Abstract:
OBJECTIVE:Prolonged mechanical ventilation (PMV) is closely associated with higher morbidity and mortality after total cavopulmonary surgery. The aim of the present study was to identify the clinical risk factors for PMV. DESIGN:A retrospective case-control study. SETTING:Fuwai Hospital. PARTICIPANTS:The study comprised 504 patients who underwent total cavopulmonary surgery from 2010 to 2018. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:The definition of PMV was derived from the Cox regression model for predicting postoperative length of hospital stay. Least absolute shrinkage and selection operator regression, logistic regression, and Cox regression were applied to identify predictors for PMV. Patients with mechanical ventilation time >9 hours were identified as having PMV. Independent predictors of PMV included age, intraoperative maximum vasoactive-inotropic score, minimal temperature during cardiopulmonary bypass, postoperative prothrombin time, alkaline phosphatase and total bilirubin levels, and postoperative fluid balance. These predictors also were achieved in the Cox regression for predicting the duration of mechanical ventilation. Patients with PMV were associated with increased blood transfusions, more consumption of vasopressin and antipulmonary hypertension medication, higher incidence of reintubation, more renal replacement treatment, longer intensive care unit stay, greater hospitalization costs, and more specialist visits. CONCLUSIONS:Age at surgery, maximal vasoactive-inotropic score and minimal temperature during cardiopulmonary bypass, postoperative prothrombin time, alkaline phosphatase and total bilirubin levels, and postoperative fluid balance were demonstrated to be independent predictors of PMV. Adopting a comprehensive strategy of perioperative management that targets the identified risk factors might significantly lower the risk of PMV and improve in-hospital outcomes, and furthermore, patients with PMV might need more specialist visits.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Luo Q,Su Z,Jia Y,Liu Y,Wang H,Zhang L,Li Y,Wu X,Liu Q,Yan Fdoi
10.1053/j.jvca.2019.10.043subject
Has Abstractpub_date
2020-04-01 00:00:00pages
940-948issue
4eissn
1053-0770issn
1532-8422pii
S1053-0770(19)31118-8journal_volume
34pub_type
杂志文章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::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::During the insertion of an automatic implantable cardioverter defibrillator, repeated induction of ventricular tachycardia or ventricular fibrillation and subsequent defibrillation is performed to determine the defibrillation threshold. In this study, the influence of these testing episodes on myocardial function was ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(93)90167-j
更新日期:1993-08-01 00:00:00
abstract::In this review, the authors discussed criteria for diagnosing ALI; incidence, etiology, preoperative risk factors, intraoperative management, risk-reduction strategies, treatment, and prognosis. The anesthesiologist needs to maintain an index of suspicion for ALI in the perioperative period of thoracic surgery, partic...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2009.10.032
更新日期:2010-08-01 00:00:00
abstract::This study was designed to compare the cardiovascular effects of pipecuronium bromide (PIP) to vecuronium (V) when combined with sufentanil (SF) in patients undergoing coronary artery bypass surgery. Eighty-two patients were studied; 40 were normotensive and 42 had hypertension currently controlled by pharmacological ...
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:10.1016/1053-0770(91)90321-j
更新日期:1991-04-01 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:OBJECTIVE:To examine the role of the CHA2DS2-VASc (Congestive heart failure; Hypertension; Age ≥75 years [doubled]; Diabetes; previous Stroke, transient ischemic attack, or thromboembolism [doubled]; Vascular disease; Age 65-75 years; and Sex category) score as a prognostic marker of in-hospital mortality in critically...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2019.11.044
更新日期:2020-05-01 00:00:00
abstract::Appropriate anesthesia for LVAD placement needs to incorporate an understanding of the surgical procedure and LVAD physiology, the altered physiology and pharmacology of the cardiac failure patient, and a knowledge of the interaction of anesthesia with the potent cardiac drugs used in end-stage heart failure therapy. ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:
更新日期:2000-06-01 00:00:00
abstract:OBJECTIVE:The aim of the present study was to evaluate the correlation, accuracy, and precision of transpulmonary thermodilution cardiac output (CO) measurement. For this purpose, this technique was compared with the clinical gold standard, the CO measurement by pulmonary artery catheter in patients after coronary arte...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(98)90093-3
更新日期:1998-10-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to evaluate the prognostic impact of cerebral regional oxygen saturation (crSO2) in patients undergoing surgery for Stanford type A aortic dissection (TAAD). DESIGN:Observational, retrospective, institutional study. SETTING:University hospital. PARTICIPANTS:A total of 152 patient...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.10.011
更新日期:2020-10-13 00:00:00
abstract:OBJECTIVE:To identify patients with poor tissue factor pathway inhibitor (TFPI) response to heparin and observe any association with increased risk of excessive coagulation activation, morbidity, or mortality. DESIGN:Prospective, observational cohort study. SETTING:University hospital. PARTICIPANTS:Patients (n = 96)...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2002.29677
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to investigate whether the use of modified ultrafiltration at the end of cardiopulmonary bypass for cardiac surgical procedures significantly changes vancomycin serum concentrations. DESIGN:Prospective study. SETTING:Single tertiary cardiac center. PARTICIPANTS:Twenty-six elective...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.06.004
