Abstract:
OBJECTIVE:At the authors' institution, before 2015, patients cannulated for peripheral venoarterial extracorporeal membrane oxygenation (VA-ECMO) did not undergo left ventricular (LV) decompression with the use of an LV vent. After 2015, the authors' institution began using the Impella device to vent the left ventricle in patients on VA-ECMO. The authors hypothesized that survival outcomes would improve in patients on VA-ECMO with the use of an Impella for LV venting. DESIGN:Retrospective, chart based review study. SETTING:Single center, university-based hospital. PARTICIPANTS:All adult patients at the authors' institution who required VA-ECMO between January 2015 and May 2017. INTERVENTION:An Impella (Abiomed, Danvers, MA) device was placed percutaneously in patients cannulated for VA-ECMO as a mechanism to provide LV venting and decompression, therefore unloading the heart. MEASUREMENTS AND MAIN RESULTS:Manual chart review was conducted, and a survival analysis was performed. It was observed that patients on VA-ECMO in whom an Impella was implanted had improved survival and an improvement in LV function as demonstrated by echocardiography compared with patients maintained on VA-ECMO alone. CONCLUSIONS:Patients on VA-ECMO plus Impella implantation demonstrated improved survival compared with patients treated with VA-ECMO alone. Key echocardiographic characteristics such as improved LV function after Impella placement and LV cavity size reduction during therapy may help predict those patients who may benefit most from this cannulation strategy.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Fiedler AG,Dalia A,Axtell AL,Ortoleva J,Thomas SM,Roy N,Villavicencio MA,D'Alessandro DA,Cudemus Gdoi
10.1053/j.jvca.2018.05.019subject
Has Abstractpub_date
2018-12-01 00:00:00pages
2585-2591issue
6eissn
1053-0770issn
1532-8422pii
S1053-0770(18)30351-3journal_volume
32pub_type
杂志文章abstract:OBJECTIVE:To evaluate the effect of two anesthetic agents (sevoflurane or propofol) on postoperative delirium (POD) in patients undergoing off-pump coronary artery bypass grafting (CABG). DESIGN:Retrospective observational design. SETTING:University hospital. PARTICIPANTS:Two hundred ninety-two patients undergoing o...
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.2017.02.047
更新日期:2017-12-01 00:00:00
abstract:STUDY OBJECTIVE:Cardiac surgery is complicated by decreased postoperative respiratory muscle strength and spirometry with accompanying increased atelectasis. The specific respiratory symptoms attributable to these physiologic changes are unknown, and this study looked at the symptoms and underlying physiology. DESIGN:...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(96)80130-3
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVES:To compare changes in blood flow in a grafted internal mammary artery (IMA) after cardiopulmonary bypass (CPB) in response to the administration of milrinone or nitroglycerin and to establish the effects of alpha-adrenergic stimulation. DESIGN:Randomized study. SETTING:A university medical center hospital ...
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.2001.28316
更新日期:2001-12-01 00:00:00
abstract::This study compared the use of high-frequency jet ventilation (HFJV) and tidal ventilation (TV) in a group of dogs with induced global myocardial ischemia before and after cardiopulmonary bypass. Transesophageal echocardiography was used to determine whether HFJV with its lower airway pressures could improve cardiac p...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(91)90153-k
更新日期:1991-08-01 00:00:00
abstract:OBJECTIVE:Over 150,000 carotid endarterectomy (CEA) procedures are performed each year. Perioperative anesthetic management may be complex due to multiple patient and procedure-related risk factors. The authorsaimed to determine whether the use of general anesthesia (GA), when compared with regional anesthesia (RA), wo...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.08.195
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:This study was designed to assess the clinical applicability of a small, handheld, portable transthoracic echocardiography device by noncardiologist intensivists. DESIGN:Prospective, observational study. After 10 one-hour tutorials, intensivists performed a limited transthoracic echocardiography (TTE) (2-4 v...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2005.01.023
更新日期:2005-04-01 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:OBJECTIVES:Mesenteric ischemia is still a fatal event after cardiac procedures. No adequate intraoperative methods are available to monitor the gastrointestinal mucosal microcirculation in real-time conditions. The aim of the study was to assess a newly designed microprobe using laser Doppler flowmetry and remission sp...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2014.07.003
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:The study's aim was to compare response entropy (RE) and state entropy (SE) with bispectral index (BIS) electroencephalography (EEG) as an alternative cerebral monitoring tool in patients scheduled for coronary artery bypass graft surgery. DESIGN:Prospective, observational single-center study. SETTING:Unive...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2009.09.013
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to evaluate the pretreatment effect of simvastatin on spinal cord ischemia-reperfusion injury. DESIGN:Prospective, interventional study. SETTING:University research laboratory. PARTICIPANTS:Forty-five male Sprague-Dawley rats. INTERVENTIONS:Rats were treated with oral simvastatin...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2012.01.025
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVES:In the present study, the authors have investigated whether rotational thromboelastometry (ROTEM) could predict thrombocytopenia and hypofibrinogenemia in cardiac surgery using the clot amplitude after 5 minutes (A5). Another parameter, PLTEM, in which the contribution of fibrinogen is eliminated by subtract...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2013.12.004
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVES:Recent studies have demonstrated that perioperative myocardial ischemia, detected by electrocardiography, is a risk factor for myocardial infarction. ST-segment analyzers and hemodynamic monitors may be useful for on-line detection in perioperative and critical care environments. However, independent perform...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(05)80230-7
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVE:To describe the use of either deep intravenous sedation with propofol or light sedation with midazolam and topical anesthesia during transesophageal echocardiography (TEE) and to report the incidence of respiratory complications and their management. DESIGN:Retrospective study from March 2000 through August ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(03)00147-2
更新日期:2003-08-01 00:00:00
abstract:OBJECTIVES:To investigate the association between adenosine diphosphate (ADP)-induced platelet aggregation measured by single-platelet count testing and postoperative blood loss in clopidogrel-treated patients with acute coronary syndromes undergoing coronary artery bypass grafting (CABG). DESIGN:Prospective observati...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2013.10.007
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the left ventricular lusitropic effects of epinephrine versus milrinone after cardiopulmonary bypass. DESIGN:Prospective randomized study. SETTING:Single institution, university teaching hospital. PARTICIPANTS:Adult patients undergoing coronary artery bypass grafti...
