tailieunhanh - Báo cáo y học: "Intensified thermal management for patients undergoing transcatheter aortic valve implantation (TAVI)"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Wertheim cung cấp cho các bạn kiến thức về ngành y đề tài: Intensified thermal management for patients undergoing transcatheter aortic valve implantation (TAVI). | Brandes et al. Journal of Cardiothoracic Surgery 2011 6 117 http content 6 1 117 JCTS JOURNAL OF CARDIOTHORACIC SURGERY RESEARCH ARTICLE Open Access Intensified thermal management for patients undergoing transcatheter aortic valve implantation TAVI 1 1 2 2 1 1 Ivo F Brandes Marc Jipp Aron F Popov Ralf Seipelt Michael Quintel and Anselm Brauer Abstract Background Transcatheter aortic valve implantation via the transapical approach TAVI-TA without cardiopulmonary bypass CPB is a minimally invasive alternative to open-heart valve replacement. Despite minimal exposure and extensive draping perioperative hypothermia still remains a problem. Methods In this observational study we compared the effects of two methods of thermal management on the perioperative course of core temperature. The methods were standard thermal management STM with a circulating hot water blanket under the patient forced-air warming with a lower body blanket and warmed infused fluids and an intensified thermal management ITM with additional prewarming using forced-air in the preoperative holding area on the awake patient. Results Nineteen patients received STM and 20 were treated with ITM. On ICU admission ITM-patients had a higher core temperature C vs. C p required less time to achieve normothermia median IQR in min 0 0-15 vs. 150 0-300 p and a shorter period of ventilatory support median IQR in min 0 0-0 vs. 246 0-451 p . Conclusion ITM during TAVI-TA reduces the incidence of hypothermia and allows for faster recovery with less need of ventilatory support. Keywords Transcatheter aortic valve implantation hypothermia thermal management core temperature prewarming forced air warming Background Aortic valve replacement with cardiopulmonary bypass CPB is currently the treatment of choice for symptomatic aortic stenosis but carries a significant risk of morbidity and mortality particularly in frail elderly patients with severe .