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  1. Article ; Online: Dynamic anterior mediastinal mass compression of the superior vena cava during airway stent deployment.

    Navas-Blanco, Jose R

    Annals of cardiac anaesthesia

    2021  Volume 24, Issue 3, Page(s) 399–401

    Abstract: Mediastinal masses carry the intrinsic potential for life-threatening perioperative complications that directly impact anesthetic management, since well-recognized cardiopulmonary failure either chronic or acute may occur. A 48-year-old patient with ... ...

    Abstract Mediastinal masses carry the intrinsic potential for life-threatening perioperative complications that directly impact anesthetic management, since well-recognized cardiopulmonary failure either chronic or acute may occur. A 48-year-old patient with known airway collapse due to an anterior mediastinal mass presents for airway stent insertion, that upon manipulation of the airway, a sudden and reproducible cardiovascular collapse ensued, due to dynamic compression of the superior vena cava, witnessed via endobronchial ultrasound. Close communication with the procedural team before and during manipulation of the patient's airway plays a paramount role to assure positive clinical outcomes.
    MeSH term(s) Humans ; Mediastinal Neoplasms/complications ; Mediastinal Neoplasms/diagnostic imaging ; Mediastinal Neoplasms/surgery ; Middle Aged ; Stents/adverse effects ; Vena Cava, Superior/diagnostic imaging
    Language English
    Publishing date 2021-07-16
    Publishing country India
    Document type Case Reports ; Research Support, Non-U.S. Gov't
    ZDB-ID 2106866-5
    ISSN 0974-5181 ; 0971-9784
    ISSN (online) 0974-5181
    ISSN 0971-9784
    DOI 10.4103/aca.ACA_199_19
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Enhanced recovery after cardiac surgery: A literature review.

    Navas-Blanco, Jose R / Kantola, Austin / Whitton, Mark / Johnson, Austin / Shakibai, Nasim / Soto, Roy / Muhammad, Sheryar

    Saudi journal of anaesthesia

    2024  Volume 18, Issue 2, Page(s) 257–264

    Abstract: Enhanced recovery after cardiac surgery (ERACS) represents a constellation of evidence-based peri-operative methods aimed to reduce the physiological and psychological stress patients experience after cardiac surgery, with the primary objective of ... ...

    Abstract Enhanced recovery after cardiac surgery (ERACS) represents a constellation of evidence-based peri-operative methods aimed to reduce the physiological and psychological stress patients experience after cardiac surgery, with the primary objective of providing an expedited recovery to pre-operative functional status. The method involves pre-operative, intra-operative, and post-operative interventions as well as direct patient engagement to be successful. Numerous publications in regard to the benefits of enhanced recovery have been presented, including decreased post-operative complications, shortened length of stay, decreased overall healthcare costs, and higher patient satisfaction. Implementing an ERACS program undeniably requires a culture change, a methodical shift in the approach of these patients that ultimately allows the team to achieve the aforementioned goals; therefore, team-building, planning, and anticipation of obstacles should be expected.
    Language English
    Publishing date 2024-03-14
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 2562174-9
    ISSN 0975-3125 ; 1658-354X
    ISSN (online) 0975-3125
    ISSN 1658-354X
    DOI 10.4103/sja.sja_62_24
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Perioperative care of heart transplant recipients undergoing non-cardiac surgery.

    Navas-Blanco, Jose R / Modak, Raj K

    Annals of cardiac anaesthesia

    2021  Volume 24, Issue 2, Page(s) 140–148

    Abstract: The life expectancy of patients with end-stage heart disease undergoing Orthotopic Heart Transplantation (OHT) has increased significantly in the recent decades since its original introduction into the medical practice in 1967. Substantial advances in ... ...

