Seminars in Cardiothoracic and Vascular Anesthesia最新文献_第8页

Rotational Thromboelastometry Values After On-Pump Cardiac Surgery – A Retrospective Cohort Study 无泵心脏手术后旋转血栓弹性测量值-一项回顾性队列研究

IF 1.4

Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-05-26 DOI: 10.1177/10892532221088216

Maria S Gauger, P. Kaufmann, Firmin Kamber, J. Quitt, D. Berdajs, D. Bolliger, E. Mauermann

{"title":"Rotational Thromboelastometry Values After On-Pump Cardiac Surgery – A Retrospective Cohort Study","authors":"Maria S Gauger, P. Kaufmann, Firmin Kamber, J. Quitt, D. Berdajs, D. Bolliger, E. Mauermann","doi":"10.1177/10892532221088216","DOIUrl":"https://doi.org/10.1177/10892532221088216","url":null,"abstract":"Background Viscoelastic coagulation monitoring is recommended for coagulation management after cardiac surgery, but optimum target values are poorly defined. Aims To determine “to-be-expected” values in rotational thromboelastometry (ROTEM) after heparin reversal, to correlate ROTEM parameters with fibrinogen levels and platelet count, and to estimate the effect of hemoglobin levels on these measurements. Methods We retrospectively analyzed 571 consecutive adult patients undergoing cardiac surgery with cardiopulmonary bypass from 12/2018 to 08/2020. ROTEM and conventional laboratory measurements were performed 5 to 10 minutes after protamine administration. Results Clotting times in EXTEM, INTEM, and FIBTEM were significantly prolonged (72.6%, 96.1%, and 31.8% above reference ranges, respectively). Clot firmness parameters in EXTEM and INTEM were relevantly reduced (7.9% to 14.4% and 9.1% to 32.3% below the reference ranges, respectively). There was an excellent linear correlation of FIBTEM amplitude after 10 min (A10) and of maximal clot firmness (MCF) with fibrinogen concentrations (r = .81 and .80). Areas under receiver operating characteristic (AUROC) for identifying hypofibrinogenemia <1.5 g/L were between .80 and .87. No effect of hematocrit was observed. We also found a linear correlation of EXTEM, INTEM, and EXTEM-FIBTEM at both A10 and MCF with platelet counts (.32 to .68). The AUROCs for identifying thrombocytopenia (<100,000/μL) were .79 to .84, and were greater for A10 than for MCF measurements (P=.074, .001, and <.001, respectively). Conclusions “To-be-expected” ROTEM values after CPB are different from the published reference ranges. ROTEM parameters might allow for reliable estimation of fibrinogen level and platelet count without being influenced by hematocrit.","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":"26 1","pages":"209 - 220"},"PeriodicalIF":1.4,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47210424","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: 2

Erector Spinae Plane Catheter Analgesia in Minimally Invasive Mitral Valve Surgery: A Retrospective Case–Control Study for Inclusion in an Enhanced Recovery Program 微创二尖瓣手术中的勃起棘平面导管镇痛：纳入强化恢复计划的回顾性病例对照研究

IF 1.4

Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-05-26 DOI: 10.1177/10892532221104420

Nicholas J Statzer, Andreas C Plackis, Austin A. Woolard, B. Allen, Kara K. Siegrist, Yaping Shi, M. Shotwell

{"title":"Erector Spinae Plane Catheter Analgesia in Minimally Invasive Mitral Valve Surgery: A Retrospective Case–Control Study for Inclusion in an Enhanced Recovery Program","authors":"Nicholas J Statzer, Andreas C Plackis, Austin A. Woolard, B. Allen, Kara K. Siegrist, Yaping Shi, M. Shotwell","doi":"10.1177/10892532221104420","DOIUrl":"https://doi.org/10.1177/10892532221104420","url":null,"abstract":"Background. A retrospective case-control study was conducted to assess the feasibility of erector spinae plane (ESP) block as part of a multimodal enhanced recovery program for patients undergoing minimally invasive mitral valve replacement surgery. Methods. This retrospective analysis was conducted at a single center between January and August 2019. 61 patients were included; 23 received ESP and 38 did not. Erector spinae catheters (ESCs) were placed preoperatively, using a loading dose of 30 mL .5% ropivacaine, followed by an infusion of .2% ropivacaine at 10 mL/h throughout the study period. Primary outcome was 48-hour opioid consumption. Secondary outcomes included intraoperative morphine equivalents, extubation within 24 hours, reintubation, ICU length of stay and hospital length of stay and 30-day mortality. Results. Median [inter-quartile range] of the postoperative morphine milligram equivalents (MMEs) in the first 48 hours was 70[45-121] MMEs in the ESC) group, and 109[70–148] MMEs in the no ESC group (P-value = .16). No significant difference was observed in intraoperative morphine equivalents, extubation within 24 hours or ICU length of stay. The ESC group had shorter hospital length of stay (6.0 vs 7.0 days, P-value = .043). Conclusion. This study found a statistically insignificant, though potentially clinically significant reduction in postoperative opioid consumption. A reduced hospital length of stay as well as an acceptable safety profile was also observed in the ESC group. An adequately powered, prospective trial is warranted to accurately assess the potential role for ESP catheters for patients undergoing minimally invasive mitral valve surgery.","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":"26 1","pages":"266 - 273"},"PeriodicalIF":1.4,"publicationDate":"2022-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48195066","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: 4

