Journal of Cardiac Critical Care TSS最新文献

{"title":"Optimizing Internal Mammary Artery Harvest and Preparation","authors":"Rahul Bhushan, Vijay Grover","doi":"10.25259/jccc_75_2023","DOIUrl":"https://doi.org/10.25259/jccc_75_2023","url":null,"abstract":"The left internal mammary artery (LIMA) graft plays a pivotal role in coronary artery bypass surgery, offering unparalleled efficacy in revascularization. This review paper delves into the multifaceted considerations surrounding LIMA utilization, aiming to provide a comprehensive understanding of optimal approaches. The study encompasses the alleviation of spasm, selection of graft harvesting techniques, identification of ideal vasodilators, and exploration of optimal delivery methods. Through an analysis of extensive research spanning the past three decades, this review elucidates critical insights for cardiac surgeons and researchers alike. The review emphasizes the ubiquity of severe spasms in harvested LIMA and examines interventions to mitigate this challenge. Studies highlighting the efficacy of papaverine administration through various routes underscore the need for tailored approaches based on clinical context. The debate between skeletonized and pedicled LIMA harvests is explored, revealing the advantages and complexities associated with each technique. Findings suggest that while skeletonized grafts offer enhanced flow, the decision remains multifaceted due to potential complications. Addressing the quest for the ideal vasodilator, the review juxtaposes papaverine and sodium nitroprusside, presenting both as viable options. Despite ongoing discussions, the cost-effectiveness and accessibility of papaverine have positioned it as the favored choice among clinicians. Optimal delivery methods emerge as a crucial factor in graft success, with perivascular injection showing promise in promoting sustained and improved flow rates. The clinical implications of these findings are substantial. By integrating the evidence presented, cardiac surgeons can make informed decisions, maximizing graft patency and patient outcomes. Further, research avenues are identified, encompassing refined delivery techniques, comprehensive comparisons of vasodilators, and long-term clinical outcome evaluations. In conclusion, this review underscores the intricate considerations essential for successful LIMA utilization. By addressing spasms, selecting graft techniques, choosing vasodilators, and refining delivery methods, practitioners can tailor their strategies to the individual patient, enhancing the efficacy of coronary revascularization.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"20 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140700914","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}

{"title":"Central Retinal Artery Occlusion Secondary to Paradoxical Embolism Across a Patent Foramen Ovale","authors":"Chinmaya Nanda, Sudipto Banerjee, Yatin Mehta, S. K. S. Rawat, N. Chouhan","doi":"10.25259/jccc_61_2023","DOIUrl":"https://doi.org/10.25259/jccc_61_2023","url":null,"abstract":"","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"67 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140700009","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}

{"title":"To Compare the Efficacy of Sub-Pecto-Interfascial Block with Erector Spinae Plane Block in Postoperative Pain Management in Patients Undergoing Cardiac Surgery","authors":"Rashmi Singh, Arindam Choudhury, Sandeep Chauhan, Milind P. Hote","doi":"10.25259/jccc_69_2023","DOIUrl":"https://doi.org/10.25259/jccc_69_2023","url":null,"abstract":"\u0000\u0000Pain following sternotomy has always been an issue of major concern for anesthesiologists. The incidence of pain is as high as 49% at rest following coronary artery bypass grafting. We planned to utilize the sub-pecto-interfascial plane (SIP) block and erector spinae plane (ESP) block to determine its efficacy and quality of analgesia as compared to conventional intravenous analgesia.\u0000\u0000\u0000\u0000After the Institutional Ethics Committee’s approval, we recruited 105 patients and randomized them into three groups. Group 1 received conventional analgesia, group 2 SIP, and group 3 ESP block. Group 2 and Group 3 received allocated blocks after induction of balanced general anesthesia under ultrasound guidance. With high-frequency linear probe (13 MHz) planes identified, a mixture of injection ropivacaine (0.375%) and dexmedetomidine (1.1 mcg/mL) was deposited. In group 2, six injections of 6 mL each at the 2nd, 4th, and 6th intercostal spaces in the bilateral parasternal region. In group 3, two injections of 20 mL of the above-mentioned mixture on each side above the transverse process of the T5 vertebra under the erector spinae muscle plane were injected. All patients were monitored throughout the procedures, and their vitals were recorded. Heart rate, systolic blood pressure, and diastolic blood pressure were noted at baseline, at skin incision, at sternotomy, and 30 min post-extubation. Patients were followed for total fentanyl consumption, pain score (numerical rating scale [NRS] score), and peak inspiratory flow rate, which were noted at extubation and 2, 4, 6, 8, 12, and 24 hours post-extubation. Levels of C-reactive protein (CRP), cortisol, and prolactin were done at baseline and 24 h after surgery. Extubation time, time of first oral intake, and total length of intensive care unit (ICU) stay were also compared between the groups.\u0000\u0000\u0000\u0000Total fentanyl consumption was significantly lower (P < 0.005) in group 2 and group 3 compared to group 1. Patient receiving blocks were significantly lower NRS score compared to the control group. Spirometry has shown improved results in block groups catering to early discharge from ICU. Rise in levels of CRP, cortisol, and prolactin were much higher in group 1 as compared to group 2 and group 3.\u0000\u0000\u0000\u0000The application of ESP and SIP blocks is far superior than conventional parenteral analgesics in terms of pain score, total opioid’s consumption, hemodynamic maintenance, spirometry efforts, and length of ICU stays.\u0000","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"55 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140700586","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}

