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1. Effects of Remote Ischaemic Preconditioning on the Internal Thoracic Artery Nitric Oxide Synthase Isoforms in Patients Undergoing Coronary Artery Bypass Grafting

Author: Aleksandra Jankovic, Tamara Zakic, Miroslav Milicic, Dragana Unic-Stojanovic, Andjelika Kalezic, Aleksandra Korac, Miomir Jovic, and Bato Korac
Subjects: remote ischaemic preconditioning, internal thoracic artery, nitric oxide synthase isoforms, coronary artery graft, Therapeutics. Pharmacology, RM1-950
Abstract: Remote ischaemic preconditioning (RIPC) is a medical procedure that consists of repeated brief periods of transient ischaemia and reperfusion of distant organs (limbs) with the ability to provide internal organ protection from ischaemia. Even though RIPC has been successfully applied in patients with myocardial infarction during coronary revascularization (surgery/percutaneous angioplasty), the underlying molecular mechanisms are yet to be clarified. Thus, our study aimed to determine the role of nitric oxide synthase (NOS) isoforms in RIPC-induced protection (3 × 5 min of forearm ischaemia with 5 min of reperfusion) of arterial graft in patients undergoing urgent coronary artery bypass grafting (CABG). We examined RIPC effects on specific expression and immunolocalization of three NOS isoforms — endothelial (eNOS), inducible (iNOS) and neuronal (nNOS) in patients’ internal thoracic artery (ITA) used as a graft. We found that the application of RIPC protocol leads to an increased protein expression of eNOS, which was further confirmed with strong eNOS immunopositivity, especially in the endothelium and smooth muscle cells of ITA. The same analysis of two other NOS isoforms, iNOS and nNOS, showed no significant differences between patients undergoing CABG with or without RIPC. Our results demonstrate RIPC-induced upregulation of eNOS in human ITA, pointing to its significance in achieving protective phenotype on a systemic level with important implications for graft patency.
Published: 2021
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2. Pneumonia in medical professionals during COVID-19 outbreak in cardiovascular hospital

Author: Ivan Ilic, Marina Zdravkovic, Stefan Timcic, Dragana Unic Stojanovic, Milovan Bojic, and Goran Loncar
Subjects: coronavirus, pneumonia, influenza, immunization, Infectious and parasitic diseases, RC109-216
Abstract: Objectives: The pandemic of coronavirus associated disease (COVID-19) placed the health care workers at high risk. We investigated clinical and treatment characteristics of infected medical professionals in a cardiovascular hospital. Methods: The study was retrospective, conducted in tertiary cardiovascular hospital and included employees with confirmed coronavirus infection. They filled out a questionnaire about health status, symptoms, admission to hospital and treatment. The vaccination status against tuberculosis, hepatitis B and seasonal influenza was assessed. Pneumonia was defined as CT finding of ground glass opacifications (GGO) with consolidations typical for COVID-19. Results: The study included 107 confirmed cases of COVID - 19 out of 726 employees (15%). Most of the infected were from cardiac surgery department (74/107, 69%). Substantial number of employees did not have any symptoms [31 (28.9%)] and 38 patients (35.5%) were admitted to hospital. The average hospital length of stay was 8.1 ± 5.6 days. Seventy-five of 107 (70.1%) received seasonal influenza vaccine. Pneumonia with CT features of GGO and consolidation occurred in 25/107 (23.4%) patients of which 14/107 (13.1%) had bilateral involvement. In multivariate logistic regression analysis including recognized characteristics associated with worse outcomes in COVID-19 (obesity, diabetes mellitus, coronary artery disease, cerebrovascular disease, current smoking, heart failure, influenza immunization), only influenza immunization remained an independent predictor of occurrence of bilateral pneumonia (OR 0.207; 95%CI[0.050 – 0.847]; p = 0.029). Conclusions: The association of influenza immunization and less aggressive form of pneumonia might provide a finding that supports the institution of preventive measures that can be beneficial in reduction of global coronavirus burden.
Published: 2021
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3. Influenza immunization and COVID-19—can viral structure be responsible for the effect?

