2021: Perioperative and critical care year in review for the cardiothoracic surgery team

J W Awori Hayanga; Philippe H Lemaitre; HelenMari Merritt-Genore; Nicholas R Teman; Nathalie Roy; Pablo G Sanchez; Jeffrey Javidfar; Laura Donahoe; Rakesh C Arora

doi:10.1016/j.jtcvs.2022.05.004

2021: Perioperative and critical care year in review for the cardiothoracic surgery team

J Thorac Cardiovasc Surg. 2022 Dec;164(6):e449-e456. doi: 10.1016/j.jtcvs.2022.05.004. Epub 2022 May 17.

Authors

J W Awori Hayanga¹, Philippe H Lemaitre², HelenMari Merritt-Genore³, Nicholas R Teman⁴, Nathalie Roy⁵, Pablo G Sanchez⁶, Jeffrey Javidfar⁷, Laura Donahoe⁸, Rakesh C Arora⁹

Affiliations

¹ Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WVa. Electronic address: jeremiah.hayanga@wvumedicine.org.
² Division of Thoracic Surgery, Columbia University Irving Medical Center, New York, NY.
³ Cardiothoracic Surgeon, Methodist Physicians Clinic, Omaha, Neb.
⁴ Division of Cardiac Surgery, University of Virginia Health System, Charlottesville, Va.
⁵ Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
⁶ Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa.
⁷ Division of Cardiothoracic Surgery, Emory School of Medicine, Atlanta, Ga.
⁸ Division of Thoracic Surgery, University of Toronto, Toronto, Ontario, Canada.
⁹ Department of Surgery, Section of Cardiac Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.

Abstract

For yet another year, our lives have been dominated by a pandemic. This year in review, we feature an expert panel opinion regarding extracorporeal support in the context of COVID-19, challenging previously held standards. We also feature survey results assessing the impact of the pandemic on cardiac surgical volume. Furthermore, we focus on a single center experience that evaluated the use of pulmonary artery catheters and the comparison of transfusion strategies in the Restrictive and Liberal Transfusion Strategies in Patients With Acute Myocardial Infarction (REALITY) trial. Additionally, we address the impact of acute kidney injury on cardiac surgery and highlight the controversy regarding the choice of fluid resuscitation. We close with an evaluation of dysphagia in cardiac surgery and the impact of prehabilitation to optimize surgical outcomes.

Keywords: ECMO; acute kidney injury; catheters; critical care; fluid resuscitation; transfusions.

MeSH terms

Blood Transfusion / methods
COVID-19*
Cardiac Surgical Procedures* / adverse effects
Cardiac Surgical Procedures* / methods
Critical Care
Erythrocyte Transfusion / methods
Humans