{"title":"Partial Anomalous Pulmonary Venous Connection with Ventricular Septal Defect and Intact Atrial Septum","authors":"Mayank Yadav, Chava Harshanth Sairam","doi":"10.25259/jccc_62_2023","DOIUrl":"https://doi.org/10.25259/jccc_62_2023","url":null,"abstract":"Partial anomalous pulmonary venous connection (PAPVC) is a rare congenital cardiac abnormality in which the pulmonary veins drain into the right atrium directly or the superior vena cava 90% of PAPVC are accompanied by atrial septal defect. However, PAPVC with ventricular septal defect is a rare entity.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"8 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140702353","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}

{"title":"Factors Influencing Electrocardiogram Pattern in Children and Adolescents: A Systematic Review for Future Research","authors":"E. Thirumurugan, Edwin Dias, Karthick R","doi":"10.25259/jccc_74_2023","DOIUrl":"https://doi.org/10.25259/jccc_74_2023","url":null,"abstract":"An electrocardiogram (ECG) is a diagnostic tool that can identify heart conditions and offer valuable information about electrical activity and age-related changes. Our primary concern is studying ECG changes related to age, gender, and body mass index (BMI) for the benefit of researchers and clinicians. A comprehensive search for relevant literature was conducted in the PubMed, Embase, and Scopus databases. The selection criteria were limited to original papers published between January 1, 2015, and December 31, 2022, that were deemed eligible. We executed a meticulous selection process that involved eliminating duplicates, screening abstracts and full texts, and manually adding some articles. During the full-text screening process, we excluded articles that were not relevant to our study. Ultimately, we included only nine observational studies that fulfilled our eligibility criteria. Our primary objective was to determine the factors that influence the ECG pattern in children and adolescents. This review systematically highlights the significance of identifying ECG patterns that could be correlated to factors such as age, gender, and BMI. Identifying such patterns may play a crucial role in improving the diagnostic accuracy of ECG. Physicians who fail to recognize these patterns may mistakenly endanger their patients’ lives.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"327 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703708","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}

{"title":"Effect of Aerobic Exercise on Sleep, Depression, and Quality of Life in Postmenopausal Women","authors":"Shelly Sharma, S. Kalra, R. Rai, Afsha Parveen, Deepak Raghav, Ruchika Naswa","doi":"10.25259/jccc_72_2023","DOIUrl":"https://doi.org/10.25259/jccc_72_2023","url":null,"abstract":"\u0000\u0000Menopause is a normal life stage that frequently brings with it emotional and physical difficulties that affect women’s Quality of life (QoL) and interfere with their ability to sleep. The objective of this study was to examine how postmenopausal women (PMWs) responded to supervised aerobic exercise training versus unsupervised Walking in terms of sleep, QoL, and depression. In addition, the impact on body composition was also assessed as a secondary outcome measure.\u0000\u0000\u0000\u0000Fifty PMWs (aged 45–60) were divided into two groups at random: The control group (n = 25) performed standard unsupervised Walking, and the experimental group (n = 25) performed scheduled supervised aerobic exercise training. The Pittsburgh sleep quality index (PSQI), the 36-item short-form survey, the beck depression inventory (BDI), and the body mass index (BMI) were among the evaluations used in the 6-week, 3-day program.\u0000\u0000\u0000\u0000Remarkable advancements (P < 0.05) were noted in the aerobic training cohort. The experimental group increased total sleep duration by 37.9% and fell asleep 44.8% faster, resulting in a noteworthy 61.7% improvement in the PSQI score. BDI scores improved by 55.6%, and there was a 6.8% variation in BMI between the groups.\u0000\u0000\u0000\u0000A 6-week aerobic intervention can improve sleep quality, reduce menopausal symptoms, and enhance life quality in PMW. Furthermore, the results revealed that a regulated exercise group may offer more benefits than an unregulated one. This observation underscores the potential advantages of structured and monitored aerobic exercise program in achieving specific health and fitness goals.\u0000","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"22 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140699706","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}

