Activation of complement factor B contributes to murine and human myocardial ischemia/reperfusion injury.

The pathophysiology of myocardial injury that results from cardiac ischemia and reperfusion (I/R) is incompletely understood. Experimental evidence from murine models indicates that innate immune mechanisms including complement activation via the classical and lectin pathways are crucial. Whether factor B (fB), a component of the alternative complement pathway required for amplification of complement cascade activation, participates in the pathophysiology of myocardial I/R injury has not been addressed.

Risk assessment and outcomes of vasoplegia after cardiac surgery.

Objective: The aim of this study was to analyze risk factors and outcomes of vasoplegia after cardiac surgery based on our experience with almost 2000 cardiac operations performed at our institution.

Methods: We retrospectively analyzed patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) between 2011 and 2013. Data were available for a total of 1992 patients.

Utility of ultrasound in the ICU.

Purpose Of Review: Use of ultrasound in the acute care setting has become more common in recent years. However, it still remains underutilized in the perioperative management of critical patients. In this review, we aim to increase the awareness of ultrasound as an important diagnostic modality that can be used in the perioperative period to improve patient care.

Mechanisms contributing to low orthostatic tolerance in women: the influence of oestradiol.

The impact of 17β-oestradiol (E2) exposure on autonomic control of orthostasis in young women is unclear. We tested the hypothesis that autonomic cardiovascular regulation is more sensitive to E2 exposure in women with low orthostatic tolerance. Women underwent an initial maximal lower body negative pressure (LBNP) test to place them into a low (LT, n = 7, 22 ± 1 years old, body mass index 22 ± 1 kg m(-2)) or a high orthostatic tolerance group (HT, n = 7, 22 ± 1 years old, body mass index 24 ± 1 kg m(-2)).

The anesthesia patient with acute coronary syndrome.

This article reviews the current state of knowledge of the pathophysiology, diagnosis, and treatment of acute coronary syndrome outside and during the perioperative period. It highlights some aspects of relevance for the anesthesiologist caring for these patients. Perioperative modalities for the management of patients suffering from this syndrome, the major guidelines and the evidence behind them, and possible avenues for future research is explored.

Prophylactic amiodarone versus lidocaine for prevention of reperfusion ventricular fibrillation after release of aortic cross-clamp.

Background And Objective: Ventricular fibrillation is common after aortic cross-clamp release in patients undergoing open-heart surgeries. The aim of the study was to evaluate the efficacy of the prophylactic administration of 150 mg amiodarone by way of the pump 2 min before release of aortic cross-clamp in preventing ventricular fibrillation.

Methods: The present study is a prospective, randomized, controlled and blinded study performed at a teaching university hospital where 120 patients undergoing coronary bypass graft surgery were randomly assigned to three groups.

The relationship between the photoplethysmographic waveform and systemic vascular resistance.

Objective: The objective of this study was to determine the relationship between systemic vascular resistance (SVR), finger & ear photoplethysmographic measurements in 14 adult patients undergoing coronary artery bypass grafting (CABG).

Methods: Patients were monitored with photoplethysmographs of the finger and ear and continuous cardiac output (QT) via thermodilution catheter. The relationship between SVR, finger plethysmographic amplitude, width and ear plethysmographic amplitude, width was assessed with linear regression.

Valvular heart diseases.

Patients who have valvular heart disease coming for surgery present many challenges to the anesthesiologist. Over the past 3 decades there has been a persistent improvement in our understanding of the pathophysiology of valvular heart disease and in the surgical techniques for correcting it. With the development of efficient and safe noninvasive monitoring of cardiac function, new surgical techniques, better designs of prosthetic valves, and the development of useful guidelines for choosing the proper timing of surgical intervention, patients who have valvular disease with varying physiology can be encountered in the perioperative period.