    Abstract The life expectancy of patients with end-stage heart disease undergoing Orthotopic Heart Transplantation (OHT) has increased significantly in the recent decades since its original introduction into the medical practice in 1967. Substantial advances in post-operative intensive care, surgical prophylaxis, and anti-rejection drugs have clearly impacted survivability after OHT, therefore the volume of patients presenting for non-cardiac surgical procedures is expected to continue to escalate in the upcoming years. There are a number of caveats associated with this upsurge of post-OHT patients requiring non-cardiac surgery, including presenting to healthcare facilities without the resources and technology necessary to manage potential perioperative complications or that may not be familiar with the care of these patients, facilities in which a cardiac anesthesiologist is not available, patients presenting for emergency procedures and so forth. The perioperative care of patients after OHT introduces several challenges to the anesthesiologist including preoperative risk assessments different to the general population and intraoperative management of a denervated organ with altered response to medications and drug-drug interactions. The present review aims to synopsize current data of patients presenting for non-cardiac surgery after OHT, surgical aspects of the transplant that may impact perioperative care, physiology of the transplanted heart as well as anesthetic considerations.
    MeSH term(s) Heart ; Heart Transplantation ; Humans ; Perioperative Care ; Postoperative Period ; Risk Assessment
    Language English
    Publishing date 2021-04-21
    Publishing country India
    Document type Journal Article ; Review
    ZDB-ID 2106866-5
    ISSN 0974-5181 ; 0971-9784
    ISSN (online) 0974-5181
    ISSN 0971-9784
    DOI 10.4103/aca.ACA_130_19
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Expert Consensus Decision Pathway of the American College of Cardiology on Management of Bleeding in Patients With Oral Anticoagulants: A Review of the 2020 Update for Perioperative Physicians.

    Navas-Blanco, Jose R / Martini, Adriana / Fabbro, Michael

    Journal of cardiothoracic and vascular anesthesia

    2021  Volume 35, Issue 8, Page(s) 2471–2479

    Abstract: The use and evolution of oral anticoagulation therapies continue to advance for multiple reasons, including a growing segment of older patients with associated chronic prothrombotic illnesses including cardiovascular, pulmonary, hematologic and oncologic ...

    Abstract The use and evolution of oral anticoagulation therapies continue to advance for multiple reasons, including a growing segment of older patients with associated chronic prothrombotic illnesses including cardiovascular, pulmonary, hematologic and oncologic conditions. Correlated to this increased use of oral anticoagulants is bleeding complications associated with their use. Based on these trends, it is expected that perioperative physicians will be facing more and more of these patients requiring scheduled, urgent or emergent surgical procedures During May 2020, the American College of Cardiology updated its Expert Consensus Decision Pathway devoted to the approach of bleeding in patients on oral anticoagulants. This updated version emphasized the expanding role of the direct-acting oral anticoagulants in other conditions beyond nonvalvular atrial fibrillation, such as venous thromboembolism. Several details discussed within this most recent update are pertinent to perioperative physicians, who frequently deal with bleeding in the setting of anticoagulation. The purpose of this narrative review is to highlight and expand on these salient points because they relate to perioperative management.
    MeSH term(s) Administration, Oral ; Anticoagulants/adverse effects ; Atrial Fibrillation/complications ; Atrial Fibrillation/drug therapy ; Cardiology ; Consensus ; Humans ; Physicians ; United States/epidemiology
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2021-02-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1067317-9
    ISSN 1532-8422 ; 1053-0770
    ISSN (online) 1532-8422
    ISSN 1053-0770
    DOI 10.1053/j.jvca.2021.02.024
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Management of Respiratory Distress Syndrome due to COVID-19 infection.

    Navas-Blanco, Jose R / Dudaryk, Roman

    BMC anesthesiology

    2020  Volume 20, Issue 1, Page(s) 177

    Abstract: The management of Acute Respiratory Distress Syndrome (ARDS) secondary to the novel Coronavirus Disease 2019 (COVID-19) proves to be challenging and controversial. Multiple studies have suggested the likelihood of an atypical pathophysiology to explain ... ...

