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Development and validation of a predictive score for prolonged mechanical ventilation after cardiac surgery
Despite the steady improvement in surgical techniques and perioperative anesthetic management, cardiac surgery still has a high rate of major complications compared to non-cardiac surgery. Prolonged mechanical ventilation (PMV), like acute renal failure requiring renal remplacement therapy or post-operative stroke, is one of these major complications1. After cardiac surgery, mechanical ventilation weaning is usually achieved within 10 hours of surgery. However, 2.6% to 22.7% of patients require prolonged mechanical ventilation (PMV) depending on depending on the threshold for the definition of PMV2 –6 .
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 10, 2021 Category: Anesthesiology Authors: Ludovic Michaud, Pauline Dureau, Basile Kerleroux, Ahmed Charfeddine, Mary Regan, Jean-Michel Constantin, Pascal Leprince, Adrien Bougl é Source Type: research

Torsades de Pointes in Coronavirus Disease 2019 Infection
A 73-YEAR-OLD MAN (weight 69 kg, height 175 cm) was transferred to the authors ’ critical care unit with respiratory and acute renal failure secondary to coronavirus disease 2019 (COVID-19) infection. His past medical history included hypertension, diabetes, and previous stroke, from which he had made a full recovery. The patient was treated with mechanical ventilation and p eritoneal dialysis. He was recruited into the hydroxychloroquine arm of the RECOVERY (Randomised Evaluation of COVID-19 Therapy) trial.
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 31, 2020 Category: Anesthesiology Authors: Bagrat Lalabekyan, Gudrun Kunst, Vanessa A. Skelton Tags: Diagnostic Dilemma Source Type: research

Doing Simple Things Well: Practice Advisory Implementation Reduces Atrial Fibrillation After Cardiac Surgery
Atrial Fibrillation After Cardiac Surgery (AFACS) is associated with increased morbidity, including thromboembolic stroke, renal failure, gastrointestinal complications, infections, and prolonged ventilation, and a significant increase in the risk of subsequent chronic atrial fibrillation.1-4 Furthermore, it is associated with an increase in mortality and hospital and intensive care unit length of stay.1,3 It has a persistently high incidence, ranging from 30% to more than 50%, depending on the type of surgery.
Source: Journal of Cardiothoracic and Vascular Anesthesia - July 29, 2020 Category: Anesthesiology Authors: Martina Buerge, Rosalie Magboo, Dylan Wills, Ioannis Karpouzis, Damian Balmforth, Paul Cooper, Neil Roberts, Ben O'Brien Tags: Special Article Source Type: research

The Effect of Steroids in Patients Undergoing Cardiopulmonary Bypass: An Individual Patient Meta-Analysis of Two Randomized Trials
Steroids suppress the inflammatory response to cardiopulmonary bypass, but the impact on death at 30 days, myocardial infarction or injury, stroke, renal failure, respiratory failure, new atrial fibrillation, transfusion requirement, infection, and length of intensive care unit (ICU) and hospital stays are uncertain.
Source: Journal of Cardiothoracic and Vascular Anesthesia - August 6, 2019 Category: Anesthesiology Authors: Richard P. Whitlock, Jan M. Dieleman, Emilie Belley-Cote, Jessica Vincent, Michelle Zhang, P.J. Devereaux, Cor J. Kalkman, Diederik van Dijk, Salim Yusuf Tags: Original Article Source Type: research

Black Box Warning: Is Ketorolac Safe for Use After Cardiac Surgery?
Objective: In 2005, after the identification of cardiovascular safety concerns with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), the FDA issued a black box warning recommending against the use of NSAIDs following cardiac surgery. The goal of this study was to assess the postoperative safety of ketorolac, an intravenously administered NSAID, after cardiac surgery.Design: Retrospective observational study.Setting: Single center, regional hospital.Participants: A total of 1,309 cardiac surgical patients (78.1% coronary bypass, 28.0% valve) treated between 2006 and 2012.Interventions: A total of 488 of these patie...
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 13, 2013 Category: Anesthesiology Authors: Lisa Oliveri, Katie Jerzewski, Alexander Kulik Tags: Original Articles Source Type: research

Remote Ischemic Preconditioning Reduces Cardiac Troponin I Release in Cardiac Surgery: A Meta-Analysis
Conclusions: Current evidence suggests that RIPC reduces cardiac troponin I release in patients undergoing cardiac surgery. The clinical significance of these observations merits further investigation.
Source: Journal of Cardiothoracic and Vascular Anesthesia - October 7, 2013 Category: Anesthesiology Authors: Lijing Yang, Guyan Wang, Yingjie Du, Bingyang Ji, Zhe Zheng Tags: Original Articles Source Type: research

Challenges After the First Decade of Transcatheter Aortic Valve Replacement: Focus on Vascular Complications, Stroke, and Paravalvular Leak
Transcatheter aortic valve replacement (TAVR) is entering its second decade. Three major clinical challenges have emerged from the first decade of experience: vascular complications, stroke, and paravalvular leak (PVL). Major vascular complications remain common and independently predict major bleeding, transfusion, renal failure, and mortality. Although women are more prone to vascular complications, overall they have better survival than men. Further predictors of major vascular complications include heavily diseased femoral arteries and operator experience. Strategies to minimize vascular complications include a multimo...
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 12, 2012 Category: Anesthesiology Authors: Christopher Reidy, Aris Sophocles, Harish Ramakrishna, Kamrouz Ghadimi, Prakash A. Patel, John G.T. Augoustides Tags: Expert Review Source Type: research