Pericardiectomy - Revision history

Giovimixele at 19:29, 9 July 2025

2025-07-09T19:29:55Z

← Older revision		Revision as of 12:29, 9 July 2025
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	\| lines_access = 2+ PIVs, central venous access +/- Swan, arterial line		\| lines_access = 2+ PIVs, central venous access +/- Swan, arterial line
	\| monitors = Standard, arterial line, PA catheter, TEE		\| monitors = Standard, arterial line, PA catheter, TEE
			\| considerations_preoperative = Functional status, starting H/H for CPB management
	\| considerations_intraoperative = CPB		\| considerations_intraoperative = CPB
	\| considerations_postoperative = ICU disposition		\| considerations_postoperative = ICU disposition
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	\|-		\|-
	\|Hematologic		\|Hematologic
	\|~~Underlying~~ coagulopathy or anticoagulation given need for CPB		\|Starting H/H for CPB management/sequestration/priming of CPB cannulas. Assess underlying coagulopathy or anticoagulation given need for CPB
	\|-		\|-
	\|Renal		\|Renal

Giovimixele at 19:25, 9 July 2025

2025-07-09T19:25:55Z

← Older revision		Revision as of 12:25, 9 July 2025
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	\| lines_access = 2+ PIVs, central venous access +/- Swan, arterial line		\| lines_access = 2+ PIVs, central venous access +/- Swan, arterial line
	\| monitors = Standard, arterial line, PA catheter, TEE		\| monitors = Standard, arterial line, PA catheter, TEE
	~~\| considerations_preoperative =~~
	\| considerations_intraoperative = CPB		\| considerations_intraoperative = CPB
	\| considerations_postoperative = ICU disposition		\| considerations_postoperative = ICU disposition

Giovimixele at 19:24, 9 July 2025

2025-07-09T19:24:33Z

← Older revision		Revision as of 12:24, 9 July 2025
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	=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===		=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===

			* Isoflurane pre CPB. Isoflurane is continued by perfusionists while patient is on CPB. Patient is often transported to ICU postoperatively with IV sedation infusion(Propofol/precedex)

	=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===		=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===
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	* Intensive care unit (ICU) monitoring initially.		* Intensive care unit (ICU) monitoring initially.
	** Often intubated		** Often intubated
	** Frequently requiring ~~pressors~~ or inotropic agents post-CPB.		** Frequently requiring vasopressors or inotropic agents post-CPB.
	* Continuous ECG monitoring for arrhythmias.		* Continuous ECG monitoring for arrhythmias.

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	=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===		=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===
			*Arrhythmias (atrial fibrillation, ventricular arrhythmias)
	*		*Ventricular wall perforation
			*Infection
			*Bleeding
			*CPB specific complications
	== References ==		== References ==

	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]

Giovimixele: Updated article

2025-07-09T19:21:44Z

Updated article

← Older revision		Revision as of 12:21, 9 July 2025
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	{{Infobox surgical procedure		{{Infobox surgical procedure
	\| anesthesia_type =		\| anesthesia_type = General endotracheal
	\| airway =		\| airway = ETT
	\| lines_access =		\| lines_access = 2+ PIVs, central venous access +/- Swan, arterial line
	\| monitors =		\| monitors = Standard, arterial line, PA catheter, TEE
	\| considerations_preoperative =		\| considerations_preoperative =
	\| considerations_intraoperative =		\| considerations_intraoperative = CPB
	\| considerations_postoperative =		\| considerations_postoperative = ICU disposition
	}}		}}

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	\|-		\|-
	\|Gastrointestinal		\|Gastrointestinal
	\|		\|Rule out esophageal abnormalities, varices, issues swallowing given TEE
	\|-		\|-
	\|Hematologic		\|Hematologic
	\|		\|Underlying coagulopathy or anticoagulation given need for CPB
	\|-		\|-
	\|Renal		\|Renal
	\|		\|Assess renal function
	\|-		\|-
	\|Endocrine		\|Endocrine
	\|		\|Assess history of diabetes, preoperative A1C
	\|-		\|-
	\|Other		\|Other
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	=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===		=== Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===

			* Supine with shoulder roll, arms tucked

	=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===		=== Maintenance and surgical considerations<!-- Describe the important considerations and general approach to the maintenance of anesthesia, including potential complications. Be sure to include any steps to the surgical procedure that have anesthetic implications. --> ===

	=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===		=== Emergence<!-- List and/or describe any important considerations related to the emergence from anesthesia for this case. --> ===

			* Transport to ICU while sedated, and often while intubated

	== Postoperative management ==		== Postoperative management ==
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	=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===		=== Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===

			* Regional anesthetic techniques for sternotomy
			* Long acting opiates(dilaudid or methadone)
			* Tylenol
			* Avoid NSAIDs given patients undergoing cardiac surgery are at higher risk for kidney injury and patients are often coagulopathic from CPB

	=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===		=== Potential complications<!-- List and/or describe any potential postoperative complications for this case. --> ===

	== Procedure variants<!-- This section should only be used for cases with multiple approaches (e.g. Laparoscopic vs. open appendectomy). Otherwise, remove this section. Use this table to very briefly compare and contrast various aspects between approaches. Add or remove rows as needed to maximize relevance. Consider using symbols rather than words when possible (e.g. +, –, additional symbols such as ↑ and ↓ are available using the "Ω" tool in the editor). --> ==		*

	~~{\| class="wikitable wikitable-horizontal-scroll"~~
	\|+
	!
	~~!Variant 1~~
	~~!Variant 2~~
	\|-
	~~\|Unique considerations~~
	\|
	\|
	\|-
	~~\|Indications~~
	\|
	\|
	\|-
	~~\|Position~~
	\|
	\|
	\|-
	~~\|Surgical time~~
	\|
	\|
	\|-
	~~\|EBL~~
	\|
	\|
	\|-
	~~\|Postoperative disposition~~
	\|
	\|
	\|-
	~~\|Pain management~~
	\|
	\|
	\|-
	~~\|Potential complications~~
	\|
	\|
	\|}

	== References ==		== References ==

	[[Category:Surgical procedures]]		[[Category:Surgical procedures]]

Giovimixele at 20:09, 1 July 2025

2025-07-01T20:09:28Z

@@ Line 38: / Line 38: @@
 === Surgical procedure<!-- Briefly describe the major steps of this surgical procedure. --> ===
 == Preoperative management ==
@@ Line 76: / Line 85: @@
 === Labs and studies<!-- Describe any important labs or studies. Include reasoning to justify the study and/or interpretation of results in the context of this procedure. If none, this section may be removed. --> ===
 == Intraoperative management ==
 === Monitoring and access<!-- List and/or describe monitors and access typically needed for this case. Please describe rationale for any special monitors or access. --> ===
 === Induction and airway management<!-- Describe the important considerations and general approach to the induction of anesthesia and how the airway is typically managed for this case. --> ===
 === Positioning<!-- Describe any unique positioning considerations, including potential intraoperative position changes. If none, this section may be removed. --> ===
@@ Line 92: / Line 119: @@
 === Disposition<!-- List and/or describe the postoperative disposition and any special considerations for transport of patients for this case. --> ===
 === Pain management<!-- Describe the expected level of postoperative pain and approaches to pain management for this case. --> ===

Giovimixele: Created article

2025-07-01T19:59:24Z

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