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Journal of Cardiac Critical Care TSS最新文献

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On-table Extubation Facilitated by Regional Analgesic Techniques Combined with General Anesthesia for PDA Ligation: A Case-series and Literature Review 局部镇痛技术联合全身麻醉促进在床上拔管用于PDA结扎:病例系列和文献回顾
Journal of Cardiac Critical Care TSS Pub Date : 2023-06-14 DOI: 10.25259/jccc_22_2023
R. Magoon, Jes Jose, Brajesh Kaushal, R. Kaushal, Praveena Sharma
{"title":"On-table Extubation Facilitated by Regional Analgesic Techniques Combined with General Anesthesia for PDA Ligation: A Case-series and Literature Review","authors":"R. Magoon, Jes Jose, Brajesh Kaushal, R. Kaushal, Praveena Sharma","doi":"10.25259/jccc_22_2023","DOIUrl":"https://doi.org/10.25259/jccc_22_2023","url":null,"abstract":"\u0000\u0000An increasing embracement of safer regional techniques as pivotal components of multimodal analgesia regimen has made fast-tracking possible following pediatric cardiac surgery. Speaking of fast-tracking in pediatrics, the feasibility of on-table extubation (OTE), and its’ potential benefits are also being ardently researched with simultaneous emphasis on appropriate patient selection and adequate perioperative safety.\u0000\u0000\u0000\u0000We report eight consecutive pediatric cases featuring a combination of serratus anterior plane block (SAPB) or erector spinae plane block (ESPB) to general anesthesia (GA) for patent ductus arteriosus (PDA) ligation through a left thoracotomy incision. Following induction of GA, the left-sided SAPB was performed in five patients and the other three patients received left-sided ESPB, each with 0.5 mL/kg of 0.2% ropivacaine. Demonstrating a mean intraoperative fentanyl requirement of 3.25 ± 0.71 µg/kg, OTE could be successfully contemplated in all the 8 patients. Subsequently, the post-operative face, leg, activity, cry, and consolability (FLACC) score was recorded at 1, 2, 4, 6, 8, and 12 h. Meanwhile, all the patients depicted acceptable pain scores till 4 h, administration of 0.5 µg/Kg rescue fentanyl was necessitated in three patients each at 6-h and 8-h postoperatively (given FLACC scores ≥4), amounting to a mean 0.375 ± 0.23 µg/kg post-operative fentanyl requirement. All patients received intravenous paracetamol at 8-h postoperatively. No block-related complication or need for reintubation was discovered.\u0000\u0000\u0000\u0000Incorporation of fascial plane blocks (SAPB or ESPB) to the conduct of GA for PDA ligation, allowed for safe OTE in our experience, due to an opioid-sparing potential.\u0000","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83956468","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}
引用次数: 0
Femoral Nerve Block for Emergency Femoral Artery Saddle Embolectomy 股神经阻滞用于紧急股动脉鞍状栓塞切除术
Journal of Cardiac Critical Care TSS Pub Date : 2023-05-30 DOI: 10.25259/jccc_10_2023
Rashmi Singh, Sambhunath Das
{"title":"Femoral Nerve Block for Emergency Femoral Artery Saddle Embolectomy","authors":"Rashmi Singh, Sambhunath Das","doi":"10.25259/jccc_10_2023","DOIUrl":"https://doi.org/10.25259/jccc_10_2023","url":null,"abstract":"","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83680082","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}
引用次数: 0
Functional Evaluation of Microcirculation in Response to Fluid Resuscitation in Hypovolemic Adult Post-cardiac Surgical Patients 成人心脏手术后低血容量患者液体复苏对微循环功能的影响
Journal of Cardiac Critical Care TSS Pub Date : 2023-01-30 DOI: 10.25259/mm_jccc_308
G. Bhavya, Apoorva Gupta, K. Nagesh, P. Murthy, P. Nagaraja, S. Ragavendran, S. Mishra, Gowthami Veera
