Journal d'anesthésiologie clinique : accès libre

Coagulation management plays a crucial role in cardiac surgery, as patients undergoing these procedures are at an increased risk of bleeding and thrombotic complications. The advancements in monitoring techniques and management strategies have significantly improved patient outcomes and reduced perioperative morbidity and mortality. Anesthesiologists play a pivotal role in the perioperative management of coagulation, and it is essential for them to be aware of the latest developments in this field. This article aims to provide an overview of the recent advances in monitoring and management of coagulation in cardiac surgery and their implications for anesthetic practice. Cardiac surgery poses unique challenges to coagulation management due to the complex interactions between surgical trauma, blood flow alterations, and the effects of cardiopulmonary bypass (CPB). Anesthesia providers must have a comprehensive understanding of the coagulation cascade and the latest techniques available for monitoring and managing coagulopathy in cardiac surgical patients.

Enhanced Recovery After Surgery (ERAS) protocols have gained significant attention in the field of cardiothoracic surgery for their potential to improve patient outcomes and optimize perioperative care. This systematic review aims to evaluate the impact of implementing ERAS protocols specifically in the context of anesthetic management and patient outcomes following cardiothoracic surgery. A comprehensive search of electronic databases was conducted, and relevant studies were selected based on predetermined inclusion criteria. A total of X studies were included in the review, encompassing various aspects of ERAS implementation in cardiothoracic surgery. The findings highlight the potential benefits of ERAS protocols, including reduced length of hospital stay, decreased postoperative complications, improved pain management, and enhanced patient satisfaction. Moreover, the review sheds light on the modifications required in anesthetic management to support successful ERAS implementation. These modifications include the use of multimodal analgesia techniques, minimization of intraoperative fluid administration, early extubation, and early initiation of postoperative mobilization. The review concludes that ERAS protocols have a positive impact on anesthetic management and patient outcomes in cardiothoracic surgery, and their implementation should be strongly considered to improve perioperative care and enhance patient recovery.