記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1186/s12871-025-03348-9

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Cerebrospinal fluid drainage (CSFD) is recommended during open or endovascular thoracic aortic repair. However, the incidence of CSFD complications is still high. Recently, CSF pressure has been kept high to avoid complications, but the efficacy of CSFD at higher pressures has not been confirmed. We hypothesize that CSFD at higher pressures is effective for preventing motor deficits. METHODS: This prospective observational study included 14 hospitals that are members of the Japanese Society of Cardiovascular Anesthesiologists. Patients who underwent thoracic and thoracoabdominal aortic repair were divided into four groups: Group 1, CSF pressure around 10 mmHg; Group 2, CSF pressure around 15 mmHg; Group 3, CSFD initiated when motor evoked potential amplitudes decreased; and Group 4, no CSFD. We assessed the association between the CSFD group and motor deficits using mixed-effects logistic regression with a random intercept for the institution. RESULTS: Of 1072 patients in the study, 84 patients (open surgery, 51; thoracic endovascular aortic repair, 33) had motor deficits at discharge. Groups 1 and 2 were not associated with motor deficits (Group 1, odds ratio (OR): 1.53, 95% confidence interval (95% CI): 0.71-3.29, p = 0.276; Group 2, OR: 1.73, 95% CI: 0.62-4.82) when compared with Group 4. Group 3 was significantly more prone to motor deficits than Group 4 (OR: 2.56, 95% CI: 1.27-5.17, p = 0.009). CONCLUSION: CSFD is not associated with motor deficits in thoracic and thoracoabdominal aortic repair with CSF pressure around 10 or 15 mmHg.

DOI： 10.1007/s00540-023-03179-3

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The number of elderly patients undergoing elective as well as emergent cardiac surgery is increasing. Octogenarian and older patients undergoing surgery for acute type A aortic dissection (AAD) have a significantly higher risk of postoperative mortality than younger patients. Hemostasis is difficult in octogenarians with AAD. However, few studies have investigated perioperative blood transfusion volumes and hemostatic conditions in patients undergoing AAD surgery. We retrospectively investigated whether these factors differed between octogenarians and younger patients with AAD. METHODS: The records of 207 patients who underwent emergency surgery for AAD were reviewed between 2008 and 2014. We compared the total volumes of transfused blood components (red blood cell concentrate, fresh frozen plasma, platelets concentrate, and cryoprecipitate), perioperative blood coagulation test results (prothrombin time-international normalized ratio, activated partial thrombin time, and activated coagulation time), and intensive care unit and hospital stay durations between octogenarians (n = 33) and patients < 80 years old (n = 170). RESULTS: A significantly greater volume of red blood cell concentrates was transfused in octogenarians than in patients < 80 years old. Isolated prolonged activated partial thromboplastin time was observed in octogenarian patients. Duration of hospital stays was significantly longer in octogenarians than in patients < 80 years old. CONCLUSIONS: Octogenarians required more red blood cells during surgery for AAD and exhibited isolated APTT prolongation.

DOI： 10.1186/s40981-020-00358-z

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: To determine the accuracy and trending ability of the fourth-generation FloTrac/Vigileo in patients with low cardiac index by comparing FloTrac/Vigileo-derived cardiac index with that measured by 3-dimensional echocardiography. DESIGN: Prospective clinical study. SETTING: Cardiac surgery operating room in a single cardiovascular center. PARTICIPANTS: Twenty-five patients undergoing elective cardiac resynchronization therapy lead implantation. INTERVENTIONS: FloTrac/Vigileo-derived cardiac index and 3-dimensional echocardiography-derived cardiac index were determined simultaneously before and after phenylephrine bolus and cardiac resynchronization therapy using 3-dimensional echocardiography-derived cardiac index as the reference method. MEASUREMENTS AND MAIN RESULTS: Cardiac index measured by the fourth-generation FloTrac/Vigileo had a wide limit of agreement with that measured by 3-dimensional echocardiography, with a percentage error of 59.1%. The tracking ability of the unit after both phenylephrine administration and cardiac resynchronization therapy were measured by concordance rate, and both were below the acceptable limit (72.7% and 85%, respectively). CONCLUSIONS: The degree of accuracy of the fourth-generation FloTrac/Vigileo in patients with low cardiac index was not acceptable, and high systemic vascular resistance in patients with low cardiac index may have contributed to this inaccuracy. The tracking ability of the fourth-generation FloTrac/Vigileo after phenylephrine administration or cardiac resynchronization therapy was below acceptable limits.

DOI： 10.1053/j.jvca.2016.06.016

PubMed

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記述言語：日本語   出版者・発行元：克誠堂出版  

CiNii Books

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本心臓血管麻酔学会  

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記述言語：日本語   出版者・発行元：克誠堂出版  

CiNii Books

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