Author: Ivan Ilic, Dragana Unic Stojanovic, and Goran Loncar
Subjects: Infectious and parasitic diseases, RC109-216
Published: 2021
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4. European Association of Cardiothoracic Anesthesiology and Intensive Care (EACTAIC) Fellowship Curriculum: Second Edition

Author: Gabor Erdoes, Patrick F. Wouters, R. Peter Alston, Jan-Uwe Schreiber, Dominique Bettex, Theofani Antoniou, Maria Benedetto, Stefaan Bouchez, Laszlo Szegedi, Kirstin Wilkinson, Giovanni Landoni, Sascha Treskatsch, Purificación Matute, Vera von Dossow, Dieter Van Beersel, Dragana Unic-Stojanovic, Mona Momeni, Philippe Gaudard, Andrea Szekely, Philippe Burtin, Anna Flo-Forner, Caetano Nigro Neto, Jens Fassl, Manuel Granell, Joachim M. Erb, Ricard Navarro-Ripoll, Marc Vives, Fawzia Aboul Fetouh, Simon J. Howell, Nandor Marczin, Alberto Hernandez Martinez, Alain Vuylsteke, Hossam El-Ashmawi, Blanca Martinez Lopez de Arroyabe, Chirojit Mukherjee, Steffen Rex, Gianluca Paternoster, Fabio Guarracino, Mohamed R. El-Tahan, MUMC+: MA Anesthesiologie (9), RS: MHeNs - R3 - Neuroscience, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, Erdoes, Gabor, Wouters, Patrick F, Alston, R Peter, Schreiber, Jan-Uwe, Bettex, Dominique, Antoniou, Theofani, Benedetto, Maria, Bouchez, Stefaan, Szegedi, Laszlo, Wilkinson, Kirstin, Landoni, Giovanni, Treskatsch, Sascha, Matute, Purificación, von Dossow, Vera, Van Beersel, Dieter, Unic-Stojanovic, Dragana, Momeni, Mona, Gaudard, Philippe, Szekely, Andrea, Burtin, Philippe, Flo-Forner, Anna, Neto, Caetano Nigro, Fassl, Jen, Granell, Manuel, Erb, Joachim M, Navarro-Ripoll, Ricard, Vives, Marc, Fetouh, Fawzia Aboul, Howell, Simon J, Marczin, Nandor, Martinez, Alberto Hernandez, Vuylsteke, Alain, El-Ashmawi, Hossam, de Arroyabe, Blanca Martinez Lopez, Mukherjee, Chirojit, Rex, Steffen, Paternoster, Gianluca, Guarracino, Fabio, and El-Tahan, Mohamed R
Subjects: Critical Care, education, Internship and Residency, Cardiac Procedures, Anesthesiology and Pain Medicine, [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system, Anesthesiology, Medicine and Health Sciences, Anesthesia, Cardiac Procedures, Anesthesiology/education, Humans, Anesthesia, Curriculum, Fellowships and Scholarships, Cardiology and Cardiovascular Medicine
Abstract: International audience; This document represents the first update of the Cardiothoracic and Vascular Anaesthesia Fellowship Curriculum of the European Association of Cardiothoracic Anaesthesiology and Intensive Care. After obtaining feedback from exit interviews with fellows in training, graduate fellows, and program directors, 2 modified online Delphi procedures with questionnaires were conducted. A consensus was reached when two-thirds of responding committee members gave green or yellow ratings on a traffic light system, and >70% indicated strong agreement or agreement on a 5-point Likert scale. The new regulations include the following: (1) more flexibility in the fellows` rotation, as long as the total number of days, rotations, and cases are completed during the training year; (2) recommendation for strict compliance with national working-time guidelines; (3) no extension of fellowship training to compensate for annual and/or sick leave, unless the required minimum number of cases and rotations are not reached; (4) interruption of fellowship training for >12 months is allowed for personal or medical reasons; (5) introduction of a checklist for quantitative assessment of standard clinical skills; (6) recommendations for a uniform structure of exit interviews; (7) possibility of a 1-month training rotation in a postanesthesia care unit instead of an intensive care unit; and (8) provided all other requirements have been met, the allowance of progression from the basic training year to the advanced fellowship training year without first passing the transesophageal echocardiography examination.
Published: 2022
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5. A complete versus inducible ischemia-guided revascularization after a culprit-only primary percutaneous coronary intervention in multivessel coronary artery disease: A pilot study

