In this episode of The Cardiac Recovery Room, moderator Dr. Rawn Salenger, Chief of Cardiac Surgery at the University of Maryland St. Joseph Medical Center, engages in a conversation with Dr. Shuba Chatterjee, Associate Professor of Surgery and Director of Thoracic Surgical ICU and ECMO Program at Baylor College of Medicine in Houston, TX, USA, and nurse practitioner Amanda Rea, Lead of Advanced Practice and Clinical Program Manager in the Division of Cardiac Surgery at the University of Maryland St. Joseph Medical Center in Townson, MD, USA. Their conversation focused on hemodynamics and atrial fibrillation.
Chapters
00:00 Intro
01:17 Vasoplegia/Vasodilatory Shock
06:13 Vasopressors, Cost Considerations
07:32 Vasoplegia Misconceptions
08:41 Defining Vasoplegia
10:54 Blood Pressure Target Variable
12:54 Inotropes
17:03 Approach to Atrial Fibrillation
19:08 Patient Monitoring
19:27 Surgical/Concomitant Ablation
23:13 Postop AFib, Preventive Strategies
28:37 Example Scenario, High Heart Rate
29:56 Out of AFib Into Sinus Rhythm
33:01 Anticoagulation
39:43 Key Points
Key topics include vasoplegia, vasodilatory shock, and the use of vassopressors, including norepinephrine. They address common misconceptions surrounding vasoplegia shock, the role of epinephrine, and the use of methylene blue. Their conversation further delves into approaches for atrial fibrillation, concomitant surgical ablation, and postoperative atrial fibrillation. They highlight the best preventative strategies for atrial fibrillation and the use of beta blockers for atrial fibrillation. Finally, they discuss current guidelines and the role of anticoagulation in patients with atrial fibrillation.
The Cardiac Recovery Room is the place to hear the conversations colleagues are having after the meetings. Each month, a new episode will be released featuring a leadership panel from the ERAS Cardiac Society.
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