HSR proceedings in intensive care & cardiovascular anesthesia最新文献_第8页

A case of radiological dilemma after a central venous catheter positioning. 中心静脉置管后放射学困境1例。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2011-01-01

S Romagnoli

引用次数: 0

Major themes for 2010 in cardiothoracic and vascular anesthesia. 2010 年心胸和血管麻醉的主要专题。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2011-01-01

H Riha, J Fassl, P Patel, T Wyckoff, J Choi, J G Augoustides

{"title":"Major themes for 2010 in cardiothoracic and vascular anesthesia.","authors":"H Riha, J Fassl, P Patel, T Wyckoff, J Choi, J G Augoustides","doi":"","DOIUrl":"","url":null,"abstract":"Significant variability in transfusion practice persists despite guidelines. Although the lysine analogues are effective antifibrinolytics, safety concerns exist with high doses tranexamic acid. Despite recombinant activated factor VII promising results in massive bleeding after cardiac surgery, it significantly increases arterial thromboembolic risk. Aortic valve repair may evolve to standard of care. Transcatheter aortic valve implantation is an established therapy for aortic stenosis. The cardiovascular anesthesiologist features prominently in the new guidelines for thoracic aortic disease. Although intense angiotensin blockade improves outcomes in heart failure, it might aggravate the maintenance of perioperative systemic vascular tone. Ultrafiltration is an alternative to diuresis for volume overload in heart failure. Management of heart failure titrated to brain natriuretic peptide activity reduces mortality. A major surgical advance has been the significant outcome improvement achieved with continuous-flow left ventricular assist devices. Advanced liver disease is a significant predictor for perioperative bleeding, transfusion and mortality after ventricular assist device insertion. Acquired von Willebrand syndrome is not only common in patients with these devices but often aggravating bleeding and transfusion in this setting. Metabolic myocardial modulation with perhexilene significantly enhances effort tolerance in hypertrophic cardiomyopathy. A landmark report has highlighted future priorities in this disease. Pediatric cardiac surgical trials have revealed the importance of perioperative cerebral oxygen saturation monitoring and the Sano shunt. Advances in pediatric-specific ventricular assist devices will likely revolutionize pediatric heart failure. Recent reports have highlighted the priorities for future perioperative trials and for training models in pediatric cardiac anesthesia.","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"3 1","pages":"33-43"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/84/3a/hsrp-03-033.PMC3484604.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31264047","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

Vascular connector devices increase the availability of minimally invasive cardiac surgery to ischemic heart patients. 血管连接装置增加了缺血性心脏病患者微创心脏手术的可用性。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2011-01-01

M Ramchandani, K Bedeir

{"title":"Vascular connector devices increase the availability of minimally invasive cardiac surgery to ischemic heart patients.","authors":"M Ramchandani, K Bedeir","doi":"","DOIUrl":"","url":null,"abstract":"The revival of off-pump cardiac surgery and the exploration of less invasive techniques for coronary artery bypass grafting, have lead to an increasing technical difficulty, as compared to conventional surgery using cardiopulmonary bypass. The moving target vessel in off-pump coronary artery bypass surgery, as well as the increasingly limited space in minimally invasive cardiac surgery were not convenient to many surgeons, a fact that lead many surgeons to deprive their patients the potential benefits of these techniques. Since the 1950's, surgeons have attempted to make the anastomotic procedure less cumbersome and less time consuming. Many creative ideas and devices were made, but for many different reasons, they eventually faded away. Since then, hand-sewn anastomoses have been the standard of care in coronary artery bypass grafting. Today, with the obvious need for a facilitated and fast coronary anastomosis, interest in these anastomotic devices has been re-awakened. The exact geometry, physiology and dynamics of the perfect anastomosis have thus been studied, in an attempt to provide an understanding of reasons behind anastomosis and graft failure after coronary artery bypass surgery, and eventually design the best performing device. These devices would allow for a faster, more accurate and a more reproducible coronary anastomosis using minimally invasive techniques. Also, due to a short learning curve, the standardization of percutaneous devices would allow much more surgeons to more widely adopt less invasive techniques. In summary, we see anastomotic devices as a solution to the technical challenges surgeons encounter with minimally invasive coronary artery bypass grafting.","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"3 4","pages":"239-43"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/74/7c/hsrp-03-239.PMC3563438.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31263441","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 making of the Roland Hetzer International Cardiothoracic and Vascular Surgery Society. Roland Hetzer国际心胸血管外科学会的成立。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2011-01-01

E M Delmo Walter

引用次数: 0

Neuraxial anesthesia for cardiac surgery: thoracic epidural and high spinal anesthesia - why is it different? 心脏手术的轴向麻醉:胸椎硬膜外麻醉和脊柱高位麻醉-为什么不同?

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2011-01-01

R Kowalewski, D Seal, T Tang, C Prusinkiewicz, D Ha

{"title":"Neuraxial anesthesia for cardiac surgery: thoracic epidural and high spinal anesthesia - why is it different?","authors":"R Kowalewski, D Seal, T Tang, C Prusinkiewicz, D Ha","doi":"","DOIUrl":"","url":null,"abstract":"Anesthesiologists can offer much more then stable blood pressure and heart rate in the intraoperative period. By choosing appropriate anesthetic techniques they can tremendously influence perioperative stress. This may positively impact on the overall surgical outcome. One of the most intriguing aspects of neuraxial anesthesia is its ability to attenuate the stress response to surgery. At present there is no agreement on the clinical importance of such a response but there is substantial indirect evidence that it may play an important role in a patient's outcome. Neuraxial anesthesia supplemented by general anesthesia is justified and can be safely used in cardiac surgery. The authors of this expert opinion prefer spinal anesthesia to thoracic epidural anesthesia and have been using it routinely for the last 20 years without any neurological complications. The risk of spinal hematoma from a 27G spinal needle prior to full heparinization is unknown but in our opinion is remote. Both epidural and spinal techniques can and should have a place in modern cardiac anesthesia practice and should be further investigated.","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"3 1","pages":"25-8"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/37/7f/hsrp-03-025.PMC3484610.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31264910","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