{"title":"Technical Details of a Novel Surgical Procedure for Construction of the Modified Blalock–Taussig Shunt (UKC’s Modification): A Video Presentation","authors":"U. Chowdhury, Niwin George, B. Kanmaniyan, Sundeep Mishra, Chaitanya Chittimuri, Poonam Malhotra Kapoor, Sikha Goja, N. Pandey","doi":"10.25259/jccc_63_2023","DOIUrl":"https://doi.org/10.25259/jccc_63_2023","url":null,"abstract":"We describe herein the surgical technique on a 2.5-years-old male child weighing 10 kilograms diagnosed with a functionally univentricular heart, disproportionately small right subclavian artery, and hypoplastic pulmonary arteries (Mc Goon’s ratio of less than 1.0).5 We interposed a short segment of polytetrafluroethylene graft between the right brachiocephalic artery and the intrapericardial portion of the right pulmonary artery closest to the bifurcation of the pulmonary trunk on the right side.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"29 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140375732","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}

{"title":"Step-by-Step Atraumatic Technique of Harvesting of the Radial Artery using Harmonic Scalpel: A Video Presentation","authors":"U. Chowdhury, Niwin George, B. Kanmaniyan, Sundeep Mishra, Chaitanya Chittimuri, Poonam Malhotra Kapoor, Sikha Goja, N. Pandey","doi":"10.25259/jccc_65_2023","DOIUrl":"https://doi.org/10.25259/jccc_65_2023","url":null,"abstract":"We present here-in the technical details of harvesting the left radial artery in a 50-year- old man undergoing coronary artery bypass grafting. The radial artery has been harvested atraumatically using a Harmonic scalpel (Ethicon Endosurgery LLC, Johnson & Johnson Company, Guaynaba, Puerto Rico, USA) and two vessel loops by “No touch” technique, thereby preventing perioperative spasm. The postoperative recovery was uneventful.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"23 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140435769","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}

{"title":"Implementation of Patient Blood Management – A Long and Winding Road but Worth Doing!","authors":"Klaus Görlinger","doi":"10.25259/jccc_24s1_kgie","DOIUrl":"https://doi.org/10.25259/jccc_24s1_kgie","url":null,"abstract":"","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"14 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139609382","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}

{"title":"Blood and Bleeding Management in Developing Economies: Perceptions, Preparedness, and the Evolving Practices","authors":"Anurag Kumar Mishra, Atul K. Agarwal, Ajay Gandhi","doi":"10.25259/jccc_24s1_ag1","DOIUrl":"https://doi.org/10.25259/jccc_24s1_ag1","url":null,"abstract":"\u0000\u0000The growing concerns around the judicious use of blood components have paved the way for the dissemination of awareness around the best practices related to the use of this precious resource. With the World Health Organization issuing a policy brief on the urgent implementation of Patient Blood Management (PBM), there has been an accelerated impetus within the healthcare ecosystem to imbibe and implement the principles and practices of PBM. This research work aims to understand the current level of understanding, adequacy, and appropriateness of practices and readiness toward the universal and standardized implementation of PBM.\u0000\u0000\u0000\u0000This article summarizes the findings of an online survey. The survey consisted of a Google Form questionnaire with responses in multiple-choice, open and closed ends, as well as short notes. The survey responses were analyzed and summed up graphically. The survey established that there is still a huge gap in the “multispecialty approach” to setting up of the safe tolerance limits to anemia, optimal cutoffs, and thresholds for transfusion and shifting focus from “blood product” safety to “patient” safety.\u0000\u0000\u0000\u0000A lot of guidance- and evidence-based recommendations on transfusion practices are available in developed economies; the developing world still continues to weigh the advantages against the availability of and access to resources needed for implementation. Within these economies, and among different strata of healthcare infrastructure, there is still a significant difference in the perceptions and practices around blood transfusion and bleeding management.\u0000","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139606685","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}