A Review of Recent Advances in Anesthetic Drugs for Patients Undergoing Cardiac Surgery

A Review of Recent Advances in Anesthetic Drugs for Patients Undergoing Cardiac Surgery

This review explores recent advancements in anesthetic drugs for cardiac surgery. With no standard protocol for anesthesia in these procedures, the article examines commonly used agents such as opioids (fentanyl, sufentanil, remifentanil), volatile anesthetics, and novel drugs like dexmedetomidine and remimazolam. The study highlights opioid-free anesthesia approaches, innovative drug delivery systems, and enhanced recovery techniques to improve patient outcomes and reduce complications.

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The Role of Continuous Monitoring of Venous Drainage Flow and Integrated Oxygen Extraction (ERiO2) via Bilateral Near-Infrared Spectroscopy in Cerebral Perfusion During Aortic Arch Surgery

The Role of Continuous Monitoring of Venous Drainage Flow and Integrated Oxygen Extraction (ERiO2) via Bilateral Near-Infrared Spectroscopy in Cerebral Perfusion During Aortic Arch Surgery

This study evaluates the role of continuous monitoring of venous drainage flow and oxygen extraction (ERiO2) using near-infrared spectroscopy (NIRS) in cerebral perfusion during aortic arch surgery. A retrospective review of 10 patients undergoing selective antegrade cerebral perfusion (SACP) found a strong correlation (r = 0.91, p < 0.01) between ERiO2 and NIRS-derived regional oxygen saturation (rSO2). The study suggests that integrated monitoring improves perfusion management and neurological outcomes.

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Lethal Myocardial Infarction in a Neonate During Extracorporeal Membrane Oxygenation

Lethal Myocardial Infarction in a Neonate During Extracorporeal Membrane Oxygenation

This case study explores a neonate with congenital diaphragmatic hernia (CDH) who experienced a lethal myocardial infarction (MI) while on extracorporeal membrane oxygenation (ECMO). The patient developed a large thrombus extending from the arterial cannula into the left main coronary artery, leading to severe cardiac dysfunction. Despite anticoagulation efforts, the clot progressed, resulting in a fatal outcome. The study highlights the challenges of managing neonatal ECMO and intracardiac thrombosis.

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Outcomes and Biochemical Parameters Following Cardiac Surgery: Effects of Transfusion of Residual Blood Using Centrifugation and Multiple-Pass Hemoconcentration

Outcomes and Biochemical Parameters Following Cardiac Surgery: Effects of Transfusion of Residual Blood Using Centrifugation and Multiple-Pass Hemoconcentration

This study compares centrifugation (CF) and multiple-pass hemoconcentration (MPH) for salvaging residual blood after cardiopulmonary bypass. A randomized trial with 61 patients found that MPH resulted in higher postoperative albumin, total protein, fibrinogen, and platelet levels compared to CF. While CF processed blood faster and cleared heparin more consistently, MPH was associated with lower allogeneic transfusion needs and reduced fluid retention. Overall, MPH demonstrated improved biochemical and clinical outcomes.

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Transfusion Use and Hemoglobin Levels by Blood Conservation Method After Cardiopulmonary Bypass

Transfusion Use and Hemoglobin Levels by Blood Conservation Method After Cardiopulmonary Bypass

This study evaluates three blood conservation techniques—online modified ultrafiltration (MUF), off-line MUF, and centrifugation—following cardiopulmonary bypass. A cohort of 99 patients was analyzed for transfusion rates, hemoglobin levels, and fluid balance. Results indicated no significant advantage of online MUF in reducing transfusions. Off-line MUF had the lowest transfusion rates, while online MUF showed greater hemoglobin improvement, likely due to fluid shifts.

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Pulmonary Artery Systolic Pressure Associated with Inflammatory Factors Among Pediatric Congenital Heart Disease with Pulmonary Arterial Hypertension After Cardiopulmonary Bypass

Pulmonary Artery Systolic Pressure Associated with Inflammatory Factors Among Pediatric Congenital Heart Disease with Pulmonary Arterial Hypertension After Cardiopulmonary Bypass

This study investigates the relationship between pulmonary artery systolic pressure (PASP) and inflammatory factors in pediatric congenital heart disease (CHD) patients with pulmonary arterial hypertension (PAH) after cardiopulmonary bypass (CPB). The study found that elevated preoperative PASP correlates with increased postoperative inflammatory cytokines, particularly IL-6 and IL-10. Higher PASP (>52 mmHg) predicted prolonged ventilation time (>21 hours), suggesting worsened postoperative outcomes.

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Vasoplegic Syndrome Following Bypass: A Comprehensive Review of Pathophysiology and Proposed Treatments

Vasoplegic syndrome (VS) is a severe circulatory condition occurring post-cardiopulmonary bypass (CPB), affecting up to 44% of high-risk patients with mortality rates reaching 50%. It is characterized by profound hypotension, vasopressor resistance, and vascular collapse. The review explores pathophysiology, risk factors, and treatments, including nitric oxide synthase inhibitors (methylene blue, hydroxocobalamin), vasopressors, and fluid management to mitigate complications and improve survival.

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Risk Factors Influencing the Prognosis of Patients with Acute Myocardial Infarction

Risk Factors Influencing the Prognosis of Patients with Acute Myocardial Infarction and Cardiogenic Shock Undergoing Extracorporeal Membrane Oxygenation Therapy

This study examines risk factors affecting survival in patients with acute myocardial infarction (AMI) and cardiogenic shock (CS) treated with extracorporeal membrane oxygenation (ECMO). Analyzing 63 cases from 2020–2023, findings indicate that elevated arterial blood lactate, prolonged time to PCI, and higher vasoactive-inotropic scores (VIS) are key predictors of poor prognosis. Early intervention, including timely PCI and metabolic stabilization, is crucial to improving survival outcomes.

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The Influence of Cardiopulmonary Bypass Residual Volume Processing Technique on Blood Management in Cardiac Surgical Patients

The Influence of Cardiopulmonary Bypass Residual Volume Processing Technique on Blood Management in Cardiac Surgical Patients

This study examines different techniques for processing post-cardiopulmonary bypass (CPB) residual blood and their impact on intraoperative red blood cell (RBC) transfusions. Analyzing data from over 77,000 adult cardiac surgeries, the study found that using Hemobag (HB) resulted in the lowest transfusion risk, while not processing blood (NO) led to the highest. The findings highlight the importance of effective blood conservation strategies in cardiac surgery.

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