SAGE Cardiology and Cardiovascular Medicine SAGE Publications Ltd.

Dr. Ross Hanson and Dr. Andi Chatburn discuss the ethical and legal implications of changes to traditional standards of care during the COVID-19 pandemic.

Dr. Ross Hanson and Dr. Stephanie Jones discuss integration of anesthesiology into the critical care and hospital response to the COVID-19 pandemic.

The 3-factor prothrombin complex concentrate (3FPCC) may be used off-label to treat refractory bleeding during cardiac surgery in children. This retrospective study examined the rate of clinical complications following the use of 3FPCC. Patients treated with 3FPCC were matched to controls for age, gender, prematurity, weight, cardiopulmonary bypass times, and cross-clamp times. Fifty-nine cases were individually matched to 59 controls based on propensity scores. 3FPCC was not associated with an increased risk of thromboembolic events, mortality, or need for postoperative extracorporeal membrane oxygenator support. These results suggest the safety of 3FPCC when used for refractory bleeding after cardiopulmonary bypass in children undergoing congenital heart surgery.
 
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SCVA Editorial Board member and Director of Pediatric Cardiothoracic Anesthesiology, Dr. Gregory Latham, discusses the importance of meeting abstracts and highlights a few abstracts from the CCAS 2019 annual meeting, while providing an overview of the remaining abstracts.

In this article, the authors present the annual review of the literature relevant for the practice of cardiovascular critical care. This is not an exhaustive review of the year, but rather selected highlights to summarize contributions to the literature since our last review. The topics covered this year include advances in the reversal of anticoagulants, introduction of a new class of vasopressor, innovative measures of acute kidney injury risk and presence after cardiac surgery, use of bicarbonate in severe acidosis, and finally, new information regarding the ongoing drug shortage issue.
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The anesthesia community has openly debated if the care of transplant patients was generalist or specialist care ever since the publication of an opinion paper in 1999 recommended subspecialty training in the field of liver transplantation anesthesia. In the past decade, liver transplant anesthesia has become more complex with a sicker patient population and evolving evidence-based practices. Transplant training is currently not required for accreditation or certification in anesthesiology, and not all anesthesia residency programs are associated with transplant centers. Yet there is evidence that patient outcome is affected by the experience of the anesthesiologist with liver transplants as part of a multidisciplinary care team. Requests for a formal review of the inequities in training opportunities and requirements led the Society for the Advancement for Transplant Anesthesia (SATA) to begin the task of developing post-graduate fellowship training recommendations. In this article, members of the SATA Working Group on Transplant Anesthesia Education present their reasoning for specialized education and conclusions about which pathways can better prepare trainees to care for complex transplant patients.
 
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