The role of anesthesiology in modern cardiac surgery: overview of key techniques and issues

Автор: Novikova A.I., Lyubushkin V.E., Studenikina A.V., Albotova D.K., Torchinova D.A., Chkareuli D.N., Kazakova M.S., Sevriugina E.A., Pyrchenkova A.S., Bakhmeteva P.I.

Журнал: Cardiometry @cardiometry

Рубрика: Original research

Статья в выпуске: 31, 2024 года.

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Anesthesiology plays a key role in modern cardiac surgery, ensuring the safe conduct of surgical interventions on the heart and blood vessels. The paper provides an overview of the main techniques and problems in the field of anesthesiology in cardiac surgery. The first section is devoted to the basic methods of anesthesiological provision of cardiac surgery. He describes the various types of anesthesia used in cardiac surgery, including general anesthesia, epidural and spinal anesthesia, as well as combined methods. The advantages and disadvantages of each of them are considered, as well as the specifics of their application, depending on the type of operation and the patient’s condition. The second section examines the key problems faced by anesthesiologists in cardiac surgery. This includes managing hemodynamic parameters during surgery, monitoring heart and respiratory function, ensuring adequate analgesia, and preventing possible complications such as myocardial ischemia, arrhythmias, hypothermia, and thromboembolic events. Special attention is paid to solving problems related to patients with concomitant diseases such as hypertension, diabetes mellitus, chronic obstructive pulmonary disease, etc. The article discusses the features of the use of cardiothoracic anesthesia in cardiac surgery, as well as emerging problems and prospects in this area. An overview of the use of anesthesia in the field of cardiac surgery is presented, both current challenges and problems in this area are highlighted. The current state of anesthesia in cardiac surgery is analyzed and a number of problems faced by anesthesiologists during cardiac surgery, including problems of cardiothoracic anesthesia, are highlighted. This includes difficulties with controlling the depth of anesthesia, ensuring safety while maintaining artificial circulation, managing fluid balance, and monitoring cardiac function during surgery. The article reveals the relevance and importance of the work of anesthesiologists in cardiac surgery and the problems they face, as well as reveals the prospects for the development of anesthesia in cardiac surgery. This work will help anesthesiologists and cardiac surgeons better understand the specifics of anesthesiological care in cardiac surgery and effectively solve emerging problems, ensuring maximum safety and comfort for patients.

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Anesthesiology, cardiac surgery, modern techniques, cardiothoracic anesthesia, problems of anesthesia in surgery, safety of anesthesia, treatment of cardiovascular diseases, problems of anesthesia in cardiac surgery

Короткий адрес: https://sciup.org/148328843

IDR: 148328843   |   DOI: 10.18137/cardiometry.2024.31.145150

Список литературы The role of anesthesiology in modern cardiac surgery: overview of key techniques and issues

  • Pisano A, et al. Effect of anesthesia regimen on outcomes of cardiac surgery in adults: a narrative review. J Cardiothorac Vask Anest. 2021;35:711–29.
  • Szabo K, et al. PRO: The pulmonary artery catheter plays a paramount role in modern clinical practice. Anne Card, anesthesiologist. 2021;24:4–7.
  • Rong LK, et al. Cardiac output obtained by two- or three-dimensional echocardiography cannot replace a catheter pulmonary artery in cardiac surgery. J Cardiothorac Vask Anest. 2020;34:2691-7.
  • Scandroglio AM, et al. Cardiac surgery in 260 octogenarians: a case series. BMK Anesthesiol. 2015;15:15.
  • Pieri M, et al. Outcome of cardiac surgery in patients with low preoperative ejection fraction. BMK Anesthesiol. 2016;16:97.
  • Dreyfus G, Windecker S. How to shape the future of cardiology and cardiac surgery? Eur Heart J. 2020; 41:3693–701.
  • Pisano A., et al, editors. Cardiopulmonary bypass: advances in extracorporeal life support. Cambridge, MA: Academic Press (2023). pp. 237–58.
  • Capasso A, Masserini F, Pisano A. Leukocyte depletion of transfused blood may reduce mortality in cardiac surgery patients. In: Landoni G, Ruggeri L, Zangrillo A, editors. Reduced mortality in the perioperative period. Cham: Springer. 2017, p. 63–71.
  • De Hert S, et al. Use and safety of aprotinin in routine clinical practice: a European post-marketing safety study in patients undergoing cardiac surgery. Eur J Anesthesiol. 2022;39:685–94.
  • Landoni G, et al. Volatile anesthetics compared with total intravenous anesthesia in cardiac surgery. N Engl J Med. 2019;380:1214-25.
  • O’Gara B, et al. Anesthetics to prevent lung injury in cardiac surgery (APLICS): protocol for a randomized controlled trial. Tests. 2019;20:312.
  • Mehta RH, et al. Levosimendan in patients with left ventricular dysfunction undergoing cardiac surgery. N Engl J Med. 2017;376:2032-42.
  • Landoni G, et al. Levosimendan for hemodynamic support after cardiac surgery. N Engl J Med. 2017; 376:2021-31.
  • Heringlake M, et al. Update on levosimendan in emergency cardiac care: use and recommendations for optimal effectiveness and safety. Expert Rev. Cardiovasc Ter. 2021;19:325-35. doi: 10.1080/14779072.2021.1905520
  • Chen Y, et al. Early administration of levosimendan improved rates of successful termination of extracorporeal membrane oxygenation in patients with cardiogenic shock. Front Cardiovasc Med. 2022;9:912321.
  • Ellouz O, et al. Levosimendan during venoarterial ECMO withdrawal. Rationale and design of a randomized, double-blind, multicenter study. Heart failure ESC. 2021;8:3339–47.
  • Franco RA, et al. Dobutamine conservation strategy versus dobutamine for all strategy in cardiac surgery: a randomized noninferiority trial. Ann, intensive care. 2021;11:15.
  • Pisano A, Di Fraja D, Palmieri C. Cerebral oximetry monitoring using near-infrared spectroscopy (NIRS) in anesthesia and intensive care: progress and prospects. In: Casella M, editor. General anesthesia studies. New York, NY: Humana Press (2020), p. 75–96.
  • Wong ZZ, et al. The use of cerebral oximetry in surgery: a systematic review and meta-analysis of randomized controlled trials. J Cardiothorac Vask Anest. 2022; 36:2002–11.
  • Pieri M, et al. Studies on the prevention and treatment of delirium after cardiac surgery: a systematic review of randomized data. J Cardiothorac Vask Anest. 2020; 34:1641–54.
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