Dr. Ross Hanson and Dr. Andi Chatburn discuss the ethical and legal implications of changes to traditional standards of care during the COVID-19 pandemic.

SAGE Cardiology and Cardiovascular Medicine

SCVA COVID-19 Podcast Part 2

Dr. Ross Hanson and Dr. Stephanie Jones discuss integration of anesthesiology into the critical care and hospital response to the COVID-19 pandemic.

SCVA COVID-19 Podcast Part 1

The 3-factor prothrombin complex concentrate (3FPCC) may be used off-label to treat refractory bleeding during cardiac surgery in children. This retrospective study examined the rate of clinical complications following the use of 3FPCC. Patients treated with 3FPCC were matched to controls for age, gender, prematurity, weight, cardiopulmonary bypass times, and cross-clamp times. Fifty-nine cases were individually matched to 59 controls based on propensity scores. 3FPCC was not associated with an increased risk of thromboembolic events, mortality, or need for postoperative extracorporeal membrane oxygenator support. These results suggest the safety of 3FPCC when used for refractory bleeding after cardiopulmonary bypass in children undergoing congenital heart surgery.   To view the article, click here.

SCVA March 2020 Podcast: A Retrospective Analysis of the Use of 3-Factor Prothrombin Complex Concentrates for Refractory Bleeding After Cardiopulmonary Bypass in Children Undergoing Heart Surgery: A Matched Case-Control Study

SCVA Editorial Board member and Director of Pediatric Cardiothoracic Anesthesiology, Dr. Gregory Latham, discusses the importance of meeting abstracts and highlights a few abstracts from the CCAS 2019 annual meeting, while providing an overview of the remaining abstracts.

SCVA July 2019 Podcast: Congenital Cardiac Anesthesia Society Meeting Abstracts

In this article, the authors present the annual review of the literature relevant for the practice of cardiovascular critical care. This is not an exhaustive review of the year, but rather selected highlights to summarize contributions to the literature since our last review. The topics covered this year include advances in the reversal of anticoagulants, introduction of a new class of vasopressor, innovative measures of acute kidney injury risk and presence after cardiac surgery, use of bicarbonate in severe acidosis, and finally, new information regarding the ongoing drug shortage issue. To view the article, click here.

SCVA June 2019 Podcast: Noteworthy Literature in 2018 for Cardiovascular Anesthesiologists and Intensivists

The anesthesia community has openly debated if the care of transplant patients was generalist or specialist care ever since the publication of an opinion paper in 1999 recommended subspecialty training in the field of liver transplantation anesthesia. In the past decade, liver transplant anesthesia has become more complex with a sicker patient population and evolving evidence-based practices. Transplant training is currently not required for accreditation or certification in anesthesiology, and not all anesthesia residency programs are associated with transplant centers. Yet there is evidence that patient outcome is affected by the experience of the anesthesiologist with liver transplants as part of a multidisciplinary care team. Requests for a formal review of the inequities in training opportunities and requirements led the Society for the Advancement for Transplant Anesthesia (SATA) to begin the task of developing post-graduate fellowship training recommendations. In this article, members of the SATA Working Group on Transplant Anesthesia Education present their reasoning for specialized education and conclusions about which pathways can better prepare trainees to care for complex transplant patients.   To view the article, click here. 

SCVA April 2018 Podcast: Society for the Advancement of Transplant Anesthesia: Liver Transplant Anesthesia Fellowship—White Paper Advocating Measurable Proficiency in Transplant Specialties Training

Anesthesia providers are frequently exposed to radiation during routine patient care in the operating room and remote anesthetizing locations. Eighty-two percent of anesthesiology residents (n = 57 responders) at our institution had a “high” or “very high” concern about the level of ionizing radiation exposure, and 94% indicated interest in educational materials about radiation safety. This article highlights key learning points related to basic physical principles, effects of ionizing radiation, radiation exposure measurement, occupational dose limits, considerations during pregnancy, sources of exposure, factors affecting occupational exposure such as positioning and shielding, and monitoring. Continued education and awareness of the risks of ionizing radiation and protective strategies will reduce exposure and potential for associated sequelae.   To view the article, click here.

SCVA June 2017 Podcast: Occupational Radiation Exposure of Anesthesia Providers

More than 3000 peer-reviewed publications on the topic of liver transplantation were published in 2016. The goal of this article is to provide a concise review of pertinent literature for anesthesiologists who participate in liver transplantation. The authors selected and presented 33 articles published in 2016 on the topics of MELD policy; cardiovascular, pulmonary, and renal issues; coagulation and transfusion; anesthetic agents; hemodynamic monitors; acute liver failure; and donor issues.   To view the article, click here.

SCVA March 2017 Podcast: Noteworthy Literature Published in 2016 for Abdominal Organ Transplantation Anesthesiologists: Liver

Nathaen Weitzel, one of the Editors-in-Chief of SCVA, talks to Ernesto Pretto of The Society for the Advancement of Transplant Anesthesia (SATA). They discuss transplant anesthesia and highlight how Seminars in Cardiothoracic and Vascular Anesthesia will now serve as the official home journal for SATA.   To view the SATA Editorial in the March 2017 issue of SCVA, click here.