The Year in Review: Anesthesia for Congenital Heart Disease 2021 年度回顾:麻醉治疗先天性心脏病2021

IF 1.4

Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-05-26 DOI: 10.1177/10892532221095038

Faith J. Ross, D. Joffe, Leah M Landsem, Gregory J. Latham

引用次数: 2

Abdominal Organ Transplantation: Noteworthy Literature in 2021 腹部器官移植：2021年值得关注的文献

IF 1.4

Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-05-24 DOI: 10.1177/10892532221093955

Robert St Jules, Daniel Blech, N. Smith, T. Sakai

引用次数: 1

Anesthetic Challenges in a Patient With TANGO2 Gene Deletion, DiGeorge Syndrome, and Tetralogy of Fallot: A Case Report TANGO2基因缺失、DiGeorge综合征和法洛四联症患者的麻醉挑战:一例报告

IF 1.4

Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-05-20 DOI: 10.1177/10892532221080946

Ivana Wrobleski, Nischal K. Gautam, Richard M. Hubbard

引用次数: 2

Noteworthy Cardiac Literature From 2021: Coronary Guideline Change Without New Data, Heart Transplant Donation After Cardiac Death, Covid Effects on Global Cardiac Surgery, and Attempt to Improve Dissection Remodeling 2021年值得注意的心脏文献:无新数据的冠状动脉指南变化，心脏死亡后心脏移植捐赠，Covid对全球心脏手术的影响，以及改善解剖重构的尝试

IF 1.4

Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-05-19 DOI: 10.1177/10892532221101298

J. Hoffman, Kelly Higa, Yihan Lin, T. B. Reece, J. Cleveland, Muhammad Aftab, Jessica Y. Rove

引用次数: 1

Year in Review 2021: Noteworthy Literature in Cardiothoracic Critical Care 2021年回顾：心胸重症监护领域值得注意的文献

IF 1.4

Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-05-09 DOI: 10.1177/10892532221100663

Samuel Gilliland, Sarah M. Alber, Hans Tregear, Andrew W. Hennigan, N. Weitzel

引用次数: 1

Intraoperative Transesophageal Echocardiographic Detection of a Gerbode Defect in a Patient Referred for Aortic Valve Endocarditis: A Case Report 一例主动脉瓣心内膜炎患者术中经食管超声心动图检测Gerbode缺陷

IF 1.4

Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-04-12 DOI: 10.1177/10892532221080920

Rohesh J. Fernando, Sean D. Johnson, K. Richardson

{"title":"Intraoperative Transesophageal Echocardiographic Detection of a Gerbode Defect in a Patient Referred for Aortic Valve Endocarditis: A Case Report","authors":"Rohesh J. Fernando, Sean D. Johnson, K. Richardson","doi":"10.1177/10892532221080920","DOIUrl":"https://doi.org/10.1177/10892532221080920","url":null,"abstract":"This clinical challenge discusses a case in which a patient was referred for aortic valve repair or replacement due to severe aortic regurgitation from infective endocarditis. In addition to discovering a previously unknown tricuspid valve vegetation, the intraoperative echocardiographic evaluation was instrumental in revealing an undiagnosed Gerbode defect. The flow through this Gerbode defect was previously mistaken for tricuspid regurgitation, and the patient was misdiagnosed as exhibiting severe pulmonary hypertension. This case highlights the importance of reviewing preoperative echocardiographic imaging, as well as diligence in completing a thorough intraoperative transesophageal echocardiographic exam prior to cardiopulmonary bypass. In addition, while flow typically occurs in Gerbode defects during systole, this case demonstrates that flow can also occur during diastole, which was most likely due to the severe aortic regurgitation. Fortunately, the patient was able to undergo successful treatment for the unexpected sequalae of the infective endocarditis, including repair of the Gerbode defect, tricuspid valve repair, and aortic valve and root replacement. Importantly, the incorrect diagnosis of severe pulmonary hypertension was removed.","PeriodicalId":46500,"journal":{"name":"Seminars in Cardiothoracic and Vascular Anesthesia","volume":"26 1","pages":"245 - 252"},"PeriodicalIF":1.4,"publicationDate":"2022-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49488096","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: 2

Tracheal Bronchus With Difficult Lung Isolation: A Case Report 气管支气管伴肺部分离困难1例报告

IF 1.4

Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-03-28 DOI: 10.1177/10892532211069243

Daniel A Friedlander, Rabi Panigrahi, Dhamodaran Palaniappan

引用次数: 2

Transesophageal Echocardiographic Assessment of the Repaired Mitral Valve: A Proposed Decision Pathway. 经食管超声心动图评估修复的二尖瓣:一种建议的决策途径。

IF 1.4

Seminars in Cardiothoracic and Vascular Anesthesia Pub Date : 2022-03-01 Epub Date: 2021-09-02 DOI: 10.1177/10892532211036655

Jose Liza Reshmi, G Gopan, Praveen Kerala Varma, Madathil Thushara, Vanga Babu Sudheer, Rajesh Gopalakrishnan Madavathazhathil, Aveek Jayant

引用次数: 4