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292550 | anesthesia-for-aortic-surgery-with-hypothermia-and-elective-circulatory-arrest-in-adult-patients - THE POSTBYPASS PERIOD | The process of weaning from cardiopulmonary bypass (CPB) is discussed in a separate topic. (See"Weaning from cardiopulmonary bypass".) |
292551 | anesthesia-for-aortic-surgery-with-hypothermia-and-elective-circulatory-arrest-in-adult-patients - THE POSTBYPASS PERIOD - Problems in the postbypass period | Postbypass problems after weaning from CPB are discussed separately. (See Postbypass problems after weaning from CPB are discussed separately. (See "Intraoperative problems after cardiopulmonary bypass" .)
The following problems are particularly challenging after CPB with deep hypothermia and circulatory arrest (DHCA) ... |
292552 | anesthesia-for-aortic-surgery-with-hypothermia-and-elective-circulatory-arrest-in-adult-patients - THE POSTBYPASS PERIOD - Problems in the postbypass period - -Control of coagulopathy to achieve hemostasis | Surgical bleeding is exacerbated by coagulopathy due to ( Surgical bleeding is exacerbated by coagulopathy due to ( table 1 ) [ 7,14,15 ]:
●The anti-hemostatic effects of deep hypothermia
●Ischemia and reperfusion injury due to elective circulatory arrest
●Fibrinolysis and platelet activation due to prolonged duratio... |
292553 | anesthesia-for-aortic-surgery-with-hypothermia-and-elective-circulatory-arrest-in-adult-patients - THE POSTBYPASS PERIOD - Problems in the postbypass period - -Control of blood pressure | Episodes of hypertension and hypotension are common after aortic surgery with DHCA and should be promptly treated. Episodes of hypertension and hypotension are common after aortic surgery with DHCA and should be promptly treated.
●Postbypass control of hypertension with intravenous (IV) boluses or infusion of antihyper... |
292554 | anesthesia-for-aortic-surgery-with-hypothermia-and-elective-circulatory-arrest-in-adult-patients - THE POSTBYPASS PERIOD - Transport to the intensive care unit | Hemostasis and hemodynamic stability must be achieved prior to transport to the intensive care unit (ICU). (See Hemostasis and hemodynamic stability must be achieved prior to transport to the intensive care unit (ICU). (See "Anesthesia for cardiac surgery: General principles", section on 'Transport and handoff in the i... |
292555 | anesthesia-for-aortic-surgery-with-hypothermia-and-elective-circulatory-arrest-in-adult-patients - SOCIETY GUIDELINE LINKS | Links to society and government-sponsored guidelines from selected countries and regions around the world are provided separately. (See"Society guideline links: Management of cardiopulmonary bypass"and"Society guideline links: Aortic and other peripheral aneurysms"and"Society guideline links: Aortic dissection and othe... |
292556 | anesthesia-for-aortic-surgery-with-hypothermia-and-elective-circulatory-arrest-in-adult-patients - SUMMARY AND RECOMMENDATIONS | ●Preanesthetic assessment and planning–Routine aspects of the preanesthetic consultation for cardiac surgery are discussed separately. (See'Preanesthetic assessment and planning'above.)
•Coexisting pathology–The presence of aortic or carotid arterial atherosclerosis; chronic or acute aortic regurgitation (AR) (movie 2... |
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