    Abstract The management of Acute Respiratory Distress Syndrome (ARDS) secondary to the novel Coronavirus Disease 2019 (COVID-19) proves to be challenging and controversial. Multiple studies have suggested the likelihood of an atypical pathophysiology to explain the spectrum of pulmonary and systemic manifestations caused by the virus. The principal paradox of COVID-19 pneumonia is the presence of severe hypoxemia with preserved pulmonary mechanics. Data derived from the experience of multiple centers around the world have demonstrated that initial clinical efforts should be focused into avoid intubation and mechanical ventilation in hypoxemic COVID-19 patients. On the other hand, COVID-19 patients progressing or presenting into frank ARDS with typical decreased pulmonary compliance, represents another clinical enigma to many clinicians, since routine therapeutic interventions for ARDS are still a subject of debate.
    MeSH term(s) Adrenal Cortex Hormones/therapeutic use ; Betacoronavirus ; Biomarkers/metabolism ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques/methods ; Coronavirus Infections/diagnosis ; Coronavirus Infections/drug therapy ; Coronavirus Infections/therapy ; Coronavirus Infections/transmission ; Critical Care/methods ; Cross Infection/transmission ; Cytokines/metabolism ; Diagnostic Imaging ; Extracorporeal Membrane Oxygenation/methods ; Humans ; Hypoxia/virology ; Immune System Diseases/virology ; Intubation, Intratracheal ; Neuromuscular Blockade/methods ; Pandemics ; Patient Positioning/methods ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/therapy ; Pneumonia, Viral/transmission ; Pneumonia, Viral/virology ; Prone Position/physiology ; Respiration, Artificial/methods ; Respiratory Distress Syndrome/therapy ; Respiratory Distress Syndrome/virology ; SARS-CoV-2 ; Thrombophilia/virology ; Vasodilator Agents/therapeutic use ; COVID-19 Drug Treatment
    Chemical Substances Adrenal Cortex Hormones ; Biomarkers ; Cytokines ; Vasodilator Agents
    Keywords covid19
    Language English
    Publishing date 2020-07-20
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 2091252-3
    ISSN 1471-2253 ; 1471-2253
    ISSN (online) 1471-2253
    ISSN 1471-2253
    DOI 10.1186/s12871-020-01095-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Analyzing the impact of preoperative interrogation of cardiac implantable electronic devices.

    Navas-Blanco, Jose R / Williams, Derrick V / Modak, Raj K

    Annals of cardiac anaesthesia

    2021  Volume 24, Issue 4, Page(s) 447–451

    Abstract: Background: Cardiac implantable electronic devices (CIED) are becoming more common for the management of underlying of cardiac dysrhythmias, and more patients with these devices are presenting for cardiac and noncardiac procedures.: Methods: We ... ...

    Abstract Background: Cardiac implantable electronic devices (CIED) are becoming more common for the management of underlying of cardiac dysrhythmias, and more patients with these devices are presenting for cardiac and noncardiac procedures.
    Methods: We performed a retrospective, cohort, single-center study at a tertiary teaching medical center, gathering 151 patients with CIED undergoing elective and emergent surgeries for the time period between November 2013 and December 2016. We aimed to determine whether patients with CIED had the device interrogated before surgery as recommended by the Heart Rhythm Society (HRS)/American Society of Anesthesiologists (ASA) consensus, whether this lack of compliance led to delay in the holding area before surgery and determine the presence of intra- or postoperative cardiac events in these patients.
    Results: A total of 76% of patients had interrogation of the device before surgery. Emergent cases were not interrogated as much as elective cases preoperatively (43% vs. 18%, respectively; P < 0.05). In total, 6% of cases had a CIED-related average holding area delay time of 54 minutes. Patients without preoperative device interrogation had more perioperative cardiac events than those who had the device checked (25% vs. 8%, respectively; odds ratio [OR] 0.26; 95% CI, 0.09-0.7, P < 0.013).
    Conclusions: Our findings suggest that preoperative interrogation of the device plays a significant role to minimize the incidence of perioperative cardiac adverse events. Institutional providers show a lack of compliance with HRS/ASA recommendations for preoperative CIED management. Further research is required to determine if improved compliance to recommendations will lead to enhanced outcomes.
    MeSH term(s) Arrhythmias, Cardiac ; Cohort Studies ; Defibrillators, Implantable ; Electronics ; Humans ; Retrospective Studies
    Language English
    Publishing date 2021-11-08
    Publishing country India
    Document type Journal Article
    ZDB-ID 2106866-5
    ISSN 0974-5181 ; 0971-9784
    ISSN (online) 0974-5181
    ISSN 0971-9784
    DOI 10.4103/aca.ACA_32_20
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: The role of supplemental oxygen and tissue oxygenation monitoring in management of severe post-hemorrhagic anemia in Jehovah's witnesses.

    Navas-Blanco, Jose R / Dudaryk, Roman / Martinez-Ruiz, Ricardo

    Journal of clinical anesthesia

    2020  Volume 67, Page(s) 109978

    MeSH term(s) Anemia/etiology ; Anemia/therapy ; Hemorrhage/etiology ; Hemorrhage/therapy ; Humans ; Jehovah's Witnesses ; Oxygen ; Perioperative Care
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2020-07-10
    Publishing country United States
    Document type Letter
    ZDB-ID 1011618-7
    ISSN 1873-4529 ; 0952-8180
    ISSN (online) 1873-4529
    ISSN 0952-8180
    DOI 10.1016/j.jclinane.2020.109978
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: CON: Pulmonary artery catheter use should be forgone in modern clinical practice.

