Abstract:
OBJECTIVES:To characterize the longitudinal hemostatic profile during adult ECMO using point-of-care tests (POCT) for coagulation and to compare these parameters to standard laboratory tests. In addition, the clinicians' responses during bleeding episodes using available information were compared to a POCT-based response. DESIGN:Prospective observational cohort study. SETTING:ECMO-referral center in a university teaching hospital. PARTICIPANTS:Ten critically ill adult ECMO patients. INTERVENTIONS:Daily laboratory coagulation profile, transfusion history and near-daily thromboelastometry (ROTEM®) and platelet aggregometry (Multiplate®). MAIN RESULTS:Six male and four female patients, seven with VA- and three with VV-ECMO were studied over 110 days. Seventy-five thromboelastometry (TEM) and 36 platelet aggregometry (MEA) results were analyzed. A majority of TEM values were within the normal range, except for FIBTEM (majority high), which remained consistent over long (>5 days) ECMO runs. In MEA there were low values, particularly in the adenosine diphosphate- and ristocetin-induced assay, implying possibly a vWF-factor or GpIb-receptor defect. There was correlation between laboratory and POCT as well as good correlation between the clot firmness after 10 minutes (A10) and the maximum clot firmness in ROTEM, suggesting that reliable information can be obtained within 15 minutes. Twenty-two bleeding episodes were observed in five patients. When comparing the clinicians' response to a transfusion algorithm based on POCT, there was a concordance in less than 20% of episodes. CONCLUSIONS:POCT for coagulation can provide specific, reliable, and timely information during bleeding episodes and the use of targeted therapy algorithms could improve outcomes and reduce costs.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Nair P,Hoechter DJ,Buscher H,Venkatesh K,Whittam S,Joseph J,Jansz Pdoi
10.1053/j.jvca.2014.06.006subject
Has Abstractpub_date
2015-04-01 00:00:00pages
288-96issue
2eissn
1053-0770issn
1532-8422pii
S1053-0770(14)00283-3journal_volume
29pub_type
杂志文章abstract:OBJECTIVE:To compare paravertebral block under thoracoscopy with wound infiltration at an early stage after video-assisted thoracic lobectomy surgery. DESIGN:A prospective, randomized, triple-blinded, placebo-controlled trial. SETTING:A single-center university hospital. PARTICIPANTS:Patients scheduled for video-ass...
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.2015.06.013
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to compare the effects of a direct-acting arterial dilator, sodium nitroprusside, to an alpha-adrenergic receptor blocker, phenoxybenzamine, in infants with congenital heart defects undergoing cardiac repairs on cardiopulmonary bypass. DESIGN:A prospective, multicenter, observa...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,多中心研究
doi:10.1053/j.jvca.2004.11.010
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVES:The authors tested the hypothesis that ischemic and desflurane-induced preconditioning are blocked by propofol. DESIGN:A prospective, randomized, vehicle-controlled study. SETTING:A university research laboratory. SUBJECTS:New Zealand white rabbits (n = 52). METHODS:Pentobarbital-anesthetized rabbits wer...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2010.07.018
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:Mixed venous oxygen saturation and central venous oxygen saturation are considered possible indicators of the adequacy of oxygen delivery with respect to the oxygen needs of critically ill adult and pediatric patients. The present study was aimed at validating the accuracy of a new technology (Pediasat centra...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2008.04.003
更新日期:2008-12-01 00:00:00
abstract::Perioperative myocardial ischemia was evaluated in 36 consecutive carotid endarterectomy procedures carried out on patients with a high (72.2%) prevalence of ischemic heart disease. The procedures were performed under cervical plexus block plus a prophylactic intravenous nitroglycerin infusion. Findings of myocardial ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(93)90002-3
更新日期:1993-06-01 00:00:00
abstract:OBJECTIVE:Intraoperative monitoring of myogenic motor evoked potentials to transcranial electrical stimulation (tc MEPs) is a new method to assess the integrity of the motor pathways. The authors studied the effects of 50% nitrous oxide (N2O) and a low-dose propofol infusion on tc MEPs paired electrical stimulation dur...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(99)90169-6
更新日期:1999-02-01 00:00:00
abstract:DESIGN:A prospective, randomized, open study. The regional technique used was not blinded. SETTING:A university teaching hospital. PARTICIPANTS:Forty-eight patients undergoing video-assisted thoracoscopic surgery (VATS) for tumor resection. INTERVENTIONS:Patients received either continuous extrapleural block or cont...
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.2011.07.026
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the association between general (GA), regional (RA), and local (LA) anesthetic techniques with respect to the development of delirium after vascular surgery. The authors hypothesized that patients undergoing GA for vascular surgery would have a higher incidence of ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2013.12.003
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:Patients undergoing aortic surgery with deep hypothermic circulatory arrest (DHCA) usually are associated with a high rate of allogeneic blood transfusion, and their red blood cell (RBC) transfusion threshold is unclear and controversial. The purpose of this study was to explore whether a restrictive transfus...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.03.128
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the association of postoperative hemoglobin values and mortality in patients undergoing double- lung transplantation with intraoperative transfusion. DESIGN:Retrospective cohort study. SETTING:University hospital. PARTICIPANTS:Adult patients who underwent double-lung transplantation at the auth...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.12.040
更新日期:2020-12-29 00:00:00
abstract:OBJECTIVE:This study was planned to pool existing data on outcome and to evaluate the efficacy of postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO) in adult patients. DESIGN:Systematic review of the literature and meta-analysis. SETTING:Multi-institutional study. PARTICIPANTS:Adult patients w...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1053/j.jvca.2017.08.048
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVES:Perioperative treatment with angiotensin-converting enzyme (ACE) inhibitors in cardiac surgery with cardiopulmonary bypass is still controversial. Using ACE inhibitors during cardiac surgery might be associated with an increased risk of critical hypotensive episodes. On the other hand, ACE inhibitors could h...
