.3-132.8 mL/kg). Thrombectomy was successful in 8 of 13 patients, although 3 of these 8 patients experienced recurrent thrombosis.</div></div><div><h3>Conclusions</h3><div>Mechanical aspiration thrombectomy is being increasingly used to treat critically ill pediatric patients and presents unique anesthetic considerations, particularly related to the need for volume and blood product resuscitation.</div></div>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142093193","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

Letter in Response to “One-Lung Ventilation in a Small Child” 回应 "幼儿单肺通气 "的信件。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-08-09 DOI: 10.1053/j.jvca.2024.08.009

引用次数: 0

Perioperative Implications of the 2024 AHA/ACC/AMSSM/HRS/PACES/SCMR Guideline for the Management of Hypertrophic Cardiomyopathy 2024 年 AHA/ACC/AMSSM/HRS/PACES/SCMR 肥厚型心肌病管理指南的围手术期影响。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-08-09 DOI: 10.1053/j.jvca.2024.07.039

引用次数: 0

Analysis of Perioperative Factors Leading to Postoperative Pulmonary Complications, Graft Injury and Increased Postoperative Mortality in Lung Transplantation 导致肺移植术后肺部并发症、移植物损伤和术后死亡率增加的围手术期因素分析。

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-08-08 DOI: 10.1053/j.jvca.2024.08.002

{"title":"Analysis of Perioperative Factors Leading to Postoperative Pulmonary Complications, Graft Injury and Increased Postoperative Mortality in Lung Transplantation","authors":"","doi":"10.1053/j.jvca.2024.08.002","DOIUrl":"10.1053/j.jvca.2024.08.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Postoperative complications such as postoperative pulmonary complications (PPCs) and other organ complications are associated with increased morbidity and mortality after successful lung transplantation and have a detrimental effect on patient recovery. The aim of this study was to investigate perioperative risk factors for in-hospital mortality and postoperative complications with a focus on PPC and graft injury in patients undergoing lung transplantation</div></div><div><h3>Design</h3><div>Single-center retrospective cohort study of 173 patients undergoing lung transplantation</div></div><div><h3>Setting</h3><div>University Hospital, Medical Center Freiburg.</div></div><div><h3>Main Results</h3><div>In the stepwise multivariate regression analysis, donor age >60 years (odds ratio [OR], 1.85; 95% confidence interval [CI], 1.27-2.81), intraoperative extracorporeal membrane oxygenation (OR, 2.4; 95% CI, 1.7-3.3), transfusion of >4 red blood cell concentrates (OR, 3.1; 95% CI, 1.82-5.1), mean pulmonary artery pressure of >30 mmHg at the end of surgery (OR, 3.5; 95% CI, 2-6.3), the occurrence of postoperative graft injury (OR, 4.1; 95% CI, 2.8-5.9), PPCs (OR, 2.1; 95% CI, 1.7-2.6), sepsis (OR, 4.5; 95% CI, 2.8-7.3), and Kidney disease Improving Outcome grading system stage 3 acute renal failure (OR, 4.3; 95% CI, 2.4-7.7) were associated with increased in hospital mortality, whereas patients with chronic obstructive pulmonary disease had a lower in-hospital mortality (OR, 1.6; 95% CI, 1.4-1.9). The frequency and number of PPCs correlated with postoperative mortality.</div></div><div><h3>Conclusions</h3><div>Clinical management and risk stratification focusing on the underlying identified factors that could help to improve patient outcomes.</div></div>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Outflow Graft Tamponade: An Underrecognized Cause of Obstruction 气流导管填塞：未被充分认识的阻塞原因

IF 2.8 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-08-08 DOI: 10.1053/j.jvca.2024.07.055

Estefania Oliveros MD MSc, Arjun Gupta MD MPH, Kiran Mahmood MD, Vinh Q. Chau MD, Javier Sanz MD, Barry Love MD, Anuradha Lala MD, Sean P. Pinney MD, Donna M. Mancini MD, Anelechi Anyanwu MD, Sumeet S. Mitter MD MSc, Noah Moss MD