Author: Dragana Unic-Stojanovic, Milica Stefanovic, Srdjan Kafedzic, Ivan Ilic, Ivan Stankovic, Aleksandra Zivanic, Aleksandra Janicijevic, Radosav Vidakovic, and Gojko Obradović
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Percutaneous coronary intervention, General Medicine, medicine.disease, Revascularization, Culprit, 3. Good health, Coronary artery disease, stress, 03 medical and health sciences, myocardial infarction, 0302 clinical medicine, Internal medicine, medicine, Cardiology, echocardiography, Medicine, Inducible ischemia, cardiovascular diseases, 030212 general & internal medicine, business, coronary artery disease
Abstract: Introduction/Objective. Revascularization in multivessel coronary artery disease (MVD) in patients with ST elevation myocardial infarction (STEMI) is a matter of debate. We sought to compare outcomes between revascularization strategies based on angiographic lesion severity or inducible ischemia. Methods. In prospective study, first ever STEMI patients with MVD, defined as > 70% stenosis in non-culprit vessel, treated with culprit only primary PCI were randomized to: A. Complete revascularization of all nonculprit significant lesions during initial hospitalization; B. Complete revascularization after 30 days, or C. Revascularization based on non-invasive testing for inducible ischemia. The study explored occurrence of major adverse cardio-cerebral events (MACCE) (cardiac death, repeated MI, cerebrovascular event). Results. The study enrolled 120 patients with door to balloon time within appropriate limits (A 51 ? 26 vs. B 47 ? 33 vs. C 44 ? 29 min, p = 0.604) The patients in group A underwent complete revascularization at 6 [4?7] days after primary PCI, while in the group B it was 35 [32?39] days. In group C, 16/43 (37.2%) patients underwent PCI at 82 [66?147] days after infarction (p < 0.001). The patients were followed for 2.7 ? 0.8 years. The events occurred less frequently in patients that underwent planned complete revascularization compared to those who underwent ischemia testing (7.8 vs. 20.9%, p = 0.040). Kaplan?Meier analysis favored complete delayed revascularization (MACCE A 8.8 vs. B 6.9 vs. C 20.9%, log rank p = 0.041). Conclusions. Planned, angiography guided, complete revascularization after initial event may be favorable strategy compared to single stress test for MVD in STEMI.
Published: 2021
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6. SYNTAX SCORE II VERSION 2020: EXTERNAL VALIDATION OF PATIENTS TREATED BY CORONARY ARTERY BYPASS GRAFTING IN A SINGLE LARGE VOLUME CARDIO-SURGICAL CENTER

Author: Miodrag C. Ostojic, Natalija Arnautovic, Duško Nežic, Tatjana Raguš, Slobodan Micovic, Petar Otasevic, Aleksandra Tomislav Nikolic, Nebojša Tasic, Tamara Kovacevic-Preradovic, Bojan Stanetic, Dragana Unic-Stojanovic, Milan Dobric, Milan Milojevic, Stefan Veljkovic, Nikola N. Boskovic, Dragoljub Djokic, Luka Cucic, Vladimir Mihajlovic, Jelena Kotur Stevuljevic, Ivan Ivanovic, Bela Balint, Sasa Hinic, Snežana Boric, Vlado Djajic, and Milovan Bojic
Subjects: Cardiology and Cardiovascular Medicine
Published: 2023
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7. Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

