What are the options for cardiac standstill during aneurysm surgery? A systematic review

Meling, Torstein R.; Lavé, Alexandre

doi:10.1007/s10143-019-01183-4

Cited by 12 publications

(8 citation statements)

References 28 publications

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“…201 It is not suitable for patients with coronary heart disease and cardiac arrhythmias, and its safety in patients with aneurysmal subarachnoid hemorrhage is undetermined. 202 Deep hypothermic circulatory arrest for aneurysm surgery is now seldom required given the complex set-up, high complication rates, and the availability of other treatment innovations including endovascular approach. 202…”

Section: Management Of Aneurysmal Subarachnoid Hemorrhagementioning

confidence: 99%

Perioperative Management of Aneurysmal Subarachnoid Hemorrhage

Sharma

2020

Anesthesiology

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Aneurysmal subarachnoid hemorrhage is an acute neurologic emergency. Prompt definitive treatment of the aneurysm by craniotomy and clipping or endovascular intervention with coils and/or stents is needed to prevent rebleeding. Extracranial manifestations of aneurysmal subarachnoid hemorrhage include cardiac dysfunction, neurogenic pulmonary edema, fluid and electrolyte imbalances, and hyperglycemia. Data on the impact of anesthesia on long-term neurologic outcomes of aneurysmal subarachnoid hemorrhage do not exist. Perioperative management should therefore focus on optimizing systemic physiology, facilitating timely definitive treatment, and selecting an anesthetic technique based on patient characteristics, severity of aneurysmal subarachnoid hemorrhage, and the planned intervention and monitoring. Anesthesiologists should be familiar with evoked potential monitoring, electroencephalographic burst suppression, temporary clipping, management of external ventricular drains, adenosine-induced cardiac standstill, and rapid ventricular pacing to effectively care for these patients.

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Section: Management Of Aneurysmal Subarachnoid Hemorrhagementioning

confidence: 99%

Perioperative Management of Aneurysmal Subarachnoid Hemorrhage

Sharma

2020

Anesthesiology

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“…Como se mencionó anteriormente, la complejidad radica en la causa subyacente de la ECPNQ 1,5,6 . Es decir, factores como: el tipo y técnica del procedimiento quirúrgico; el manejo farmacológico pre, intra y post-quirúrgico; la biometría y posición del paciente para el procedimiento, son algunos determinantes en el nivel de complejidad del caso.…”

Section: Emergencias Cardíacas En Paciente Neuroquirúrgico (Ecpnq)unclassified

“…Las ECPNQ pueden clasificarse de acuerdo al tipo de procedimiento en: emergencias cardíacas en cirugía supratentorial (ECCST), emergencias cardíacas en cirugía de la base del cráneo (ECCBC), emergencias cardíacas en cirugía de la fosa craneana posterior (ECCFCP), emergencias cardíacas en cirugía cerebrovascular (ECCCV), emergencias cardíacas en cirugía de médula espinal (ECCME) y emergencias cardíacas inducidas por fármacos durante neurocirugía (ECF) 1,5,7 (Tabla 1).…”

Section: Emergencias Cardíacas En Paciente Neuroquirúrgico (Ecpnq)unclassified

“…La mayor atención ha sido dirigida a identificar técnicas de prevención, manejo y determinación de las secuelas, debido a que cuando un paciente entra en parada cardiaca mientras se le practica un procedimiento neuroquirúrgico es un desafío saber qué hacer incluso para los que contemplan los algoritmos del Advance cardiac life support (ACLS) 1 . La atención de una ECPNQ requiere la capacidad analítica y no la de reproducir de forma sistemática y de memoria los pasos de un algoritmo, porque cuando en varios pacientes la emergencia cardiaca es la misma, la causa subyacente podría ser muy diferente 1,5 .…”

Section: Introductionunclassified

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Emergencias cardiacas en pacientes neuroquirúrgicos

et al. 2021

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Las emergencias cardiacas en pacientes neuroquirúrgicos (ECPNQ) han sido estudiadas últimamente debido a que su ocurrencia genera una alta morbimortalidad. Entendemos ECPNQ como la fibrilación ventricular, actividad eléctrica sin pulso, arresto cardiaco, asistolia y bradicardia severa, y pueden clasificarse según la ubicación de la neurocirugía al momento de producirse. Sin embargo, diferentes mecanismos fisiopatológicos explican la aparición de cada emergencia, como los reflejos neurales, el aumento del tono parasimpático y la embolia aérea venosa. El manejo radica en controlar y equilibrar la causa de la emergencia y en ocasiones reanimación cardiopulmonar teniendo en cuenta la posición en la que está el paciente, pues esto incide en el pronóstico y desenlace.

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“…Recently, the effectiveness of adenosine-induced transient asystole for cases unsuitable for temporary clip placement in surgical clipping has been reported. [4][5][6][7][8][9][10] In Japan, adenosine is approved for various symptoms related to complications following head trauma, heart failure, muscular dystrophy, acute poliomyelitis, cerebral palsy, progressive spinal amyotrophy, accommodative asthenopia, tinnitus, hearing loss, chronic gastritis, and chronic hepatic disease, and adenosine-induced decompression of UCAs is an off-label use. The aim of this specific clinical trial is to investigate whether adenosine is a safe and viable alternative to temporary clip placement in clipping surgery for UCAs.…”

Section: Introductionmentioning

confidence: 99%

An Evaluation of the Safety and Feasibility of Adenosine-assisted Clipping Surgery for Unruptured Cerebral Aneurysms: Study Protocol

Hishikawa

Murai

Hiramatsu

et al. 2021

Neurol. Med. Chir.(Tokyo)

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The effectiveness of adenosine-induced flow arrest in surgical clipping for the cerebral aneurysms with difficulties in temporary clip placement to the proximal main trunk has been reported. This is the first clinical trial to evaluate the safety and feasibility of adenosine-assisted clipping surgery for unruptured cerebral aneurysms (UCAs) in Japan. The inclusion criteria are as follows: patients over 20 years old, patients who agree to be enrolled in this study after providing informed consent, patients who undergo clipping surgery for UCA in our institute, and patients in whom the surgeons (T.H. or I.D.) judge that decompression of the aneurysm is effective. The primary endpoint is a modified Rankin Scale (mRS) score 30 days after surgery. We plan to enroll 10 patients in this study. The original protocol of adenosine administration was established in this trial. Herein, we present the study protocol.

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What are the options for cardiac standstill during aneurysm surgery? A systematic review

Cited by 12 publications

References 28 publications

Perioperative Management of Aneurysmal Subarachnoid Hemorrhage

Perioperative Management of Aneurysmal Subarachnoid Hemorrhage

Emergencias cardiacas en pacientes neuroquirúrgicos

An Evaluation of the Safety and Feasibility of Adenosine-assisted Clipping Surgery for Unruptured Cerebral Aneurysms: Study Protocol

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