HSR proceedings in intensive care & cardiovascular anesthesia最新文献_第6页

Epidural analgesia in high risk cardiac surgical patients. 高危心脏手术患者的硬膜外镇痛。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

Y Mehta, D Arora, M Vats

{"title":"Epidural analgesia in high risk cardiac surgical patients.","authors":"Y Mehta, D Arora, M Vats","doi":"","DOIUrl":"","url":null,"abstract":"Cardiac surgery is associated with high morbidity and mortality in patients with renal, hepatic or pulmonary dysfunction, advanced age and morbid obesity. Thoracic epidural analgesia is associated with decreased morbidity in these patients. Thoracic epidural analgesia in cardiac surgery is associated with haemodynamic stability, decreased catecholamine response, good pulmonary function, early extubation and discharge from intensive care unit. It is an important component of fast tracking in cardiac surgery as well. Its use has significantly increased over the years and has been used as an adjuvant to general anaesthesia as well as the sole anaesthetic technique in selected groups of patients. Proper selection of patients for thoracic epidural analgesia is mandatory. Timing of epidural catheter insertion and removal should be judiciously selected. The risk of epidural hematoma secondary to anticoagulation or residual effects of antiplatelet drug that can be reduced by taking standard precautions. In conclusion thoracic epidural analgesia in high risk cardiac surgery might decrease pulmonary, cardiovascular or renal complications, provide excellent analgesia and allow early extubation.","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"4 1","pages":"11-4"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/af/b2/hsrp-04-011.PMC3484927.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31264668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Who on earth is this person talking to? 这个人到底在跟谁说话?

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

M John

引用次数: 0

Anesthetic management for percutaneous aortic valve implantation: an overview of worldwide experiences. 经皮主动脉瓣植入术的麻醉管理:世界经验综述。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

L Ruggeri, C Gerli, A Franco, L Barile, M S Magnano di San Lio, N Villari, A Zangrillo

{"title":"Anesthetic management for percutaneous aortic valve implantation: an overview of worldwide experiences.","authors":"L Ruggeri, C Gerli, A Franco, L Barile, M S Magnano di San Lio, N Villari, A Zangrillo","doi":"","DOIUrl":"","url":null,"abstract":"Transcatheter aortic valve implantation is an emergent technique for high risk patients with aortic stenosis. Transcatheter aortic valve implantation poses significant challenges about its management, due to the procedure itself (i.e. the passage of large stiff sheaths in diseased vessels, the valve dilatation and the prosthesis positioning during a partial cardiac standstill) and the population of elder and high-risk patients who undergo the implantation. Retrograde transfemoral approach is the most popular procedure and a great number of cases is reported. Nevertheless, there is not a consensus regarding the intraoperative anesthesiological strategies, which vary in the different Centers. Sedation plus local anesthesia or general anesthesia are both valid alternatives and can be applied according to patient's characteristics and procedural instances. Most groups started the implantation program with a general anesthesia; indeed, it offers many advantages, mainly regarding the possibility of an early diagnosis and treatment of potential complications, through the use of the transesophageal echocardiography. However, after the initial experiences, many groups began to employ routinely sedation plus local anesthesia for transcatheter aortic valve implantation and their procedural and periprocedural success demonstrates that it is feasible, with many possible advantages. Many aspects about perioperative anesthetic management for transcatheter aortic valve implantation are still to be defined. Aim of this work is to clarify the different management strategies through a review of the available literature published in pubmed till June 2011.","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"4 1","pages":"40-6"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e3/d6/hsrp-04-040.PMC3484922.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31265591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The first 24 hours after surgery: how an anesthetist, a surgeon and a nurse would like to be treated if they were patients. 手术后的第一个24小时:如果麻醉师、外科医生和护士是病人，他们希望得到怎样的对待。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

L Beretta, M Braga, U Casiraghi

引用次数: 0

Stentless aortic valves. Current aspects. 无支架主动脉瓣。当前的方面。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

J Ennker, A Albert, I C Ennker

{"title":"Stentless aortic valves. Current aspects.","authors":"J Ennker, A Albert, I C Ennker","doi":"","DOIUrl":"","url":null,"abstract":"The design of stentless valve prostheses is intended to achieve a more physiological flow pattern and superior hemodynamics in comparison to stented valves. First - generation stentless bioprosthesis were the Prima valve, the Freestyle valve and the Toronto stentless porcine valve. The second generation of stentless valves, as the Super stentless aortic porcine valve, need only one suture line. The Sorin Pericarbon Freedom and the Equine 3F heart Valve belong to the third generation of stentless valve pericardial bioprostheses. A stentless valve to replace a full root can be implanted by several surgical techniques: complete or modified subcoronary, root inclusion and full root. The full root technique is accompanied by the lowest incidence of patient-prothesis mismatch. Our own clinical experience reflects more than 3000 stentless valve implantations since April 1996. Randomized study trials showed a hemodynamic advantage for stentless valves, but several could not reach a significant level. Also reported was a significant advantage of stentless bioprostheses concerning transvalvular gradients, effective valve area and quicker regression of the left ventricular mass 6 months after the operation, but at 12 months. Advantages are obvious in patients with a decreased left ventricle ejection fraction of less than 50% and in smaller implanted valve size, concomitant aortic root pathology (e.g. dissection) and aortic valve endocarditis. A survival advantage for stentless bioprostheses in comparison to stented ones has been reported by all studies in the literature. Stentless valves enrich the surgical armamentarium. Time will define the place of stentless valves in the future.","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"4 2","pages":"77-82"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/38/37/hsrp-04-077.PMC3484938.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31263419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