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.2005.03.011
更新日期:2005-06-01 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:OBJECTIVE:To compare the hemodynamic effects, efficacy, and safety of intravenous milrinone (M), 50 microg/kg during 10 minutes followed by 0.5 microg/kg/min, with intravenous dobutamine (D), 10 to 20 microg/kg/min, in patients with low cardiac output after cardiac surgery. DESIGN:Randomized, open-label, multicenter s...
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.2001.23274
更新日期:2001-06-01 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:OBJECTIVES:To investigate the efficacy and safety of perioperative administration of nitric oxide in cardiac surgery. DESIGN:Meta-analysis of randomized controlled trials (RCTs). PARTICIPANTS:Cardiac surgery patients. INTERVENTIONS:A search of Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and MED...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,meta分析,评审
doi:10.1053/j.jvca.2018.02.003
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVES:Potassium and magnesium are frequently administered after cardiac surgery to reduce the risk of atrial fibrillation (AF). The evidence for this practice is unclear. This study was designed to evaluate the relationship between serum potassium and magnesium levels and AF after cardiac surgery. DESIGN:Observat...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.10.045
更新日期:2020-05-01 00:00:00
abstract::Systemic intravenous administration of opioids is the main treatment strategy for intraoperative and postoperative pain management in patients undergoing cardiac surgery with sternotomy. However, using lower doses of opioids may achieve the well-established benefits of the fast-track approach, with minimal opioid-rela...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.07.041
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:To identify the prevalence of and risk factors for inadvertent hypothermia after procedures performed with procedural sedation and analgesia in a cardiac catheterization laboratory. DESIGN:A single-center, prospective observational study. SETTING:A tertiary-care private hospital in Australia. PARTICIPANTS...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2015.06.002
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:The aging brain shows decreased venous oxygenation predominantly in the frontal cortex, which seems sex- dependent. The authors hypothesized that age and sex would influence baseline regional cerebral oxygen saturation (rScO2) measured by the INVOS 5100. DESIGN:Subanalysis of published data. SETTING:Tertia...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.06.025
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVES:The postoperative course following on-pump coronary artery bypass grafting (CABG) in patients with severe left ventricular (LV) systolic dysfunction is often unpredictable. Therefore, the aim of this study was to identify predictors of poor postoperative outcome in this subset of patients. DESIGN:Prospectiv...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.04.025
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:This study was designed to assess the use of 100% oxygen or 50% oxygen in air or nitrous oxide after cardiopulmonary bypass (CPB) on atelectasis, as evidenced by the oxygenation index (PaO2/F(I)O2), after coronary artery bypass graft (CABG) surgery. DESIGN:Prospective, randomized clinical study. SETTING:Uni...
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.2005.11.017
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVES:To determine the effect of the introduction of a specialty-specific progressive care unit (PCU) on the intensive care unit (ICU) to which relatively low-acuity patients had previously been admitted. DESIGN:Retrospective cohort study. SETTING:The thoracic (noncardiac) surgical ICU of a tertiary referral ins...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2007.12.015
更新日期:2008-06-01 00:00:00
abstract:OBJECTIVES:Cell saver reinfusate ideally should contain low, clinically insignificant heparin concentrations. The American Association of Blood Banks has defined the clinically insignificant threshold as 0.5 IU/mL. Furthermore, there is uncertainty about the meaning of cell saver "heparin elimination rates." These conc...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2016.06.014
更新日期:2017-02-01 00:00:00
abstract::Middle aortic syndrome (MAS) is a rare vascular disease occurring in pediatric patients. MAS describes narrowing of the abdominal aorta, often referred to as abdominal coarctation. Extra-aortic vessels are commonly involved, including the renal and mesenteric arteries. Pediatric patients with MAS frequently present wi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2019.07.130
更新日期:2020-04-01 00:00:00
abstract::Two-dimensional visualization of complex congenital heart disease has limitations in that there is variation in the interpretation by different individuals. Three-dimensional printing technology has been in use for decades but is currently becoming more commonly used in the medical field. Congenital heart disease serv...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2017.11.037
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the success and complication rates of a single center's multidisciplinary approach to transvenous lead extraction. SETTING:One university hospital. PARTICIPANTS:One hundred ninety-five patients scheduled for transvenous lead extraction. INTERVENTIONS:A multidisciplinary approach to transvenous ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2014.11.010
更新日期:2015-04-01 00:00:00