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Perioperative management of patients with left ventricular assist devices undergoing noncardiac surgery
AIM: The aim of this study was to describe our institutional experience, primarily with general anesthesiologists consulting with cardiac anesthesiologists, caring for left ventricular assist device (LVAD) patients undergoing noncardiac surgery. MATERIALS AND METHODS: This is a retrospective review...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2016
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070328/ https://www.ncbi.nlm.nih.gov/pubmed/27716699 http://dx.doi.org/10.4103/0971-9784.191545 |
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author | Degnan, Meredith Brodt, Jessica Rodriguez-Blanco, Yiliam |
author_facet | Degnan, Meredith Brodt, Jessica Rodriguez-Blanco, Yiliam |
author_sort | Degnan, Meredith |
collection | PubMed |
description | AIM: The aim of this study was to describe our institutional experience, primarily with general anesthesiologists consulting with cardiac anesthesiologists, caring for left ventricular assist device (LVAD) patients undergoing noncardiac surgery. MATERIALS AND METHODS: This is a retrospective review of the population of patients with LVADs at a single institution undergoing noncardiac procedures between 2009 and 2014. Demographic, perioperative, and procedural data collected included the type of procedure performed, anesthetic technique, vasopressor requirements, invasive monitors used, anesthesia provider type, blood product management, need for postoperative intubation, postoperative disposition and length of stay, and perioperative complications including mortality. STATISTICAL ANALYSIS: Descriptive statistics for categorical variables are presented as frequency distributions and percentages. Continuous variables are expressed as mean ± standard deviation and range when applicable. RESULTS: During the study, 31 patients with LVADs underwent a total of 74 procedures. Each patient underwent an average of 2.4 procedures. Of the total number of procedures, 48 (65%) were upper or lower endoscopies. Considering all procedures, 81% were performed under monitored anesthesia care (MAC). Perioperative care was provided by faculty outside of the division of cardiac anesthesia in 62% of procedures. Invasive blood pressure monitoring was used in 27 (36%) procedures, and a central line, peripherally inserted central catheter or midline was in place preoperatively and used intraoperatively for 38 (51%) procedures. Vasopressors were not required in the majority (65; 88%) of procedures. There was one inhospital mortality secondary to multiorgan failure; 97% of patients survived to discharge after their procedure. CONCLUSION: At our institution, LVAD patients undergoing noncardiac procedures most frequently require endoscopy. These procedures can frequently be done safely under MAC, with or without consultation by a cardiac anesthesiologist. |
format | Online Article Text |
id | pubmed-5070328 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-50703282016-11-01 Perioperative management of patients with left ventricular assist devices undergoing noncardiac surgery Degnan, Meredith Brodt, Jessica Rodriguez-Blanco, Yiliam Ann Card Anaesth Original Article AIM: The aim of this study was to describe our institutional experience, primarily with general anesthesiologists consulting with cardiac anesthesiologists, caring for left ventricular assist device (LVAD) patients undergoing noncardiac surgery. MATERIALS AND METHODS: This is a retrospective review of the population of patients with LVADs at a single institution undergoing noncardiac procedures between 2009 and 2014. Demographic, perioperative, and procedural data collected included the type of procedure performed, anesthetic technique, vasopressor requirements, invasive monitors used, anesthesia provider type, blood product management, need for postoperative intubation, postoperative disposition and length of stay, and perioperative complications including mortality. STATISTICAL ANALYSIS: Descriptive statistics for categorical variables are presented as frequency distributions and percentages. Continuous variables are expressed as mean ± standard deviation and range when applicable. RESULTS: During the study, 31 patients with LVADs underwent a total of 74 procedures. Each patient underwent an average of 2.4 procedures. Of the total number of procedures, 48 (65%) were upper or lower endoscopies. Considering all procedures, 81% were performed under monitored anesthesia care (MAC). Perioperative care was provided by faculty outside of the division of cardiac anesthesia in 62% of procedures. Invasive blood pressure monitoring was used in 27 (36%) procedures, and a central line, peripherally inserted central catheter or midline was in place preoperatively and used intraoperatively for 38 (51%) procedures. Vasopressors were not required in the majority (65; 88%) of procedures. There was one inhospital mortality secondary to multiorgan failure; 97% of patients survived to discharge after their procedure. CONCLUSION: At our institution, LVAD patients undergoing noncardiac procedures most frequently require endoscopy. These procedures can frequently be done safely under MAC, with or without consultation by a cardiac anesthesiologist. Medknow Publications & Media Pvt Ltd 2016 /pmc/articles/PMC5070328/ /pubmed/27716699 http://dx.doi.org/10.4103/0971-9784.191545 Text en Copyright: © 2016 Annals of Cardiac Anaesthesia http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Degnan, Meredith Brodt, Jessica Rodriguez-Blanco, Yiliam Perioperative management of patients with left ventricular assist devices undergoing noncardiac surgery |
title | Perioperative management of patients with left ventricular assist devices undergoing noncardiac surgery |
title_full | Perioperative management of patients with left ventricular assist devices undergoing noncardiac surgery |
title_fullStr | Perioperative management of patients with left ventricular assist devices undergoing noncardiac surgery |
title_full_unstemmed | Perioperative management of patients with left ventricular assist devices undergoing noncardiac surgery |
title_short | Perioperative management of patients with left ventricular assist devices undergoing noncardiac surgery |
title_sort | perioperative management of patients with left ventricular assist devices undergoing noncardiac surgery |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5070328/ https://www.ncbi.nlm.nih.gov/pubmed/27716699 http://dx.doi.org/10.4103/0971-9784.191545 |
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