cardiothoracic

Functional Residual Capacity (FRC) And Pulmonary Vascular Resistance (PVR)

Cardiopulmonary physiology has always been an interest of mine. I've previously written about how cardiac output is affected by spontaneous versus positive pressure ventilation, and now I want to discuss how pulmonary vascular resistance (PVR)...

Ventilation Modes Change Cardiac Output

Take a deep breath. Your diaphragm is contracting downward increasing your intrathoracic volume with a resulting decrease in pressure according to Boyle's Law. This new pressure is less than that of atmospheric pressure ("negative...

Acute Hemodynamic Management – Aggressive Undertreatment

This post was inspired by a discussion I had with Dr. Les Yarmush, one of my cardiothoracic anesthesia attendings. I've become accustomed to titrating many short acting medications to manage hemodynamics in the ICU and...

Maintain Coronary Perfusion!

Maintaining coronary perfusion pressure (CPP) is arguably the most important objective in cardiac anesthesiology. CPP is defined as the difference between aortic diastolic pressure (AoDP) and left ventricular end-diastolic pressure (LVEDP) when describing perfusion...

Hypotension With Initiation Of Cardiopulmonary Bypass

Cardiopulmonary bypass (CPB) circuits are typically primed with ~1500 cc of volume (crystalloid, colloid, and/or blood). Thus, if a 70-kilogram male (~5-liter blood volume) is placed on CPB, one would expect his hematocrit to...

Finished With Week 1 Of VA Cardiothoracic Anesthesia

I'm finished with my first week of cardiothoracic anesthesiology at the Veterans Affairs Hospital, and its been wonderful! Compared to my last month at Texas Heart Institute, the VA usually does only 1-2 cardiothoracic...

ACLS/BLS Recertification 2016

Yesterday was a "research day" for the surgery department, so most of the elective surgeries didn't start till around 1:30 PM. In the meantime, the anesthesia providers were scrambling all over the hospital throughout...

Halfway Done With Cardiothoracic Anesthesia As A CA-2

With half this rotation under my belt, I wanted to reflect on how my initial trepidation has transformed into enthusiasm doing cardiovascular anesthesiology. At the end of December, I had been out of the...

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