What we need to know on timing principle of nondepolarizing muscle relaxant administration. 我们需要了解的非去极化肌肉松弛剂用药时机原则。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

A Uvelin, A Sunjkić

引用次数: 0

Current state of the reimplantation technique (DAVID Operation): surgical details and results. 再植技术(DAVID手术)的现状:手术细节和结果。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

F Beyersdorf, B Rylski

引用次数: 0

Coronary artery surgery: now and in the next decade. 冠状动脉手术：现在和未来十年。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

J C Ennker, I C Ennker

{"title":"Coronary artery surgery: now and in the next decade.","authors":"J C Ennker, I C Ennker","doi":"","DOIUrl":"","url":null,"abstract":"In coronary artery surgery the superiority of the internal mammary artery graft in 10-year survival was documented in 1986. In 1999 it was demonstrated that death, reoperation and percutaneous transluminary coronary angioplasty were more frequent in patients undergoing single rather than bilateral internal mammary artery grafting. Today coronary artery bypass grafting surgery is challenged by the success story of modern interventional cardiology. The Syntax Study, however, clearly underlined the better outcome for patients with triple-vessel and/or left main disease undergoing coronary artery bypass grafting in terms of repeat revascularization. Another point of ongoing discussion is the comparison between on-pump and off-pump coronary artery revascularization techniques. Even if mixed results exists in the literature, in experienced hands the combination of aortic no-touch and total arterial revascularization, probably leads to the superiority in off pump coronary artery bypass grafting in terms of significantly decreased rates of mortality, stroke, major adverse cardiac and cerebral vascular events. Coronary artery surgery in the next decade will be influenced by the further progression of minimally invasive surgical principles and by a variety of other factors. The role of robotics and hybrid surgery has yet to be defined. Alternatives within surgery will not only need to move to a less disruptive strategy (e.g. from on-pump to off-pump bypass) but also have to secure sustained innovation, as we can be sure that the current coronary artery bypass grafting activity will change substantially.","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"4 4","pages":"217-23"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/9e/hsrp-04-217.PMC3563555.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31263551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of heart transplantation in infancy and adolescence on quality of life and compliance. 婴幼儿和青少年心脏移植对生活质量和依从性的影响。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

W Albert, A Hudalla, K Traue, R Hetzer

{"title":"Impact of heart transplantation in infancy and adolescence on quality of life and compliance.","authors":"W Albert, A Hudalla, K Traue, R Hetzer","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Young patients who undergo heart transplantation in their early childhood or adolescence are confronted with typical developmental problems, which affect their specific adjustment to heart transplantation. This study aims at evaluating patients' health related quality of life and at determining the degree and sources of non-compliant behavior with its somatic and psychosocial consequences.Methods: The study sample consists of 38 patients, who received heart transplantation between the age of 1 and 18 and are now between 16 and 34 years old. All participants received self-rating instruments: The Short-Form Health Survey (SF-36), Giessen Subjective Complaints List (GBB), Medication Experience Scale for Immunosuppressants (MESI), and Health Questionnaire for Children and Young People (KIDSCREEN-27). Patient´s scores were compared to the scores of the specific norm sample. Further assessment was done by semi-structured interviews directed at psychosocial outcome, compliance, relationship to family and peer-group and integration into the work environment.Results: In comparison to healthy controls the patients showed a significantly reduced quality of life (SF-36) in all psychological and nearly all somatic domains. Patients emphasized a very close and satisfying relationship to their parents and pronounced overall social support. Almost 50% of the patients reported some reduced medical compliance and 20% are to be seen as a high risk group for noncompliance, simultaneously characterized by poor physical and mental status.Conclusion: Young adult transplant patients are to be carefully evaluated for psychosocial risks to avoid noncompliance and reduced quality of life in long-term follow up.","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"4 2","pages":"125-9"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a0/4c/hsrp-04-125.PMC3484934.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31263565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Sudden cardiac arrest in a marathon runner. A case report. 马拉松运动员心脏骤停。一份病例报告。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2012-01-01

F E Ghio, M Pieri, A Agracheva, G Melisurgo, A Ponti, C Serini

引用次数: 0