{"title":"Functional Evaluation of Microcirculation in Response to Fluid Resuscitation in Hypovolemic Adult Post-cardiac Surgical Patients","authors":"G. Bhavya, Apoorva Gupta, K. Nagesh, P. Murthy, P. Nagaraja, S. Ragavendran, S. Mishra, Gowthami Veera","doi":"10.25259/mm_jccc_308","DOIUrl":"https://doi.org/10.25259/mm_jccc_308","url":null,"abstract":"\u0000\u0000Microcirculation is bound to be altered during cardiac surgery due to multiple factors, mainly the intense systemic inflammatory response syndrome which peaks in the first 24-h postoperatively. Decreased microvascular flow associated with increased postoperative morbidity has been reported. The literature suggests a potential independence of macrocirculation and microcirculation during fluid loading. The present study was conducted to assess thenar muscle tissue oxygen saturation (StO2) changes during vascular occlusion test (VOT) in response to hypovolemia and to assess the dynamic responses of the StO2 variables post-volume expansion (VE).\u0000\u0000\u0000\u0000Thirty-five adult post-cardiac surgical patients, with stroke volume (SV) variation >12% were included in the study. Fifty-two fluid challenges were studied. Functional evaluation of microcirculation using VOT and near infrared spectroscopy (NIRS) variables along with monitoring of macrocirculatory indices was performed before and after VE. Statistical analysis was done using Student t-test.\u0000\u0000\u0000\u0000Post-VE, 34 were responders with increase in SV ≥15% and 18 were non-responders (SV <15%). Rate of resaturation was significantly faster in responders compared to non-responders after VE (P = 0.0293 vs. P = 0.1480). However, macrocirculatory indices including cardiac output, SV, and delivery of oxygen showed significant improvement in both responders and non-responders.\u0000\u0000\u0000\u0000Preload dependence is associated with significant change in the StO2 recovery slope measured at the thenar eminence in volume responders. Functional evaluation of microcirculation using VOT and StO2 can be a useful complimentary tool along with the macrocirculatory indices for optimal fluid rescuscitaion in adult post-cardiac surgical patients.\u0000","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"81 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85545964","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}
引用次数: 0
POCUS and Fluid Responsiveness on Venoarterial ECMO 静脉ECMO的POCUS和液体反应性
Journal of Cardiac Critical Care TSS Pub Date : 2023-01-30 DOI: 10.25259/jccc_4_2023
Sanchita Garg, P. Kapoor
{"title":"POCUS and Fluid Responsiveness on Venoarterial ECMO","authors":"Sanchita Garg, P. Kapoor","doi":"10.25259/jccc_4_2023","DOIUrl":"https://doi.org/10.25259/jccc_4_2023","url":null,"abstract":"VA ECMO allows organ perfusion and oxygenation while awaiting myocardial recovery, cardiac transplantation, or long-term mechanical circulatory support. Diagnosis of hospital-acquired pneumonia (HAP) is a daily challenge for the clinician managing patients on venoarterial ECMO. Lung ultrasound (US) can be a valuable tool as the initial imaging modality for the diagnosis of pneumonia. Point-of-care US (POCUS) is broadly used in patients with ARDS. POCUS is recommended to be performed regularly in COVID-19 patients for respiratory failure management. In this review, we summarized the US characteristics of COVID-19 patients, mainly focusing on lung US and echocardiography. Point-of-care lung US (LUS) was demonstrated to be an effective tool in case of acute respiratory failure for ICU patients, community-acquired pneumonia, and ventilator-associated pneumonia. This review describes the usefulness of LUS in the early detection of HAP in cardiac critically ill patients under VA ECMO as well as assess its sonographic features.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85628994","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}
引用次数: 0
Nosocomial Infections in Extracorporeal Membrane Oxygenation 体外膜氧合中的医院感染
Journal of Cardiac Critical Care TSS Pub Date : 2023-01-30 DOI: 10.25259/mm_jccc_302
Chitra Mehta, Y. Mehta
