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Specialty: Anesthesiology
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Total 158 results found since Jan 2013.

Efficacy and Efficiency of Perioperative Stellate Ganglion Blocks in Cardiac Surgery: A Pilot Study
Nationally, postoperative atrial fibrillation (POAF) occurs in up to 40% of patients after coronary artery bypass grafting (CABG), 50% of patients after valve surgery, 64% of patients after mitral valve and CABG, and 49% after aortic valve replacement.1 Atrial fibrillation worsens a patient ’s hemodynamic status and increases the risk of congestive heart failure, embolic events, and longer intensive care unit stays, leading to increased patient morbidity and strain on financial resources. In the United States, POAF carries a higher risk of stroke, worsened survival, and an additional 4.9 days and $10,000 to $11,500 in hospital stay costs.
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 20, 2017 Category: Anesthesiology Authors: Christopher W. Connors, Wendy Y. Craig, Scott A. Buchanan, Justin M. Poltak, James B. Gagnon, Craig S. Curry Tags: Letter to the Editor Source Type: research

Carotid Artery Disease as a Predictor of In-Hospital Postoperative Stroke After Coronary Artery Bypass Grafting From 1999 to 2011
In this study, the risk factors for stroke after coronary artery bypass grafting (CABG) were examined. In particular, the role of asymptomatic carotid artery stenosis (both unilateral and bilateral) as a predictor of in-hospital postoperative stroke was investigated. Finally, the trends surrounding in-hospital postoperative stroke from 1999 to 2011 also were examined. The purpose of the study was to appropriately identify patients at high risk for stroke after CABG and spark discussion about the perioperative management of such patients.
Source: Journal of Cardiothoracic and Vascular Anesthesia - November 20, 2017 Category: Anesthesiology Authors: Amol Mehta, Ravi Choxi, Thomas Gleason, Lawrence Wechsler, Tudor Jovin, Parthasarathy D. Thirumala Tags: Original Article Source Type: research

Statins Losing Their Luster?
STATINS HAVE NUMEROUS intriguing and potentially desirable pleiotropic anti-inflammatory effects that may clinically benefit patients undergoing cardiac surgery with/without cardiopulmonary bypass.1,2 Suggested clinical benefits include decreased postoperative morbidity (renal dysfunction, atrial fibrillation, myocardial infarction, stroke, infection) as well as decreased in-hospital mortality. While suppressing perioperative inflammation in patients undergoing cardiac surgery appears to make sense, nothing is ever as simple as it seems.
Source: Journal of Cardiothoracic and Vascular Anesthesia - September 19, 2017 Category: Anesthesiology Authors: Richa Dhawan, Mark A. Chaney Tags: Editorial Source Type: research

Anesthetic Management of Mitochondrial Encephalopathy With Lactic Acidosis and Stroke-Like Episodes (MELAS Syndrome) in a High-Risk Pregnancy: A Case Report
We present the in-hospital course of a 36-year-old gravida 2, para 0 with MELAS syndrome and severe preeclampsia, complicated by hyponatremia, hyperkalemia, and diabetes. A retained placenta with postpartum hemorrhage required urgent instrumental delivery under spinal anesthesia, transfusion, and intensive care unit admission for pulmonary edema, effusions, and atelectasis. Postpartum endometritis and sepsis also were encountered. This is to our knowledge the first case report of obstetric complications in MELAS syndrome and highlights the salient metabolic sequelae of this syndrome.
Source: A&A Case Reports - July 14, 2017 Category: Anesthesiology Tags: Case Reports: Case Report Source Type: research

Routine use of viscoelastic blood tests for diagnosis and treatment of coagulopathic bleeding in cardiac surgery: updated systematic review and meta-analysis
AbstractViscoelastic point-of-care tests are commonly used to provide prompt diagnosis of coagulopathy and allow targeted treatments in bleeding patients. We updated existing meta-analyses that have evaluated the clinical effectiveness of viscoelastic point-of-care testsvs the current standard of care for the management of cardiac surgery patients at risk of coagulopathic bleeding. Randomized controlled trials comparing viscoelastic point-of-care diagnostic testing with standard care in cardiac surgery patients were sought. All-cause mortality, blood loss, reoperation, blood transfusion, major morbidity, and intensive care...
Source: British Journal of Anaesthesia - May 14, 2017 Category: Anesthesiology Source Type: research

Little Black Boxes: Noncardiac Implantable Electronic Medical Devices and Their Anesthetic and Surgical Implications.
Abstract Implanted electronic medical devices. or stimulators such as pacemakers and nerve stimulators have grown enormously in diversity and complexity over recent decades. The function and potential interaction of these devices with the perioperative environment is of increasing concern for anesthesiologists and surgeons. Because of the innate electromagnetic environment of the hospital (operating room, gastrointestinal procedure suite, and imaging suite), implanted device malfunction, reprogramming, or destruction may occur and cause physical harm (including nerve injury, blindness, deafness, burn, stroke, para...
Source: Anesthesia and Analgesia - May 4, 2017 Category: Anesthesiology Authors: Srejic U, Larson P, Bickler PE Tags: Anesth Analg Source Type: research

