Key Points 1. Pulmonary complications following cardiopulmonary bypass (CPB) are relatively common with up to 12% of patients experiencing some degree of acute lung injury and approximately 1% requiring tracheostomy for long-term ventilation. 2. Patients with preexisting chronic obstructive lung…
Key Points 1. Point-of-care ultrasound performed in the critical care setting is a valuable tool for augmenting traditional methods of clinical evaluation. 2. Key components of this examination include portable ultrasound imaging with “real-time” interpretation at the bedside in a…
Key Points 1. Despite a progressive decrease in cardiac surgical mortality, the incidence of postoperative neurologic complications has remained relatively unchanged over the decades. During this same interval, the age and the extent of comorbidities in cardiac surgical patients have…
Key Points 1. Inadequate postoperative analgesia and/or an uninhibited perioperative surgical stress response has the potential to initiate pathophysiologic changes in all major organ systems, including the cardiovascular, pulmonary, gastrointestinal, renal, endocrine, immunologic, and/or central nervous systems, all of which…
Key Points 1. Enhanced recovery is a multidisciplinary approach to quality improvement that spans all phases of surgical care. 2. The patient’s experience, health-related outcomes, and functional recovery are optimized through the standardized application of perioperative care bundles consisting of…
Key Points 1. Clinical hemostasis reflects an integrated interplay between the coagulation system, the fibrinolytic system, platelets, and the vascular endothelium. 2. The coagulation cascade has four main components, namely the contact activation, the extrinsic, the intrinsic, and the common…
Key Points 1. Extracorporeal membrane oxygenation (ECMO) continues to experience a profound expansion as therapy for acute cardiopulmonary failure. 2. Advancements in equipment and improvements in techniques and management have led to improved outcomes for patients undergoing ECMO. 3. Venoarterial…
Key Points 1. The key to successful weaning from cardiopulmonary bypass (CPB) is proper preparation and close communication between the surgeon, anesthesiologist, and perfusionist. A checklist may be useful. 2. After rewarming the patient, correcting any abnormal blood gases, and…
Key Points 1. All anesthesiologists who care for patients undergoing cardiopulmonary bypass (CPB) should be intimately familiar with the details and function of the extracorporeal circuit (ECC) or “heart-lung machine,” and be involved in the establishment of protocols and the…
Key Points 1. Arrhythmias with triggered mechanisms are often initiated from repetitive depolarizations that occur after membrane repolarization. 2. Atrioventricular reciprocating tachycardia requires an accessory pathway to initiate and maintain the supraventricular arrhythmia. 3. Catheter-based ablation is a reasonable therapeutic…