Landry Elizabeth, Muehlschlegel Jochen Daniel
1 Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA.
Semin Cardiothorac Vasc Anesth. 2019 Jun;23(2):148-155. doi: 10.1177/1089253219842651. Epub 2019 Apr 15.
The year 2018 was marked by high-quality, impactful articles spanning the basic, translational, and clinical spectrum in the field of cardiothoracic anesthesia. In this article, we present several hand-picked articles from the past year that we feel were the most significant in shaping our specialty. Large multicenter, randomized controlled trials presenting clinical outcome data dominated the publishing arena: is a restrictive red blood cell transfusion strategy superior to a liberal red blood cell transfusion strategy during cardiopulmonary bypass? Does a low mean arterial blood pressure strategy during cardiopulmonary bypass increase stroke incidence? Does the obesity paradox apply to cardiac surgery? Advancing technology continues to revolutionize our field: can the MitraClip be used to effectively treat secondary mitral regurgitation? Can stem cells improve cardiac function in patients with left ventricular assist devices? These studies allow us to shape our practice in an evidence-based manner, so that we may evolve as a specialty and deliver the best care to our patients.
2018年的特点是心胸麻醉领域出现了涵盖基础、转化和临床各个方面的高质量、有影响力的文章。在本文中,我们展示了过去一年中精心挑选的几篇文章,我们认为这些文章对塑造我们的专业领域最为重要。呈现临床结果数据的大型多中心随机对照试验主导了出版领域:在体外循环期间,限制性红细胞输血策略是否优于宽松的红细胞输血策略?体外循环期间低平均动脉血压策略是否会增加中风发生率?肥胖悖论是否适用于心脏手术?不断进步的技术继续给我们的领域带来变革:MitraClip能否有效治疗继发性二尖瓣反流?干细胞能否改善左心室辅助装置患者的心脏功能?这些研究使我们能够以循证为基础来规范我们的实践,以便我们作为一个专业领域不断发展,并为患者提供最佳护理。