{"title":"Nosocomial Infections in Extracorporeal Membrane Oxygenation","authors":"Chitra Mehta, Y. Mehta","doi":"10.25259/mm_jccc_302","DOIUrl":"https://doi.org/10.25259/mm_jccc_302","url":null,"abstract":"Extra corporeal membrane oxygenation (ECMO) has become an important modality in ICU for treating patients with severe hemodynamic and respiratory failure. It helps clinicians gain time for the primary disease to recover with definitive treatment, and aids in cardio pulmonary recovery of the patient. Most of the patients who require ECMO support are quite sick and fragile. Nosocomial infection is second most common complication after hemorrhage in ECMO patients.It affects about two-third of patients receiving ECMO. There is a lack of sufficient knowledge in this particular area. More focused efforts should be made in future to combat nosocomial infection in ECMO patients.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82657481","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}
引用次数: 0
Reconstruction of the Left Atrioventricular Valve with Pericardial Patch Closure of the Ostium Primum Atrial Septal Defect in a Patient with Partial Atrioventricular Septal Defect under Mild Hypothermic Extracorporeal Circulation and Cardioplegic Arrest (UKC’s Modification): A Video Presentation 在轻度低温体外循环并心脏骤停的部分房室间隔缺损患者中，经心包补片封闭原口房间隔缺损的左房室瓣膜重建(UKC的修正):一份视频报告
Journal of Cardiac Critical Care TSS Pub Date : 2023-01-30 DOI: 10.25259/mm_jccc_ujjwal-partial-av-canal(video)
U. Chowdhury, Niwin George, B. Sushamagayatri, Sai Manjusha, Sraddha Gupta, S. Goja, S. Sharma, P. Kapoor
{"title":"Reconstruction of the Left Atrioventricular Valve with Pericardial Patch Closure of the Ostium Primum Atrial Septal Defect in a Patient with Partial Atrioventricular Septal Defect under Mild Hypothermic Extracorporeal Circulation and Cardioplegic Arrest (UKC’s Modification): A Video Presentation","authors":"U. Chowdhury, Niwin George, B. Sushamagayatri, Sai Manjusha, Sraddha Gupta, S. Goja, S. Sharma, P. Kapoor","doi":"10.25259/mm_jccc_ujjwal-partial-av-canal(video)","DOIUrl":"https://doi.org/10.25259/mm_jccc_ujjwal-partial-av-canal(video)","url":null,"abstract":"A 26-year-old male patient diagnosed with partial type of atrioventricular septal defect in sinus rhythm, cleft left atrioventricular valve with mild pulmonary arterial hypertension, and severe left atrioventricular valvular regurgitation successfully underwent reconstruction of the left atrioventricular valve and pericardial patch closure of the atrial septal defect using UKC’s modification. The technical details of the surgical procedure have been elaborated in detail.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"130 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74540620","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}
引用次数: 0
Extracorporeal Membrane Oxygenation in Cardiogenic shock – A Review 心源性休克的体外膜氧合研究进展
Journal of Cardiac Critical Care TSS Pub Date : 2023-01-30 DOI: 10.25259/jccc_7_2023
Prajesh M. Nambiar, Jeetendra Sharma, Y. Mehta
{"title":"Extracorporeal Membrane Oxygenation in Cardiogenic shock – A Review","authors":"Prajesh M. Nambiar, Jeetendra Sharma, Y. Mehta","doi":"10.25259/jccc_7_2023","DOIUrl":"https://doi.org/10.25259/jccc_7_2023","url":null,"abstract":"Extracorporeal membrane oxygenation has been used in adult in cardiogenic shock due to myocardial infarction, myocardiopathy, myocarditis, or inability to come off cardiopulmonary bypass (CPB) after cardiac surgery.3 ECMO can provide partial or total support, but it is temporary. It is not a definitive treatment but a life support system that allows time for evaluation, diagnosis and treatment of the condition that causes heart failure. With high incidence of late stage coronary artery disease and infective myocarditis in India, the usage of ECMO for refractory cardiogenic shock is going to be a promising approach for effective management of refractory heat failure .ECMO has proven to be an effective therapeutic modality in managing cardiovascular collapse as a bridge to recovery or more definitive treatment options.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"362 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80153691","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}