    Navas-Blanco, Jose R / Vaidyanathan, Ashwin / Blanco, Paula Trigo / Modak, Raj K

    Annals of cardiac anaesthesia

    2021  Volume 24, Issue 1, Page(s) 8–11

    Abstract: The pulmonary artery catheter (PAC) and its role in the practice of modern medicine remains to be questioned and has experienced a substantial decline in its use in the most recent decades. The complications associated to its use, the lack of consistency ...

    Abstract The pulmonary artery catheter (PAC) and its role in the practice of modern medicine remains to be questioned and has experienced a substantial decline in its use in the most recent decades. The complications associated to its use, the lack of consistency of the interpretation provided by the PAC among clinicians, the development of new hemodynamic methods, and the deleterious cost profile associated to the PAC are some of the reasons behind the decrease in its use. Since its introduction into clinical practice, the PAC and the data obtained from its use became paramount in the management of critically ill patients as well as for the high-risk/invasive procedures. Initially, many clinicians were under the impression that regardless the clinical setting, acquiring the information provided by the PAC justified its use, until a growing body of evidence demonstrated its lack of mortality and morbidity improvement, as well as several reports of the presence of difficulties-some of them fatal-during its insertion. The authors present an updated review discussing the futility of the PAC in current clinical practice, the complications associated to its insertion, the lack of mortality benefit in critically ill patients and cardiac surgery, as well as present alternative hemodynamic methods to the PAC.
    MeSH term(s) Cardiac Surgical Procedures ; Catheterization, Swan-Ganz ; Catheters ; Critical Illness ; Hemodynamics ; Humans ; Pulmonary Artery
    Language English
    Publishing date 2021-05-03
    Publishing country India
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2106866-5
    ISSN 0974-5181 ; 0971-9784
    ISSN (online) 0974-5181
    ISSN 0971-9784
    DOI 10.4103/aca.ACA_126_19
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Management of Respiratory Distress Syndrome due to COVID-19 infection

    Navas-Blanco, Jose / Dudaryk, Roman

    BMC anesthesiology, 20(1):177

    2020  

    Abstract: The management of Acute Respiratory Distress Syndrome (ARDS) secondary to the novel Coronavirus Disease 2019 (COVID-19) proves to be challenging and controversial. Multiple studies have suggested the likelihood of an atypical pathophysiology to explain ... ...

    Abstract The management of Acute Respiratory Distress Syndrome (ARDS) secondary to the novel Coronavirus Disease 2019 (COVID-19) proves to be challenging and controversial. Multiple studies have suggested the likelihood of an atypical pathophysiology to explain the spectrum of pulmonary and systemic manifestations caused by the virus. The principal paradox of COVID-19 pneumonia is the presence of severe hypoxemia with preserved pulmonary mechanics. Data derived from the experience of multiple centers around the world have demonstrated that initial clinical efforts should be focused into avoid intubation and mechanical ventilation in hypoxemic COVID-19 patients. On the other hand, COVID-19 patients progressing or presenting into frank ARDS with typical decreased pulmonary compliance, represents another clinical enigma to many clinicians, since routine therapeutic interventions for ARDS are still a subject of debate.
    Keywords COVID-19 ; Severe acute respiratory syndrome coronavirus 2 ; Extracorporeal membrane oxygenation ; Mechanical ventilation ; Acute respiratory distress syndrome ; Coronavirus disease 19 ; Intensive care unit ; covid19
    Language English
    Publishing country de
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article: Puzzling postoperative toxin-induced acute liver failure after nonhepatobiliary surgery.

    Navas-Blanco, Jose R / Swiderek, Jennifer / Galusca, Dragos M

    Saudi journal of anaesthesia

    2018  Volume 12, Issue 4, Page(s) 658–659

    Language English
    Publishing date 2018-10-31
    Publishing country India
    Document type Journal Article
    ZDB-ID 2562174-9
    ISSN 0975-3125 ; 1658-354X
    ISSN (online) 0975-3125
    ISSN 1658-354X
    DOI 10.4103/sja.SJA_340_18
    Database MEDical Literature Analysis and Retrieval System OnLINE

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