Efficacy of inhaled iloprost in the management of pulmonary hypertension after cardiopulmonary bypass in infants undergoing congenital heart surgery. A case series of 31 patients. 吸入伊洛前列素对先天性心脏手术婴儿体外循环术后肺动脉高压的治疗效果。31例病例系列。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2011-01-01

M Müller, S Scholz, H Maxeiner, F Brenck, K Valeske, J Thul, H Akintürk

{"title":"Efficacy of inhaled iloprost in the management of pulmonary hypertension after cardiopulmonary bypass in infants undergoing congenital heart surgery. A case series of 31 patients.","authors":"M Müller, S Scholz, H Maxeiner, F Brenck, K Valeske, J Thul, H Akintürk","doi":"","DOIUrl":"","url":null,"abstract":"Introduction: Reactive pulmonary hypertension is frequent in children with high pulmonary flow and pressure. Inhaled iloprost and nitric oxide are the only substances approved as selective pulmonary vasodilators, but data about the effectiveness and safety of inhaled iloprost during cardiac surgery in infants and children are limited.Methods: We retrospectively analysed the effects of inhaled iloprost after cardiopulmonary bypass weaning on the ratio of mean pulmonary artery to mean arterial pressure. The effectiveness of the inhalation set up was tested in an in vitro study.Results: Thirty-one patients received inhaled iloprost during surgery. The clinically used inhalation set up for inhaled iloprost delivered 20% to 30% (500 to 750 ng * kg-1) of the nebulizer dose and caused a decrease in the ratio of mean pulmonary artery to mean arterial pressure from 0.6±0.2 to 0.4±0.1 and 0.4±0.1 (30 and 60 minutes after)p <0.05. In eleven (35%) patients norepinephrine infusion was started.Conclusion: Our data suggest that a single dose of inhaled iloprost significantly decreases the ratio of mean pulmonary artery to mean arterial pressure for at least 60 min. Vasopressor support may be indicated to avoid systemic hypotension. The filled dose in the nebulizer should be high enough to compensate for the high depletion rate of the pediatric inhalation system. However, our study allows no final decision about beneficial or detrimental effects of the off label use of inhaled iloprost to reduce pulmonary artery pressure during congenital heart surgery.","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"3 2","pages":"123-30"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/a3/hsrp-03-123.PMC3484621.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31262886","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 bispectral index monitoring on postoperative delirium in patients undergoing aortic surgery. 双谱指数监测对主动脉术后谵妄的影响。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2011-01-01

G Santarpino, R Fasol, J Sirch, B Ackermann, S Pfeiffer, T Fischlein

{"title":"Impact of bispectral index monitoring on postoperative delirium in patients undergoing aortic surgery.","authors":"G Santarpino, R Fasol, J Sirch, B Ackermann, S Pfeiffer, T Fischlein","doi":"","DOIUrl":"","url":null,"abstract":"Background: Bispectral index monitoring can facilitate anesthesia care. We evaluated the association of Bispectral index with postoperative neurological outcome and delirium in patients undergoing aortic surgery.Methods: From 2006 to 2009, 292 consecutive patients undergoing aortic surgery were retrospectively reviewed. Patients were classified into 5 groups according to Bispectral index reduction: Group I (≤15%), Group II (15-20%), Group III (20-25%), Group IV (25-30%), and Group V (>30%).Results: The number of patients in each group was : 52 (17.8%), Group I; 125 (42.8%), Group II;68 (23.3%), Group III; 33 (11.3%), Group IV; 14 (4.8%), Group V. The incidence of delirium and neurological events was higher in Group IV and Group V(90.9% and 18.2% in Group IV, and 71% and 79% in Group V; both p<0.001). Only Group V showed a longer intensive care unit stay compared to Group I (13.5±10.3 vs 5.4±6.6 days; p=0.002), Group II (7.3±8.6 days, p=0.005) and Group III (6.7±6.5 days, p=0.015). Group V also showed a longer intubation time compared to Group I (228±211 vs 73±112 hours; p=0.008) and Group II (105±177 hours, p=0.002).Conclusions: Our data suggest a higher incidence of neurological deficits in patients with a Bispectral index reduction of >25% from baseline. Explanations for these findings are speculative with regard to the underlying mechanisms, and larger studies are warranted to clarify these issues.","PeriodicalId":89769,"journal":{"name":"HSR proceedings in intensive care & cardiovascular anesthesia","volume":"3 1","pages":"47-58"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9a/d3/hsrp-03-047.PMC3484608.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31263446","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

Alteration in respiratory physiology in obesity for anesthesia-critical care physician. 肥胖患者呼吸生理变化对麻醉重症监护医师的影响。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2011-01-01

J Porhomayon, P Papadakos, A Singh, N D Nader

引用次数: 0

Preoperative IABP in high risk patients undergoing CABG. 高危患者行冠脉搭桥术前IABP。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2011-01-01

T Theologou, M L Field

引用次数: 0

Non-invasive ventilation after cardiac surgery. 心脏手术后无创通气。

HSR proceedings in intensive care & cardiovascular anesthesia Pub Date : 2011-01-01

L Cabrini, A Zangrillo

引用次数: 0