Anesthetic Management in the Precardiopulmonary Bypass Period
KEY POINTS 1. The incidence of ischemia during this period has been reported to be 7% to 56%. 2. The Society of Thoracic Surgeons recommends a cephalosporin as the primary…
Devices for Cardiac Support and Replacement
KEY POINTS 1. Mechanical circulatory support devices most often are ventricular assist devices, which are indicated for bridging to myocardial recovery or cardiac transplantation or as a permanent assist device…
Anesthetic Management during Cardiopulmonary Bypass
KEY POINTS 1. Prior to cannulation for cardiopulmonary bypass (CPB), the anesthesiologist must assure that adequate heparin-induced anticoagulation has been achieved, which is typically diagnosed as an activated clotting time…
Cardiovascular Physiology: A Primer
KEY POINTS 1. The heart has a fibrous skeleton that provides an insertion site at each valvular ring. This fibrous structure also connects cardiac myocytes so that “stretch” or preload…
Pain Management for Cardiothoracic Procedures
KEY POINTS 1. Chronic pain due to intercostal nerve injury develops in approximately 50% of postthoracotomy patients, and in 5% this pain becomes severe and disabling. 2. Thoracic epidural analgesia…
The Postcardiopulmonary Bypass Period: Weaning to ICU Transport
KEY POINTS 1. Core temperature (nasopharyngeal or tympanic membrane) should be greater than 36°C before terminating cardiopulmonary bypass (CPB). However, the nasopharyngeal temperature should not exceed 37°C, as this will…
Induction of Anesthesia
KEY POINTS 1. On the day of surgery, most cardiovascular medications should be administered orally, with the exceptions of angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, and (selectively) diuretic agents….
Regional Anesthesia
1. Large prospective studies indicate that regional anesthetics have a high degree of safety and efficacy in pediatric patients, and can be used for intraoperative anesthesia, postoperative analgesia, and for a…
The Head and Neck: Specialty and Multidisciplinary Surgery
1. The shaping of the skull base and contiguous structures is a dynamic process involving reciprocal influences between the cranial base, the pharynx, the face, and primary and secondary palates. 2. Multiple…
The Cardiovascular System
1. Much of our understanding of cardiac development is derived from research in nonhuman species with the expectation that the same processes occur in humans. 2. The etiology of congenital heart disease…
