Abstract:
OBJECTIVE:To investigate sedation and anesthesia trends and practice patterns for procedures in the cardiac electrophysiology laboratory (EPL). DESIGN:A survey distributed by e-mail. SETTING:US teaching hospitals with a training program in cardiac electrophysiology. PARTICIPANTS:Cardiologists involved in procedures in the electrophysiology laboratory of academic electrophysiology programs. INTERVENTIONS:A survey was e-mailed to the selected programs. The survey questions included the use of anesthesia professional (MD/CRNA) and nonanesthesia professional (RN) services, medications administered, commonly performed airway interventions, satisfaction with anesthesia services, and reasons that anesthesia professionals are not used when RNs administer sedation. MEASUREMENTS AND MAIN RESULTS:Of the 95 academic electrophysiology programs surveyed, there were 38 responses (40%). The majority (71%) of respondents used a combined model of care with both anesthesia professional care and nonanesthesia professional (RN) sedation, although there were EPLs that had exclusively anesthesia professional (n = 6) and exclusively nonanesthesia professional coverage (n = 5); 26.3% of respondents answered that care by an anesthesia professional was warranted most (>50%) of the time regardless of their current care model. The main reasons cited for having RN-administered sedation were the lack of availability of anesthesia professionals, difficulty with scheduling, and increased operating room suite turnover times. Programs using exclusively RN sedation (13%) reported all levels of anesthesia including general anesthesia (patient unarousable to repeated deep stimulation). CONCLUSIONS:This survey suggested that sedation for EPL procedures was sometimes allowed to progress to deep sedation and general anesthesia and that selection of anesthesia provider frequently was made based on availability, operating room efficiency, and economic reasons before patient safety issues. The implications of the survey must be explored further in a larger-scale sample population before more definitive statements can be made, but results suggested that sedation in the EPL is an area that would benefit from updated guidelines specific to the current practice as well as attention from the anesthesia community to address the deficiency in provision of anesthesia care.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Gaitan BD,Trentman TL,Fassett SL,Mueller JT,Altemose GTdoi
10.1053/j.jvca.2010.11.006subject
Has Abstractpub_date
2011-08-01 00:00:00pages
647-59issue
4eissn
1053-0770issn
1532-8422pii
S1053-0770(10)00483-0journal_volume
25pub_type
杂志文章abstract:OBJECTIVES:Efficacy and safety of corticosteroids in patients with 2019-nCoV (novel coronavirus 2019) infection still are debated. Because large randomized clinical trials (RCTs) and a well-conducted meta-analysis on the use of corticosteroids, focused on patients with coronavirus disease (COVID-19) in intensive care u...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,meta分析
doi:10.1053/j.jvca.2020.11.057
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVE:To assess the value of gastric intramucosal pH measurement in patients with low output after cardiac surgery. DESIGN:Prospective clinical study. SETTING:University hospital. PARTICIPANTS:Fifteen patients with low output after cardiac surgery were included. Those who survived the first postoperative day (n ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(97)90211-1
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:To determine the effect of nitroglycerin on coronary blood flow velocity during controlled hypotensive anesthesia in humans. DESIGN:Internally controlled prospective study. SETTING:Single university hospital. PARTICIPANTS:Twenty American Society of Anesthesiologists class I and II patients undergoing gener...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2000.9446
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVES:This study's purpose was to review non-cardiac surgery (NCS) in patients with hypertrophic obstructive cardiomyopathy (HOCM) to examine perioperative management and quantify postoperative mortality and worsening heart failure. DESIGN:Retrospective review. SETTING:A single tertiary care center. PARTICIPANT...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2015.08.017
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:Compare total perioperative opioid use in patients receiving naloxone continuousinfusion (NCI) for spinal cord ischemia prophylaxis, versus patients not receiving NCI, in endovascular aortic repair. DESIGN:Single-center, retrospective cohort review. SETTING:Academic medical center. PARTICIPANTS:Patients un...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.11.043
更新日期:2020-11-24 00:00:00
abstract:OBJECTIVE:Adequate maintenance of hypnosis during anesthesia throughout surgery using sevoflurane alone was investigated. In addition, sevoflurane pharmacokinetics during cardiopulmonary bypass were analyzed. DESIGN:This was a pilot pharmacokinetic study. SETTING:Tertiary care university hospital. PARTICIPANTS:The s...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.12.018
