Complete Aortomitral Curtain Dehiscence Resulting in Large Pseudoaneurysm 6 Weeks After Aortic Root Replacement.

This case report presents a unique challenge of complete aortomitral curtain dehiscence and a large pseudoaneurysm 6 weeks post-aortic root replacement in a patient with infective endocarditis. It underscores the importance of meticulous follow-up in patients who have undergone complex aortic surgeries, especially those with infective endocarditis. The patient's subtle symptoms of occasional dyspnea and lightheadedness highlight the necessity for a comprehensive evaluation and a high index of suspicion.

Dynamic Estimation of Cardiovascular State From Arterial Blood Pressure Recordings.

Real-time estimation of patient cardiovascular states, including cardiac output and systemic vascular resistance, is necessary for personalized hemodynamic monitoring and management. Highly invasive measurements enable reliable estimation of these states but increase patient risk. Prior methods using minimally invasive measurements reduce patient risk but have produced unreliable estimates limited due to trade-offs in accuracy and time resolution.

Daytime dexmedetomidine sedation with closed-loop acoustic stimulation alters slow wave sleep homeostasis in healthy adults.

Background: The alpha-2 adrenergic agonist dexmedetomidine induces EEG patterns resembling those of non-rapid eye movement (NREM) sleep. Fulfilment of slow wave sleep (SWS) homeostatic needs would address the assumption that dexmedetomidine induces functional biomimetic sleep states.

Methods: In-home sleep EEG recordings were obtained from 13 healthy participants before and after dexmedetomidine sedation.

Recovery From Acute Respiratory Distress Syndrome Is Associated With Increasing Alpha Power in the Frontal Electroencephalogram During Propofol Sedation: A Case Report.

The effects of critical illness on electroencephalographic (EEG) signatures of sedatives have not been described, limiting the use of EEG-guided sedation in the intensive care unit (ICU). We report the case of a 36-year-old man recovering from acute respiratory distress syndrome (ARDS). Severe ARDS was characterized by slow-delta (0.

Passive functional mapping of receptive language cortex during general anesthesia using electrocorticography.

Objective: To investigate the feasibility of passive functional mapping in the receptive language cortex during general anesthesia using electrocorticographic (ECoG) signals.

Methods: We used subdurally placed ECoG grids to record cortical responses to speech stimuli during awake and anesthesia conditions. We identified the cortical areas with significant responses to the stimuli using the spectro-temporal consistency of the brain signal in the broadband gamma (BBG) frequency band (70-170 Hz).

Postoperative Delirium Severity and Recovery Correlate With Electroencephalogram Spectral Features.

Background: Delirium is an acute syndrome characterized by inattention, disorganized thinking, and an altered level of consciousness. A reliable biomarker for tracking delirium does not exist, but oscillations in the electroencephalogram (EEG) could address this need. We evaluated whether the frequencies of EEG oscillations are associated with delirium onset, severity, and recovery in the postoperative period.

Quiescence during burst suppression and postictal generalized EEG suppression are distinct patterns of activity.

Objective: Periods of low-amplitude electroencephalographic (EEG) signal (quiescence) are present during both anesthetic-induced burst suppression (BS) and postictal generalized electroencephalographic suppression (PGES). PGES following generalized seizures induced by electroconvulsive therapy (ECT) has been previously linked to antidepressant response. The commonality of quiescence during both BS and PGES motivated trials to recapitulate the antidepressant effects of ECT using high doses of anesthetics.

Perioperative Glycemia Management in Patients Undergoing Craniotomy for Brain Tumor Resection: A Global Survey of Neuroanesthesiologists' Perceptions and Practices.

Objective: There is a paucity of clinical evidence that guides perioperative glycemia management in patients undergoing craniotomy for brain tumor resection. The purpose of this study was to better understand global perceptions and practices related to glycemia management in these patients.

Methods: Neuroanesthesiologists throughout North America, South America, Europe, and Asia filled out a brief online questionnaire related to their perceptions and practices regarding glycemia management in patients undergoing craniotomy for brain tumor resection.

Evaluation of automated microvascular flow analysis software AVA 4: a validation study.

Background: Real-time automated analysis of videos of the microvasculature is an essential step in the development of research protocols and clinical algorithms that incorporate point-of-care microvascular analysis. In response to the call for validation studies of available automated analysis software by the European Society of Intensive Care Medicine, and building on a previous validation study in sheep, we report the first human validation study of AVA 4.

Methods: Two retrospective perioperative datasets of human microcirculation videos (P1 and P2) and one prospective healthy volunteer dataset (V1) were used in this validation study.

Closed-Loop Acoustic Stimulation During Sedation with Dexmedetomidine (CLASS-D): Protocol for a Within-Subject, Crossover, Controlled, Interventional Trial with Healthy Volunteers.

Introduction: The relative power of slow-delta oscillations in the electroencephalogram (EEG), termed slow-wave activity (SWA), correlates with level of unconsciousness. Acoustic enhancement of SWA has been reported for sleep states, but it remains unknown if pharmacologically induced SWA can be enhanced using sound. Dexmedetomidine is a sedative whose EEG oscillations resemble those of natural sleep.

Postictal generalized electroencephalographic suppression following electroconvulsive therapy: Temporal characteristics and impact of anesthetic regimen.

Objective: Postictal generalized electroencephalographic suppression (PGES) has been defined as electroencephalographic (EEG) activity of less than 10 microvolts following a generalized seizure. PGES is associated with an increased risk of sudden unexplained death in epilepsy, as well as treatment efficacy of electroconvulsive therapy (ECT). We investigated the impact of anesthetic on PGES expression and temporal characteristics.

Protocol for the Prognosticating Delirium Recovery Outcomes Using Wakefulness and Sleep Electroencephalography (P-DROWS-E) study: a prospective observational study of delirium in elderly cardiac surgical patients.

Introduction: Delirium is a potentially preventable disorder characterised by acute disturbances in attention and cognition with fluctuating severity. Postoperative delirium is associated with prolonged intensive care unit and hospital stay, cognitive decline and mortality. The development of biomarkers for tracking delirium could potentially aid in the early detection, mitigation and assessment of response to interventions.

Head Motion Predicts Transient Loss of Consciousness in Human Head Trauma: A Case-Control Study of Mixed Martial Artists.

Objective: Concussion with transient loss of consciousness is a commonly observed but poorly understood phenomenon with mounting clinical significance. This study aimed to examine the relationship between head motion in varying planes and transient loss of consciousness in athletes with brain injuries.

Study Design: A case-control design was used.

Handgrip dynamometry for continuous assessment of volitional control during induction of anesthesia: a prospective observational study.

Purpose: Response to commands is the gold standard to assess the level of consciousness during anesthesia induction but it only provides an intermittent, binary measure with low temporal resolution. To overcome these limitations, we combined the object hold method with handgrip dynamometry to continuously record the force applied to hold a dynamometer as a surrogate measure of the level of consciousness during induction of anesthesia.

Methods: Fourteen patients scheduled for elective lumbar surgery and 14 age-matched non-anesthetized controls were enrolled.

Prognostic value of PET using 18F-FDG in Hodgkin's disease for posttreatment evaluation.

Unlabelled: Detection of relapse after completion of therapy in patients with Hodgkin's disease (HD) and non-Hodgkin's lymphomas (NHL) constitutes an important challenge in modern medical imaging. An accurate assessment of the presence of residual disease is essential to determine which patients would benefit from additional therapy. The objective of this study was to assess the diagnostic accuracy of (18)F-FDG PET in detecting residual disease or relapse during the posttherapy period in patients with HD in comparison with CT.