{"title":"Outflow Graft Tamponade: An Underrecognized Cause of Obstruction","authors":"Estefania Oliveros MD MSc, Arjun Gupta MD MPH, Kiran Mahmood MD, Vinh Q. Chau MD, Javier Sanz MD, Barry Love MD, Anuradha Lala MD, Sean P. Pinney MD, Donna M. Mancini MD, Anelechi Anyanwu MD, Sumeet S. Mitter MD MSc, Noah Moss MD","doi":"10.1053/j.jvca.2024.07.055","DOIUrl":"https://doi.org/10.1053/j.jvca.2024.07.055","url":null,"abstract":"Left ventricular assist device (LVAD) outflow graft obstruction can result in severe clinical deterioration. Underlying mechanisms may vary depending on the location. Outflow graft tamponade due to external compression can be under recognized. Management of this complication varies across institutions and a uniform approach has yet to be elucidated. Report a single center experience with outflow graft tamponade in patients with LVAD with the purpose of developing an optimal algorithm for the diagnosis and treatment of LVAD-related outflow graft tamponade. Retrospective chart review between July 2011 and July 2020. A total of 351 LVADs were implanted at our center, with outflow graft tamponade identified in 26 patients with LVAD. Fourteen (53.8%) had HeartMate II™, 8 (30.8%) had HeartMate3™ and 4 (15.4%) had HeartWare™. Individuals presented with heart failure symptoms, an audible precordial murmur and LVAD alarms after a median duration of 862 days of support (IQR 327 - 1455). Of the 26 patients, 15 (57.7%) underwent mini thoracotomy with outflow graft relief, 4 had percutaneous balloon dilatation and stenting, 2 were bridged directly to transplant and 1 had a pump exchange. No intervention was made on the remaining due to mild symptoms (n = 4). Conclusions: Outflow graft tamponade is a form outflow graft obstruction with a variable presentation that can result in significant hemodynamic compromise. It is amenable to both surgical and percutaneous interventions that restore LVAD function.","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":null,"pages":null},"PeriodicalIF":2.8,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142247503","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

Clinical Utility of Ultrasonographic Guidance for Arterial Catheterization in Patients with Obesity: A Randomized Controlled Trial. 肥胖症患者动脉导管超声引导的临床实用性：随机对照试验

IF 2.3 4区医学

Journal of cardiothoracic and vascular anesthesia Pub Date : 2024-08-08 DOI: 10.1053/j.jvca.2024.08.006

Hsiang-Ling Wu, Yu-Ming Wu, Chien-Wun Wang, Yen-Hao Su, Juan P Cata, Jui-Tai Chen, Yih-Giun Cherng, Ying-Hsuan Tai

{"title":"Clinical Utility of Ultrasonographic Guidance for Arterial Catheterization in Patients with Obesity: A Randomized Controlled Trial.","authors":"Hsiang-Ling Wu, Yu-Ming Wu, Chien-Wun Wang, Yen-Hao Su, Juan P Cata, Jui-Tai Chen, Yih-Giun Cherng, Ying-Hsuan Tai","doi":"10.1053/j.jvca.2024.08.006","DOIUrl":"https://doi.org/10.1053/j.jvca.2024.08.006","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the success and complication rates of radial artery catheterization using ultrasound guidance versus the conventional palpation technique in obese patients by anesthesia residents with similar levels of experience in both methods, and to measure the skin-to-artery distance of radial, brachial, and dorsalis pedis arteries using ultrasound with standardized anatomic landmarks.</p><p><strong>Design: </strong>Prospective, randomized controlled trial SETTING: Single tertiary center PARTICIPANTS: Eighty adults with a body mass index (BMI) ≥30 kg/m<sup>2</sup> INTERVENTIONS: Ultrasound guidance or conventional palpation method MEASUREMENTS AND MAIN RESULTS: The primary outcome was the first-attempt success rate of arterial catheterization. The skin-to-artery distance of the radial artery was significantly greater in the BMI groups of 40 to 49 kg/m<sup>2</sup> and ≥50 kg/m<sup>2</sup> compared to the BMI group of 30 to 39 kg/m<sup>2</sup> (mean difference, 1.0 mm; 95% confidence interval [CI], 0.4-1.7; p = 0.0029) for BMI 40-49 kg/m<sup>2</sup> vs 30-39 kg/m<sup>2</sup> and 1.5 mm (95% CI, 0.6-2.4 mm; p = 0.0015) for ≥50 kg/m<sup>2</sup> vs 30-39 kg/m<sup>2</sup>. Similar findings were observed for the brachial artery. BMI was inversely associated with first-attempt success rates (p = 0.0145) and positively with time to successful catheterization (p = 0.0271). The first-attempt success and vascular complication rates of catheterization did not differ significantly between the ultrasound guidance group (65.0% and 52.5%, respectively) and the conventional palpation group (70.0% [p = 0.6331] and 57.5% [p = 0.6531], respectively).</p><p><strong>Conclusion: </strong>The results of this study do not support the routine use of ultrasonography during radial arterial catheterizations for obese adults when junior practitioners perform the procedure.</p>","PeriodicalId":15176,"journal":{"name":"Journal of cardiothoracic and vascular anesthesia","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107808","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