更新日期:2017-08-01 00:00:00
abstract::Clinical manifestations of coronavirus disease 2019 in pregnant women, in contrast to previous outbreaks, seem to be similar to those of nonpregnant women. During severe acute respiratory syndrome (SARS), SARS influenza A, and Middle East respiratory syndrome outbreaks, an increased severity of disease among pregnant ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type:
doi:10.1053/j.jvca.2020.07.088
更新日期:2020-08-06 00:00:00
abstract:OBJECTIVES:Postoperative cognitive decline (POCD) has a perceivable influence on daily living and is noticed more often by close relatives than by patients themselves 3 months after aortic valve replacement. This study aimed to elucidate the longitudinal course of the subjective awareness of POCD. DESIGN:Follow-up of ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2015.12.008
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:Although volatile anesthetics have been shown to have spasmolytic effects on constricted airways, most previous studies were performed to assess bronchodilation with indirect methods such as measurement of airway resistance, whose reliability is controversial. As the authors have developed a new direct metho...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(96)80240-0
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:Because propofol is known to reduce vascular resistance, the objective of this study was to compare the indices of hepatosplanchnic circulation and oxygenation during cardiopulmonary bypass (CPB) in patients anesthetized with either propofol or midazolam/halothane. DESIGN:A prospective, randomized, nonblinde...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s1053-0770(98)90195-1
更新日期:1998-08-01 00:00:00
abstract::Near-infrared spectroscopy (NIRS) is an emerging noninvasive monitoring modality based on chromophore absorption of infrared light. Because NIRS provides instantaneous information on cerebral and somatic tissue oxygenation, it becomes mandatory to identify rapidly the etiology of impaired regional oxygenation and thus...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.03.039
更新日期:2019-08-01 00:00:00
abstract::Cardiopulmonary bypass has been shown to activate various inflammatory cascades in the body, resulting in pathophysiological changes that may affect patient outcome after cardiac surgery. Many of these inflammatory cascades are enzyme mediated, involving serine proteases. This report reviews the mechanisms of bypass-m...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s1053-0770(97)80006-7
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVE:Patients undergoing transapical cardiac procedure are a minority of cardiac surgery patients but represent a challenge for cardiac anesthesiologists because they generally are older and have more comorbidities than do open heart cardiac surgery patients. The aims of this study were to describe the anesthetic ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.10.039
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:To investigate the relationship between applied external positive end-expiratory pressure (PEEP) and auto-PEEP and the resultant total PEEP experienced by the patient during one-lung ventilation (OLV). DESIGN:A prospective clinical study. SETTING:A university hospital. PARTICIPANTS:Ten adult patients under...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(98)90318-4
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVE:To study the influence of preoperative warfarin anticoagulation on postoperative blood loss and allogeneic blood requirement. DESIGN:Retrospective study with a matched control group. SETTING:University and community hospital, single institutional. PARTICIPANTS:240 patients scheduled for cardiac surgery. I...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(05)80316-7
更新日期:1995-06-01 00:00:00
abstract::The anesthetic management and outcome data were examined in a retrospective case-controlled study that compared a conventional hypothermic cardioplegic technique with the recently described method of warm heart surgery, in patients undergoing urgent cardiac surgery. Hypothermic continuous oxygenated blood crystalloid ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(92)90185-a
更新日期:1992-04-01 00:00:00
abstract:OBJECTIVE:Cardiac surgery patients have a high risk of postoperative bleeding. Historically, the platelet count has been one of the main parameters used to establish the need for platelet transfusions, and the recent introduction of point-of-care tests for platelet function has allowed clinicians to rationalize platele...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.06.060
更新日期:2020-12-01 00:00:00
abstract::Survival of patients with congenital heart disease has significantly improved over the last 2 decades, confronting interventionalists, surgeons, anesthesiologists, cardiologists, and intensivists with often unfamiliar complex pathophysiology in the perioperative setting. Aside from cardiac catheterization, echocardiog...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.11.036
