title: Innovative approaches in the perioperative care of the cardiac surgical patient in the operating room and intensive care unit.
abstract: Perioperative care for cardiac surgery is undergoing rapid evolution. Many of the changes involve the application of novel technologies to tackle common challenges in optimizing perioperative management. Herein, we illustrate recent advances in perioperative management by focusing on a number of novel components that we judge to be particularly important. These include: the introduction of brain and somatic oximetry; transesophageal echocardiographic hemodynamic monitoring and bedside focused ultrasound; ultrasound-guided vascular access; point-of-care coagulation surveillance; right ventricular pressure monitoring; novel inhaled treatment for right ventricular failure; new approaches for postoperative pain management; novel approaches in specialized care procedures to ensure quality control; and specific approaches to optimize the management for postoperative cardiac arrest. Herein, we discuss the reasons that each of these components are particularly important in improving perioperative care, describe how they can be addressed, and their impact in the care of patients who undergo cardiac surgery.
authors.affiliation: Department of Anesthesiology, Critical Care Program, Montreal Heart Institute, and Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montreal, Quebec, Canada. Electronic address: andre.denault@umontreal.ca.
authors.forename: André
authors.initials: A
authors.lastname: Denault
authors.affiliation: Department of Cardiac Surgery and Critical Care Program, Montreal Heart Institute, and Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Yoan
authors.initials: Y
authors.lastname: Lamarche
authors.affiliation: Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Antoine
authors.initials: A
authors.lastname: Rochon
authors.affiliation: Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cogan
authors.affiliation: Department of Medicine, Cardiology and Critical Care Program, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Mark
authors.initials: M
authors.lastname: Liszkowski
authors.affiliation: Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Jean-Sébastien
authors.initials: JS
authors.lastname: Lebon
authors.affiliation: Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Christian
authors.initials: C
authors.lastname: Ayoub
authors.affiliation: Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Taillefer
authors.affiliation: Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Robert
authors.initials: R
authors.lastname: Blain
authors.affiliation: Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Claudia
authors.initials: C
authors.lastname: Viens
authors.affiliation: Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Pierre
authors.initials: P
authors.lastname: Couture
authors.affiliation: Department of Anesthesiology, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
authors.forename: Alain
authors.initials: A
authors.lastname: Deschamps
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods*; D006321:Heart / Q000503:physiopathology*; D006331:Heart Diseases / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007362:Intensive Care Units; D008991:Monitoring, Physiologic; D009873:Operating Rooms; D019990:Perioperative Care / Q000379:methods*