By Frederick A. Hensley Jr. MD, Glenn P. Gravlee MD, Donald E. Martin MD
The most generally used scientific reference in cardiac anesthesia, this massive instruction manual presents entire info on medicinal drugs, tracking, cardiopulmonary pass, circulatory help, and anesthetic administration of particular cardiac issues. It accommodates clinically proper uncomplicated technology right into a functional ''what-to-do'' technique and is written in an easy-to-read define format.
This variation has a brand new bankruptcy on surgical ventricular recovery, LV aneurysm, and CHF-related surgeries. Chapters offer elevated assurance of postoperative atrial traumatic inflammation prevention and remedy, medicines in perioperative chance relief, and the position of inhalational anesthetics in organ safety through anesthetic preconditioning. This version additionally has a remodeled artwork program.
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Additional info for A Practical Approach to Cardiac Anesthesia
17. Tu JV, Jaglal SB, Naylor D, et al. Multicenter validation of a risk index for mortality, intensive care unit stay, and overall hospital length of stay after cardiac surgery. Circulation 1995;91:677-684. 18. Ouattara A, Niculescu M, Ghazouani S, et al. Predictive performance and variability of the cardiac anesthesia risk evaluation score. Anesthesiology 2004;100:1405-1410. 19. Mark DB, Hlatky MA. Exercise treadmill score for predicting prognosis in coronary artery disease. Ann Intern Med 1987:106:793-800.
13 of silent ischemia . Preoperative electrocardiography should ideally be performed within 24 to 48 hours before the procedure. 7 Cardiac anesthesia risk evaluation (CARE) Risk factor present in three categories Risk score Cardiac disease Systemic medical disease Surgery 1 Stable None Noncomplex 2 Stable Controlled Noncomplex 3 Unstable cardiac disease (and/or) Uncontrolled (or) Complex medical problem surgery* 4 Unstable cardiac disease (and/or) Uncontrolled (and) Complex medical problem surgery* 5 Chronic or advanced cardiac diseaseâ surgery undertaken as last hope E Emergency: surgery undertaken as soon as diagnosis made and facilities available * Complex surgery: examples include reoperation, multiple valve or combined valve/CABG surgery, LV aneurysmectomy, CABG of diffuse or calcified disease.
DSE has indications similar to pharmacologic perfusion imaging with comparable sensitivity, but possibly increased specificity. Preoperative dipyridamole thallium perfusion imaging, radionuclide ventriculography, ambulatory EKG, and DSE are all able to predict adverse outcomes in with the relative risk for DSE likely to be slightly, but not significantly, greater than the other studies. For patients with poor acoustic windows due to body habitus or severe lung disease, myocardial contrast agents are now available to improve imaging.