更新日期:2020-05-01 00:00:00
abstract:OBJECTIVE:To test the reproducibility of Sonoclot coagulation analysis (SCA; Sienco Inc, Morrison, CO). The authors wished to determine if the mix/release of the preloaded celite activator in standard Sono-cuvettes could be responsible for the high variation coefficients for SCA parameters with citrated whole blood and...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(99)90209-4
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:Most-Care (powered by the pressure-recording analytic method [PRAM]; Vytech HealthTM, Padova, Italy) is a minimally invasive cardiac output monitoring. This system already has been studied and validated in cardiac surgery and in children. It already showed a correlation with thermodilution methods in hemodyna...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2010.09.027
更新日期:2011-06-01 00:00:00
abstract:OBJECTIVE:To compare measurements of regional myocardial blood flow volume between microsphere measurement of regional flow (0.5- to 2- g tissue sampling) and a potential alternative measure, local flow (1 mm3) in the microcirculation measured by laser-Doppler perfusion monitor. DESIGN:Prospective, randomized, control...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(96)80100-5
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVES:There is still controversy about whether an infant should have cardiac surgery concomitant with ongoing persistent pneumonia. This study analyzes the outcome of surgical treatment for infants with left-to-right shunt congenital heart disease accompanied with persistent pneumonia and discusses the perioperati...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.05.039
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVES:The use of monitored anesthesia care (MAC) for transcatheter aortic valve replacement (TAVR) is gaining favor in the United States, although general anesthesia (GA) continues to be common for these procedures. Open surgical cutdown for transfemoral TAVR has been a relative contraindication for TAVR with MAC ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.05.036
更新日期:2019-01-01 00:00:00
abstract::The incidence of primary cardiac tumors is very rare (0.02%) with the majority being benign. Angiosarcoma is the most common malignant cardiac tumor. However, regardless of the histological nature of cardiac tumors, they can cause life-threatening mechanical obstruction. We present a case of urgent surgical removal of...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.12.018
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:Because of the lack of data regarding the impact of obesity on propofol pharmacokinetics in patients undergoing cardiac surgery using hypothermic cardiopulmonary bypass (CPB), the authors sought to explore propofol pharmacokinetics and develop a predictive pharmacokinetic model that characterizes and predicts...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.02.003
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To examine the authors' hypothesis that during the cardiopulmonary bypass (CPB) in children, the inferior vena cava cannula tip placed proximal to the right hepatic vein orifice would produce a higher venous drainage compared with that placed distally. DESIGN:A prospective, randomized, controlled, double-bli...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1053/j.jvca.2018.10.023
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine the predictive value of 2 established risk models for surgical mortality in a contemporary cohort of patients undergoing repair of acute type-A aortic dissection. DESIGN:Retrospective analysis. SETTING:Single tertiary care hospital. PARTICIPANTS:Seventy-nine con...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2015.08.008
更新日期:2016-01-01 00:00:00
abstract::Twenty-three informed and consenting patients scheduled for CABG were anesthetized using computer-controlled infusions of alfentanil, midazolam, and pancuronium. Thirteen middle-aged patients received a preprogrammed infusion scheme of alfentanil, simulated using the population pharmacokinetic set of Maitre et al (Gro...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/1053-0770(94)90238-0
更新日期:1994-06-01 00:00:00
abstract:OBJECTIVE:To determine the feasibility, safety, and efficacy on PaO(2)/F(I)O(2) ratio of prone positioning (PP) for acute respiratory distress syndrome (ARDS) after cardiac surgery. DESIGN:Retrospective review of information entered prospectively in the authors' database. SETTING:A private community nonteaching hospi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2007.10.013
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVE:The authors tested the hypothesis that patients with metabolic syndrome are more likely to develop short-term cognitive dysfunction after cardiac surgery with cardiopulmonary bypass. DESIGN:A prospective study. SETTING:Veterans Affairs medical center. PARTICIPANTS:Fifty-six age- and education-balanced pati...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2010.06.008
更新日期:2011-04-01 00:00:00