引用次数: 0
Atrial Correction (Modified Senning) of Transposition of the Great Arteries and Intact Atrial Septum with Regressed Left Ventricle and Pulmonary Hypertension: A Video Presentation 大动脉转位和完整房间隔伴左心室退行性肺动脉高压的房内矫正(改良感觉):一段视频报道
Journal of Cardiac Critical Care TSS Pub Date : 2023-01-30 DOI: 10.25259/mm_jccc_ujjwalsenning(video)
U. Chowdhury, Niwin George, B. Sushamagayatri, Sai Manjusha, Sraddha Gupta, S. Goja, S. Sharma, P. Kapoor
{"title":"Atrial Correction (Modified Senning) of Transposition of the Great Arteries and Intact Atrial Septum with Regressed Left Ventricle and Pulmonary Hypertension: A Video Presentation","authors":"U. Chowdhury, Niwin George, B. Sushamagayatri, Sai Manjusha, Sraddha Gupta, S. Goja, S. Sharma, P. Kapoor","doi":"10.25259/mm_jccc_ujjwalsenning(video)","DOIUrl":"https://doi.org/10.25259/mm_jccc_ujjwalsenning(video)","url":null,"abstract":"A 3-year-old male child diagnosed as D-transposition of the great arteries and intact atrial septum with regressed left ventricle, Yacoub’s Type-B coronary arterial pattern, successfully underwent modified Senning operation under moderately hypothermic cardiopulmonary bypass and St. Thomas based cold blood cardioplegia. At 8 months of follow-up, there was no mitral or tricuspid regurgitation with good biventricular function in Ross clinical score of 2.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"247 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75907939","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}
引用次数: 0
Pharmacology of Drugs and Their Kinetics and Dynamicity during Extracorporeal Life Support 体外生命维持过程中药物的药理学及其动力学和动力学
Journal of Cardiac Critical Care TSS Pub Date : 2023-01-30 DOI: 10.25259/jccc_6_2023
N. Shastri
{"title":"Pharmacology of Drugs and Their Kinetics and Dynamicity during Extracorporeal Life Support","authors":"N. Shastri","doi":"10.25259/jccc_6_2023","DOIUrl":"https://doi.org/10.25259/jccc_6_2023","url":null,"abstract":"ECMO/ECLS is now a days very common modality for saving patient life in ICU. ECMO is unphysiological circulation which hampers the multiorgan function. Direct impact by releasing of pro-inflammatory cytokinin leads to impact on the many organ homeostasis. The anaesthetist/intensivist must have enough knowledge of pKa/Pd and most importantly still we do not have ideal guidelines for drug dosing.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83953956","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}
引用次数: 0
COVID and Perioperative Considerations COVID和围手术期注意事项
Journal of Cardiac Critical Care TSS Pub Date : 2023-01-30 DOI: 10.25259/jccc_2_2023
Kapil Gupta
{"title":"COVID and Perioperative Considerations","authors":"Kapil Gupta","doi":"10.25259/jccc_2_2023","DOIUrl":"https://doi.org/10.25259/jccc_2_2023","url":null,"abstract":"Coronavirus (COVID) pandemic has affected the majority of people worldwide. Patients with COVID infection might require emergent or elective surgeries. COVID-related perioperative considerations to reduce infection spread include changing the workflow to include protective gear for patients and health-care personnel, COVID-dedicated operating rooms, and appropriate perioperative management of the patient with or presumed COVID infection. COVID-specific changes to operating room environment are done. Disinfection guidelines are followed. Anesthesia considerations pertaining to pre-operative optimization of patient’s condition and prevention of spread of infection to others are foremost.","PeriodicalId":34567,"journal":{"name":"Journal of Cardiac Critical Care TSS","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73449911","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}
引用次数: 0
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