Perioperative strokes after coronary artery bypass grafting with staged carotid endarterectomy: A nationwide perspective
To examine the risk of perioperative stroke on in-hospital morbidity and mortality in staged coronary artery bypass grafting (CABG) and carotid endarterectomy (CEA) procedures.
Source: Journal of Clinical Anesthesia - March 20, 2017 Category: Anesthesiology Authors: Hannah Cheng, Reshmi Udesh, Amol Mehta, Parthasarathy D. Thirumala Source Type: research

Perioperative Strokes and Early Outcomes in Mitral Valve Surgery: A Nationwide Analysis
To demonstrate the role of perioperative stroke as an independent risk factor for in-hospital morbidity and mortality after mitral valve surgery and review the trends in the early outcomes of mitral valve surgery over the past decade.
Source: Journal of Cardiothoracic and Vascular Anesthesia - February 28, 2017 Category: Anesthesiology Authors: Reshmi Udesh, Amol Mehta, Thomas G. Gleason, Lawrence Wechsler, Parthasarathy D. Thirumala Tags: Original Article Source Type: research

Long-term consequences of acute kidney injury in the perioperative setting
Purpose of review: Recent studies indicate that acute kidney injury (AKI) and chronic kidney disease (CKD) are interconnected syndromes. Although the majority of patients who suffer an episode of AKI will recover laboratory indices suggesting complete or near complete recovery of renal function, a significant portion of post-AKI survivors will develop major kidney events, including development of late-stage CKD, need for renal replacement therapies, and death. Recent findings: Our review highlights epidemiology of adverse post-AKI events, association of AKI with late development of nonrenal adverse outcomes, use of bedsid...
Source: Current Opinion in Anaesthesiology - January 4, 2017 Category: Anesthesiology Tags: CARDIOVASCULAR ANESTHESIA: Edited by Alexander Zarbock Source Type: research

Central Poststroke Pain Can Occur With Normal Sensation
Discussion: CPSP was present in 20.7% of the stroke patients. Spinothalamic tract dysfunction may not be necessary for the development of CPSP, and it can also be seen with normal spinothalamic sensation. The location of the stroke, its type and quality, and the severity of CPSP were not related.
Source: The Clinical Journal of Pain - October 5, 2016 Category: Anesthesiology Tags: Original Articles Source Type: research

Preload dependency determines the effects of phenylephrine on cardiac output in anaesthetised patients: A prospective observational study
BACKGROUND: Although phenylephrine is widely used in the operating room to control arterial pressure, its haemodynamic effects remain controversial. OBJECTIVE: We hypothesised that the effect of phenylephrine on cardiac output is affected by preload dependency. DESIGN: A prospective observational study. SETTING: Single-centre, University Hospital of Caen, France. PATIENTS: Fifty ventilated patients undergoing surgery were studied during hypotension before and after administration of phenylephrine. MAIN OUTCOME MEASURES: Cardiac index (CI), stroke volume (SV), corrected flow time, mean arterial pressure, pulse pressure...
Source: European Journal of Anaesthesiology - August 3, 2016 Category: Anesthesiology Tags: Cardiovascular physiology Source Type: research

Recognition and Management of Perioperative Stroke in Hospitalized Patients
We sought to characterize stroke management and outcomes in a postoperative population. By using the electronic medical records, we identified 39 patients suffering perioperative stroke after noncardiac and nonneurosurgical procedures for whom documentation of management and outcomes was available. Thirty-three strokes occurred during admission, whereas 6 occurred after discharge and were recognized upon return to the hospital. Perioperative stroke was associated with delayed recognition, infrequent intervention, and significant rates of morbidity and mortality, suggesting the need for improved screening and more rapid tre...
Source: A&A Case Reports - August 1, 2016 Category: Anesthesiology Tags: Case Reports: Case Report Source Type: research

Do cardiac arrest centres save more lives?
Publication date: Available online 13 May 2016 Source:Trends in Anaesthesia and Critical Care Author(s): Eldar Søreide, Michael Busch During the last 15 years post resuscitation care after out-of-hospital cardiac arrest (OHCA) has evolved into something quite complicated and multifaceted. Still, in most countries post resuscitation care is not centralised to specialised hospitals. In other acute and life-threatening diseases like neuro-trauma, acute myocardial infarction and stroke specialised hospital care has now become standard practise. In this review, we present the historic changes in post resuscitation care wit...
Source: Trends in Anaesthesia and Critical Care - June 15, 2016 Category: Anesthesiology Source Type: research

Hemodynamic monitoring and management in high-risk surgery: a survey among Japanese anesthesiologists
Abstract The aim of this study was to assess the current practices of hemodynamic management in high-risk surgical patients among Japanese anesthesiologists. An invitation letter to the survey, which included 35 questions related to hemodynamic monitoring in high-risk surgery, was mailed to every hospital approved by the Japanese Society of Anesthesiologists (JSA) (1260 hospitals). Of the 692 JSA respondents, 573 completed the survey. Despite reporting a high rate of cardiac output (CO) and stroke volume variation (SVV) monitoring in JSA members (70 and 74 %, respectively), fluid goal-directed therapy was poorly ...
Source: Journal of Anesthesia - March 9, 2016 Category: Anesthesiology Source Type: research