Regional Cerebral Oxygen Saturation Level Predicts 30-Day Mortality Rate After Left Ventricular Assist Device Surgery

Ethnic Disparities in Cardiothoracic Anesthesiology Fellowship Training

“…We congratulate Hinske et al for demonstrating the role of a preoperative mean pulmonary arterial pressure and lung allocation score in predicting the need for extracorporeal circulation during lung transplantation. 1 However, we are surprised by the absence of any data concerning anesthetic management, vascular filling, and especially preoperative cardiac output, measured during the assessment, or intraoperative cardiac output. How to highlight pulmonary arterial pressure without knowing the cardiac output measured simultaneously?…”

“…We congratulate Ghosal and colleagues for their work. 1 In the study, it was found that the decrease in regional cerebral oxygen saturation (rSO 2 ) in patients with a left ventricular assist device was associated with mortality (postoperative 30 days). In the same study, no association was found between rSO 2 and major adverse cardio-cerebral events.…”

“…According to the United States (US) Census data, females comprise half the population, and roughly 40% of the population are of minority groups. 1 Given the mounting evidence that female and minority representation in medicine leads to equitable health care, 2À4 it is prudent that we identify and address all inequalities and inequities in health care.…”

“…The 2016À2017 Association of American Medical Colleges data show that there were 1,714 (8.2%) African-American students and 2,015 (9.6%) Hispanic students among US medical school matriculants, yet the US Census data show that African-Americans and Hispanics represent 13.4% and 18.1% of the population, respectively. 1,7 The most recent Accreditation Council Graduate Medical Education (ACGME) data resource book shows there were 282 (4.5%) and 204 (3.3%) African-American and Hispanic anesthesiology residents in 2016-2017, respectively. 8 The ACGME data resource book also reveals only 12 (6.2%) African-American and 2 (1.2%) Hispanic cardiothoracic anesthesiology fellows in 2016-2017.…”

Regional Cerebral Oxygen Saturation Level in Left Ventricular Assist Device Surgery: Is This the Crystal Ball?

“…They evaluated 210 consecutive patients undergoing LVAD insertion between 2008 and 2014 in a retrospective cohort study and demonstrated a statistically significant association between baseline rSO 2 and early mortality in patients who underwent LVAD insertion. 5 Every 1% increase in baseline cerebral oxygen saturation reduced the odds ratio for 30-day mortality by 0.94 (95% confidence interval 0.89-0.99; p o 0.032). They did not observe a significant association for the rSO 2 at skin closure.…”