Evaluation of right ventricular function during liver transplantation with transesophageal echocardiography.

Background: The pathophysiology of advanced liver cirrhosis may induce alterations in the circulatory system that may be challenging for the anesthesiologist to manage intraoperatively, and perioperative cardiovascular events are associated with worse outcomes in cirrhotic patients undergoing liver transplantation. It remains controversial whether right ventricular function is impaired during this procedure. Studies using transesophageal echocardiography for quantitative analysis of the right ventricle remain scarce in this setting, yielding conflicting results.

[Delayed trigeminocardiac reflex after maxillofacial surgery: case report].

Background: Trigeminocardiac reflex is a physiological phenomenon that may occur in head and neck surgery, and is usually benign. However, it may present with exaggerated responses with severe morbidity.

Case Report: Male patient, 26 years old, candidate for surgical treatment of zygomatic-orbital complex fracture.

[Negative pressure pulmonary edema: report of case series and review of the literature].

Background And Objectives: Negative pressure pulmonary edema occurs by increased intrathoracic negative pressure following inspiration against obstructed upper airway. The pressure generated is transmitted to the pulmonary capillaries and exceeds the pressure of hydrostatic equilibrium, causing fluid extravasation into the pulmonary parenchyma and alveoli. In anesthesiology, common situations such as laryngospasm and upper airway obstruction can trigger this complication, which presents considerable morbidity and requires immediate diagnosis and propaedeutics.

[Transesophageal echocardiography in perioperative period guiding the decision making during hemodynamic instability due to atrial fibrillation].

Background And Objective: Atrial fibrillation is the most common cardiac arrhythmia, which may occur during the perioperative period and lead to hemodynamic instability due to loss of atrial systolic function. During atrial fibrillation management, electrical cardioversion is one of the therapeutic options in the presence of hemodynamic instability; however, it exposes the patient to thromboembolic event risks. Transesophageal echocardiography is a diagnostic tool for thrombi in the left atrium and left atrial appendage with high sensitivity and specificity, allowing early and safe cardioversion.

[Consensus on Perioperative Transesophageal Echocardiography of the Brazilian Society of Anesthesiology and the Department of Cardiovascular Image of the Brazilian Society of Cardiology].

Through the Life Cycle of Intraoperative Transesophageal Echocardiography (ETTI/SBA) the Brazilian Society of Anesthesiology, together with the Department of Cardiovascular Image of the Brazilian Society of Cardiology (DIC/SBC), created a task force to standardize the use of intraoperative transesophageal echocardiography by Brazilian anesthesiologists and echocardiographers based on scientific evidence from the Society of Cardiovascular Anesthesiologists/American Society of Echocardiography (SCA/ASE) and the Brazilian Society of Cardiology.

[Intraoperative echocardiography guidelines in Brazil - Is it time for a task force?].

Background And Objectives: The Brazilian Society of Anesthesiology (SBA) has been promoting continuing education in intraoperative echocardiography in Brazil since 2011, with the implementation of an Intraoperative Echocardiography Course (ETI/SBA). Although echocardiography is a reality of anesthesiology practice in Brazil, we still do not have an established policy on the area of expertise, job training, and recognition by the other societies, such as the Brazilian Society of Cardiology (SBC). The aim of this paper is to contextualize the anesthesiology in the intraoperative echocardiography in Brazil and promote a discussion on the formation of a Task Force along with the SBC to begin drawing up the Brazilian Guidelines on Intraoperative Echocardiography.

Evaluation of the influence of pulmonary hypertension in ultra-fast-track anesthesia technique in adult patients undergoing cardiac surgery.

Objective: To evaluate the influence of pulmonary hypertension in the ultra-fast-track anesthesia technique in adult cardiac surgery.

Methods: A retrospective study. They were included 40 patients divided into two groups: GI (without pulmonary hypertension) and GII (with pulmonary hypertension).

A Randomized Blinded Study of the Left Ventricular Myocardial Performance Index Comparing Epinephrine to Levosimendan following Cardiopulmonary Bypass.

Background: The objective was to evaluate the effect of epinephrine and levosimendan on the left ventricle myocardial performance index in patients undergoing on-pump coronary artery by-pass grafting (CABG).

Methods: In a double-blind, randomized clinical trial, 81 patients (age: 45-65 years) of both genders were randomly divided to receive either epinephrine at a dosage of 0.06 mcg.

Impact of intraoperative transesophageal echocardiography in mortality in coronary artery bypass grafting.

Objective: To evaluate the rates of mortality and morbidity in patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) using routine intraoperative transesophageal echocardiography (ITEE).

Methods: We conducted a retrospective, observational review of medical records of 360 patients from April 2010 to April 2012. We analyzed: age, weight, height, gender, EuroSCORE, diabetes mellitus, ejection fraction and number of diseased vessels.

Assessment of pain and hemodynamic response in older children undergoing circumcision: comparison of eutectic lidocaine/prilocaine cream and dorsal penile nerve block.

Objective: To evaluate whether dorsal penile nerve block (DPNB) or local topical anesthesia (LT) provided better postoperative analgesia and less hemodynamic stimulation during and after circumcision surgery with Plastibell in older children.

Methods: Forty-one subjects (age: 2-13 years) undergoing circumcision with Plastibell were randomly divided into LT and DPNB groups. Inhalation induction was performed with an 8% end-tidal sevoflurane concentration.

The importance of transesophageal echocardiography in heart harvesting for cardiac transplantation.

Background And Objectives: The use of transesophageal echocardiography (TEE) during heart harvesting for transplantation can guide the heart assessment, as harvesting a marginal heart can jeopardize the cardiac transplantation.

Case Report: Male, 30 years old, suffered a car crash that resulted in a severe traumatic brain injury (TBI) that evolved to brain death. The patient was intubated and ventilated with a fraction of inspired oxygen of 0.

Comparison between the hemodynamic parameters of rigid laryngoscopy and lighted stylet in patients with coronariopathies.

Background And Objectives: Anesthesiologists are responsible for airway management whenever they assume the anesthesia of a patient. In this study, we compare the hemodynamic parameters of rigid laryngoscopy and lighted stylet in patients with coronariopathies.

Patients And Methods: This randomized clinical trial included 40 patients undergoing myocardial revascularization assigned into two groups: lighted stylet and rigid laryngoscope.

[Transesophageal echocardiography in Ross procedure].

Background And Objectives: Ross procedure is one of the surgical procedures for correction of severe congenital aortic insufficiency. Intraoperative transesophageal echocardiography is essential for optimal surgical evaluation. Furthermore, it is able to assess the blood volume profile and the need for administration of vasoactive drugs during surgery.