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:10.1053/j.jvca.2003.10.011
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:To characterize the impact, on failure to rescue, of cerebrovascular accident as a first postoperative complication after thoracic endovascular aortic aneurysm repair (TEVAR). DESIGN:A retrospective cohort study using of National Surgical Quality Improvement Program Participants User File. SETTING:United St...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.11.061
更新日期:2020-12-02 00:00:00
abstract:OBJECTIVE:To perform three-dimensional surface reconstructions to provide spatial delineations of a normal and an aneurysmatic left ventricle, using transesophageal echocardiography. DESIGN:Prospective study. SETTING:University hospital. PARTICIPANTS:Eight patients in cardiogenic shock admitted to the intensive care...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章
doi:10.1016/s1053-0770(00)90006-5
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:To evaluate magnesium as a sole or adjuvant agent with currently used prophylactic drugs in suppressing postoperative atrial tachyarrhythmias (POAT) after coronary artery bypass graft (CABG) surgery. DESIGN:Single-center prospective, randomized clinical trial. SETTING:University hospital. PARTICIPANTS:Pati...
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:10.1053/jcan.2001.21959
更新日期:2001-04-01 00:00:00
abstract:OBJECTIVE:The authors investigated the feasibility of an online sampling and display of LV flow-area loops for the determination of LV elastance and preload-recruitable stroke work (PRSW). Automated LV area measurements by echocardiography may be combined with flow velocity measurements in the internal carotid artery t...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2004.05.017
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVES:The authors performed a meta-analysis to evaluate whether levosimendan is associated with improved survival in patients undergoing cardiac surgery. DESIGN:A meta-analysis. SETTING:Hospitals. PARTICIPANTS:A total of 440 patients from 10 randomized controlled studies were included in the analysis. INTERVEN...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1053/j.jvca.2009.05.031
更新日期:2010-02-01 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:OBJECTIVE:Regional analgesia continues to evolve with the introduction of ultrasound-guided fascial plane blocks. Erector spinae plane block (ESPB) is a novel technique gaining recent acceptability as a perioperative modality of analgesia in various thoracic and abdominal surgeries. However, literature on the use of ES...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.08.009
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVES:To investigate markers of splanchnic perfusion and the extent of endotoxemia during cardiopulmonary bypass (CPB) and to compare the effects of dopamine and milrinone on both splanchnic perfusion and endotoxemia. DESIGN:Prospective, randomized, blinded study. SETTING:University teaching hospital. PARTICIPA...
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(99)90266-5
更新日期:1999-06-01 00:00:00
abstract::Cystic fibrosis (CF) is an autosomal recessive disorder affecting approximately 1 in 2,500 live births worldwide, with double this estimated frequency in Ireland. CF is characterized by a genetic defect of the CF transmembrane regulator protein, causing impairment of chloride ion transportation. This has multisystem c...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2017.11.041
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To investigate the risk factors for postoperative delirium and the impact of delirium on mortality and morbidity following transcatheter aortic valve implantation (TAVI). DESIGN:Patients who underwent TAVI were identified using the International Classification of Diseases, 9th revision clinical modification ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,多中心研究
doi:10.1053/j.jvca.2017.03.016
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:Parameters such as central venous oxygen saturation (ScvO2) are used increasingly to monitor adequate hemodynamic treatment. However, it still remains challenging to identify patients with assumed adequate circulatory status quantified by ScvO2 who suffer from macro- and microcirculatory hypoperfusion. The au...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2014.09.006
更新日期:2015-01-01 00:00:00
abstract::Advances in pediatric solid organ transplantation have furthered the understanding of end-organ failures and refined the strategies for perioperative management of these otherwise lethal diseases. As the donor pool expands, the number of transplantations increases and long-term survival continues to improve, more comp...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1016/s1053-0770(98)90205-1
更新日期:1998-08-01 00:00:00
abstract::Cardiopulmonary bypass (CPB) has been one of the most important additions to the field of heart surgery in the past century. However, significant morbidity associated with CPB has led to the increasing implementation of off-pump coronary artery bypass (OPCAB). The use of OPCAB has broadened surgical revascularization ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.05.005
更新日期:2020-01-01 00:00:00
abstract:OBJECTIVES:To evaluate the effects of transesophageal echocardiography (TEE) probe insertion on the endotracheal cuff pressure (CP). DESIGN:Prospective observational study. SETTING:Single standing, not-for-profit pediatric hospital. PARTICIPANTS:A total of 80 pediatric patients (aged 6 days to 18.4 years) who underw...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.09.032
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVES:During cardiac surgery, circulating red blood cells (RBCs) are at risk of exposure to environmental factors during extracorporeal circulation and transfusion of stored RBCs. For this study, the authors observed morphological differences, deformability, density distribution, and erythrocyte indices of RBCs du...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.03.030
更新日期:2019-11-01 00:00:00
abstract::Left ventricular assist devices (LVADs) have been used as an effective therapeutic option in patients with advanced heart failure, either as a bridge to transplantation or, in some patients, as a bridge to recovery. LVAD withdrawal with ventricular recovery represents the optimal outcome for patients previously implan...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.12.043
更新日期:2021-01-05 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: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