Transplant Anesthesia: Where We've Been, Where We're Going

Due to familiarity, short half-life, ease of monitoring, and the availability of a reversal agent, heparin remains the anticoagulant of choice for cardiac operations requiring cardiopulmonary bypass (CPB). However, occasionally patients require CPB but should not receive heparin, most often because of acute or subacute heparin-induced thrombocytopenia (HIT). In these cases, if it is not feasible to wait for the disappearance of HIT antibodies, an alternative anticoagulant must be selected. A number of non-heparin anticoagulant options have been explored. However, current recommendations suggest the use of a direct thrombin inhibitor such as bivalirudin. This review describes the use of heparin alternatives for the conduct of CPB with a focus on the direct thrombin inhibitors.   To view the article, click here.

SCVA March 2016 Podcast: Cardiopulmonary Bypass Without Heparin

The postoperative course of a patient undergoing cardiac surgery (CS) is dictated by a largely predictable set of interactions between disease-specific and therapeutic factors. ICU personnel need to quickly develop a detailed understanding of the patient’s current status and how critical care resources can be used to promote further recovery and eventual independence from external support. The goal of this article is to describe a typical operative and postoperative course, with emphasis on the latter, and the diagnostic and therapeutic options necessary for the proper care of these patients. This paper will focus on coronary artery bypass grafting as a model for understanding the course of CS patients; however, many of the principles discussed are applicable to most cardiac surgery patients.   To view the article, click here.

SCVA June 2015 Podcast: Routine Postoperative Care of Patients Undergoing Coronary Artery Bypass Grafting on Cardiopulmonary Bypass

Chronic thromboembolic pulmonary hypertension (CTEPH) results from recurrent or incomplete resolution of pulmonary embolism. CTEPH is much more common than generally appreciated. Although pulmonary embolism (PE) affects a large number of Americans, chronic pulmonary thromboembolic hypertension remains underdiagnosed. It is imperative that all patients with pulmonary hypertension (PH) be screened for the presence of CTEPH since this form of PH is potentially curable with pulmonary endarterectomy (PEA) surgery. The success of this procedure depends greatly on the collaboration of a multidisciplinary team approach that includes pulmonary medicine, cardiothoracic surgery, and cardiac anesthesiology. This review, based on the experience of more than 3000 pulmonary endarterectomy surgeries, is divided into 2 parts. Part I focuses on the clinical history and pathophysiology, diagnostic workup, and intraoperative echocardiography. Part II focuses on the surgical approach, anesthetic management, postoperative care, and complications.   To view the article, click here.

SCVA December 2014 Podcast: Pulmonary Endarterectomy Part I. Pathophysiology, Clinical Manifestations, and Diagnostic Evaluation of Chronic Thromboembolic Pulmonary Hypertension & Part II. Operation, Anesthetic Management, and Postoperative Care

The September 2013 Podcast discusses the key management points relating to delirium in the perioperative period.  Dr. Michael Wall is an leading expert in anesthesiology and intensive care, who authored the article "Delirium: past present and future."  This podcast interview discusses the etiology of perioperative delirium, as well as management tips, screening tools, and considerations for the anesthesiologist and intensivist.  This podcast is an excellent complement to the article.     To view the article, click here.

SCVA September 2013 Podcast: Delirium: Past, Present, and Future

The December 2013 Podcast discusses perioperative considerations for right heart failure in the setting of LVAD implantation. Dr. Ambardekar is a cardiologist specializing in management of heart failure, and provides a unique perspective on this subject. The podcast discusses the pathophysiology of right heart failure, predictive test modalities for right hear failure at LVAD implantation, as well as postoperative considerations in this population. The discussion is an excellent complement to the article and is highly recommended.     To view the article, click here.

SCVA December 2013 Podcast: Preoperative Evaluation and Perioperative Management of Right Ventricular Failure After Left Ventricular Assist Device Implantation

Perioperative fluid management is of significant importance during pulmonary resection surgery and esophagectomy. Excessive fluid administration has been consistently shown as a risk factor for lung injury after thoracic procedures. Probable causes of this serious complication include fluid overload, lung lymphatics and pulmonary endothelial damage. Along with new insights regarding the Starling equation and the absence of a third space, current evidence supports a restrictive fluid regimen for patients undergoing pulmonary resection surgery and esophagectomy. Multiple minimally invasive hemodyamic monitoring devices, including pulse pressure/stroke volume variation, esophageal Doppler, and extravascular lung water measurement, were evaluated for optimizing perioperative fluid therapy. Further research regarding the prevention, diagnosis, and treatment of acute lung injury after pulmonary resection and esophagectomy is required.     To view the article, click here.

SCVA March 2014 Podcast 2: Perioperative Fluid Management for Pulmonary Resection Surgery and Esophagectomy

Welcome to the official free Podcast from SAGE for Cardiology & Cardiovascular Medicine. SAGE is a leading international publisher of journals, books, and electronic media for academic, educational, and professional markets with principal offices in Los Angeles, London, New Delhi, and Singapore.

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SAGE Cardiology and Cardiovascular Medicine

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