Isetta Christian, Barbotin-Larrieu François, Massias Sylvain, El Manser Diae, Koeltz Adrien, Balram Christophe Patricia Shri, Soualhi Mohamed, Licker Marc
Department of Cardiovascular & Thoracic Anaesthesia and Critical Care, University Hospital of Martinique, F-97200 Fort de France, France.
Faculty of Medicine, University of Geneva, CH-1206 Geneva, Switzerland.
J Clin Med. 2025 Jan 13;14(2):459. doi: 10.3390/jcm14020459.
Anesthesiology, the medical specialty that deals with the management of vital functions in patients undergoing surgery, has played an important role in the successful development of cardiac interventions worldwide. Tracing the historical roots of cardiac anesthesia and critical care from its inception in the late 1950s, a paradigm shift in perioperative care has been driven by a better understanding of the mechanisms of organ dysfunction in stressful conditions and technological advances regarding surgical approach, patient monitoring, and organ protection. Although progress in cardiac anesthesia and critical care lagged a little behind in Caribbean territories, successful achievements have been accomplished over the last forty years. Compared with Western countries, the greater prevalence of obesity, diabetes mellitus, and hypertension as well as specific diseases such as cardiac amyloidosis, sickle cell anemia, rheumatic heart disease, and tropical infections may reduce a patient's physiologic reserve and increase the operative risk among the multi-ethnic population living in the French West Indies and Guiana. So far, cardiac anesthesiologists at the University Hospital of Martinique have demonstrated their abilities in implementing evidence-based clinical care processes and adaptating to efficiently working in a complex environment interacting with multiple partners. Attracting specialized physicians in dedicated cardiac surgical centers and the creation of a regional health network supported by governmental authorities, insurance companies, and charitable organizations are necessary to solve the unmet needs for invasive cardiac treatments in the Caribbean region.
麻醉学作为一门负责管理接受手术患者重要生命功能的医学专业，在全球心脏介入手术的成功发展中发挥了重要作用。追溯心脏麻醉与重症监护从20世纪50年代末诞生以来的历史根源，围手术期护理的范式转变是由对压力状态下器官功能障碍机制的更好理解以及手术方法、患者监测和器官保护方面的技术进步所推动的。尽管加勒比地区在心脏麻醉和重症监护方面的进展略显滞后，但在过去四十年中已取得了成功的成果。与西方国家相比，肥胖、糖尿病和高血压以及心脏淀粉样变性、镰状细胞贫血、风湿性心脏病和热带感染等特定疾病在法属西印度群岛和圭亚那的多民族人群中更为普遍，这可能会降低患者的生理储备并增加手术风险。到目前为止，马提尼克大学医院的心脏麻醉医生已展示出他们在实施循证临床护理流程以及适应在与多个合作伙伴互动的复杂环境中高效工作的能力。在加勒比地区，吸引专业医生到专门的心脏外科中心工作，并创建由政府当局、保险公司和慈善组织支持的区域卫生网络，对于解决该地区对侵入性心脏治疗未满足的需求是必要的。