更新日期:2019-01-01 00:00:00
abstract::Left ventricular assist device (LVAD) therapy has greatly improved outcomes in patients with end-stage heart failure. However, development of right ventricular failure (RVF) in LVAD recipients is associated with increased long- and short-term morbidity and mortality. The incidence of RVF after LVAD placement is diffic...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章,评审
doi:10.1053/j.jvca.2018.07.047
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:To assess the accuracy of respiratory-induced systolic pressure variation and its components to detect low left ventricular preload. DESIGN:Prospective study. SETTING:University hospital. PARTICIPANTS:Sixty-seven patients undergoing major surgery under general anesthesia. INTERVENTIONS:Transesophageal ech...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/jcan.2003.45
更新日期:2003-04-01 00:00:00
abstract::This study examined the effects of global normothermic hypoperfusion on the compressed spectral array (CSA) processed electroencephalogram (EEG) during high-dose narcotic anesthesia. Fifteen patients undergoing cardiac electrophysiologic surgery were studied. The patients were anesthetized with a standard high-dose na...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(91)90276-y
更新日期:1991-06-01 00:00:00
abstract:OBJECTIVES:Several substances may be released from ischemic tissues with the declamping shock that occurs during abdominal aortic aneurysm surgery. To clarify the relationship between tissue ischemia and venous endothelin-1 (ET-1) level in humans, plasma ET-1 and oxygen content in the iliac vein were measured before an...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(05)80132-6
更新日期:1995-10-01 00:00:00
abstract::To determine the effect of 1.5 MAC of two volatile anesthetics (halothane and isoflurane) on platelet-induced contraction of canine coronary artery, isolated, denuded coronary rings were suspended between two stirrups, placed into organ chambers filled with an oxygenated Krebs-Ringer solution, and connected to an isom...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/1053-0770(94)90058-2
更新日期:1994-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to test the hypothesis that meperidine induces a dilator response in the feline pulmonary vascular bed, and to identify receptors involved in the mediation or modulation of these effects. DESIGN:Prospective vehicle controlled study. SETTING:University research laboratory. SUBJ...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2005.10.003
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:To compare dexmedetomidine-based to propofol-based sedation after coronary artery bypass graft (CABG) surgery in the intensive care unit (ICU). DESIGN:Randomized, open label. SETTING:Twenty-five centers in the United States and Canada. PARTICIPANTS:Two hundred ninety-five adults undergoing CABG surgery. I...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s1053-0770(03)00200-3
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVE:To study the acute effects of angiotensin-converting enzyme inhibition by intravenous enalaprilat infusion in patients with left ventricular dysfunction after cardiac surgery. DESIGN:Prospective, consecutive sample, before-after trial. SETTING:Surgical intensive care unit in a tertiary care university hospi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(97)90009-4
更新日期:1997-08-01 00:00:00
abstract::Aprotinin has been reported to reduce bleeding in cardiac surgery patients. Its mechanisms of action on coagulation have not been fully elucidated. In a prospectively randomized study of 40 patients undergoing elective aortocoronary bypass grafting, the influence of high-dose aprotinin (2 million IU of aprotinin befor...
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:10.1016/1053-0770(94)90164-3
更新日期:1994-10-01 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: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...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2018.05.019
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:Auditory information presented during anesthesia can activate memory. Surgical stimulation may enhance memory formation. The authors' hypothesis is that implicit memory processing is not preserved during unconsciousness, even in the presence of a surgical stimulus. DESIGN:A double-blind randomized controlled...
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.2008.09.016
更新日期:2009-04-01 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:The central sympatholytic effects of alpha2-adrenergic agonists are believed to be beneficial during myocardial ischemia, but the peripheral vasoconstrictive effects are controversial. The aim of this study was to investigate the coronary vascular effects of dexmedetomidine (DM) during reactive hyperemia. DE...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1016/s1053-0770(96)80140-6
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:The value of a simplified, focused intraoperative transesophageal echocardiography (TEE) protocol in patients undergoing liver transplantation (LT) is unknown. We sought to create and assess a 5-view LT TEE examination focused on 5 prespecified common causes of hypotension during LT. DESIGN:Retrospective coh...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2020.01.028
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVES:The authors hypothesized that bioimpedance cardiography measured by the Endotracheal Cardiac Output Monitor (ECOM; ConMed, Utica, NY) is a convenient and reliable method for both cardiac index (CI) assessment and prediction in fluid responsiveness. DESIGN:A prospective observational study. SETTING:A teachi...
journal_title:Journal of cardiothoracic and vascular anesthesia
pub_type: 杂志文章
doi:10.1053/j.jvca.2011.06.023
更新日期:2012-04-01 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::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