Predictors of low cardiac output syndrome after combined mitral and tricuspid valve surgery.

Introduction: Low cardiac output syndrome (LCOS) is a common complication in cardiac surgery, and we evaluated the incidence of its early occurrence after mitral and tricuspid combined cardiac surgery and its associated risk factors.

Material And Method: Retrospective, single institution study. We included 88 consecutive adult patients with severe mitral insufficiency scheduled for elective mitral and tricuspid valve replacement surgery between January 2015 and November 2018.

Postoperative outcomes after total sevoflurane inhalation sedation using a disposable delivery system (Sedaconda-ACD) in cardiac surgery.

Introduction: The COVID-19 pandemic prompted our team to develop new solutions for performing cardiac surgery without intravenous anesthetics due to a shortage of these drugs. We utilized an anesthetic conserving device (Sedaconda-ACD) to administer total inhaled anesthesia because specific vaporizers were unavailable for administering inhaled agents during cardiopulmonary bypass (CPB) in our center. We documented our experience and postoperative cardiovascular outcomes.

Postoperative Delirium is a Risk Factor of Poor Evolution Three Years After Cardiac Surgery: An Observational Cohort Study.

Background: After cardiac surgery, postoperative delirium (POD) is common and is associated with long-term changes in cognitive function. Impact on health-related quality of life (QOL) and long-term dependence are not well known. This aim of this study is to evaluate the role of POD in poor evolution at three years after surgery including poor QOL and dependence and mortality.

Oxygen challenge test in septic shock patients: prognostic value and influence of respiratory status.

Transcutaneous oxygen pressure (PtcO2) value in response to an increase of FiO2 or oxygen challenge test (OCT) in ventilated patients has been reported to be related to peripheral perfusion and outcome during septic shock. However, patients with sepsis-related acute respiratory distress syndrome could demonstrate compromised arterial oxygenation with OCT impairment decoupled to circulatory failure. The aims of this study were to confirm the prognostic value of OCT and to explore the influence of respiratory status on OCT results.

The 90% effective dose of a sufentanil bolus for the management of painful positioning in intubated patients in the ICU.

Context: Pain and discomfort arising from the routine care of intubated patients in the ICU is managed by continuous infusion of narcotic and sedative drugs. There is benefit in keeping infusion rates low because lightening sedation improves clinical outcome, but this risks breakthrough pain. Management of this discomfort by bolus administration could permit lower background infusion rates, but the lowest effective bolus dose of sufentanil to achieve this is unknown.

Pulse pressure variations adjusted by alveolar driving pressure to assess fluid responsiveness.

Objective: To evaluate the ability of DeltaPP/DeltaP [pulse pressure variations (DeltaPP) adjusted by alveolar pressure variations (DeltaP = Pplat-PEEPtot)] in predicting fluid responsiveness, to compare its accuracy to that of DeltaPP used alone and to evaluate the influence of tidal volume (Vt) on these two indices.

Design: Prospective study.

Setting: A 22-bed general intensive care unit (ICU).

Stroke output variations calculated by esophageal Doppler is a reliable predictor of fluid response.

Objective: Esophageal Doppler allows continuous monitoring of stroke volume index (SVI) and corrected flow time (FTc). We hypothesized that variations in stroke output index SOI (SVI/FTc) during volume expansion can predict the hemodynamic response to subsequent fluid loading better than the static values.

Design And Setting: Prospective study in the intensive care unit of a university hospital.