Author: Dejan Stojkovic, Nebojsa Maric, Dragana Unic-Stojanovic, Mihailo Bezmarevic, Suzana Bojic, Vladimir Bancevic, Dusica Stamenkovic, Damjan Slavkovic, and Menelaos Karanikolas
Subjects: medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Review, dosage, catheters, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, anesthetics, medicine, postoperative therapy, Caesarean section, pain, 030212 general & internal medicine, biology, Prostatectomy, business.industry, Local anesthetic, indwelling, Laminectomy, Surgical wound, General Medicine, biology.organism_classification, Colorectal surgery, 3. Good health, Surgery, Valgus, Pain Origin, Medicine, business, local/administration
Abstract: Local anesthetic wound infiltration (WI) provides anesthesia for minor surgical procedures and improves postoperative analgesia as part of multimodal analgesia after general or regional anesthesia. Although pre-incisional block is preferable, in practice WI is usually done at the end of surgery. WI performed as a continuous modality reduces analgesics, prolongs the duration of analgesia, and enhances the patient’s mobilization in some cases. WI benefits are documented in open abdominal surgeries (Caesarean section, colorectal surgery, abdominal hysterectomy, herniorrhaphy), laparoscopic cholecystectomy, oncological breast surgeries, laminectomy, hallux valgus surgery, and radical prostatectomy. Surgical site infiltration requires knowledge of anatomy and the pain origin for a procedure, systematic extensive infiltration of local anesthetic in various tissue planes under direct visualization before wound closure or subcutaneously along the incision. Because the incidence of local anesthetic systemic toxicity is 11% after subcutaneous WI, appropriate local anesthetic dosing is crucial. The risk of wound infection is related to the infection incidence after each particular surgery. For WI to fully meet patient and physician expectations, mastery of the technique, patient education, appropriate local anesthetic dosing and management of the surgical wound with “aseptic, non-touch” technique are needed.
Published: 2021

8. Results of simultaneous application of hyperbaric oxygen and negative pressure wound therapy in diabetic foot ulcers treatment

Author: Djordje Cejic, Dragana Unic-Stojanovic, Dragoslav Nenezic, Predrag Matic, Djordje Radak, and Slobodan Tanaskovic
Subjects: medicine.medical_specialty, business.industry, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, 030209 endocrinology & metabolism, medicine.disease, Revascularization, Diabetic foot, Surgery, 03 medical and health sciences, 0302 clinical medicine, Diabetic foot ulcer, Negative-pressure wound therapy, Diabetes mellitus, Internal Medicine, Etiology, Medicine, 030212 general & internal medicine, business, Prospective cohort study, Foot (unit)
Abstract: The aim of this paper is to determine which therapy gives best results regarding process of healing of diabetic foot ulcers among three proposed: only negative pressure wound therapy, only hyperbaric oxygen therapy, and both when used in conjunction. This bicentric prospective study included 60 patients, and they were, consecutively, assigned to one of three groups. The first group consisted of 20 patients who were treated only by hyperbaric oxygen therapy, second group consisted of 20 patients treated with combined hyperbaric oxygen and negative pressure wound therapy, and third group consisted of 20 patients who were treated only by negative pressure wound therapy. In some cases, previous revascularization of lower limb was performed and patients with poor run-off, without possibility to perform revascularization, were excluded from the study. Patients were predominantly men (56.7%) and mean age was 60.57 years. Majority of patients had ulcers of ischemic origin (45%), in 30% of cases, the reason of foot ulceration was neuropathy, and in 25% of patients, the etiology was combined. During the study, in three patients (5%), minor amputations were observed. Regarding Wagner classification of foot ulcers, most dominant was stage II (χ = 12.618, df = 4, p
Published: 2019
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9. Intraoperative transfusion practices and perioperative outcome in the European elderly: A secondary analysis of the observational ETPOS study

Author: Grusser L., Keszei A., Coburn M., Rossaint R., Ziemann S., Kowark A, Daniela Filipescu, Sibylle Kozek-Langenecker, Juan V Llau Pitarch, Susan Mallett, Peter Martus, Idit Matot, Jens Meier, Axel Unterrainer, Dieter Adelmann, Daniel von Langen, Petra Innerhofer, Nicole Innerhofer-Pompernigg, Stefan De Hert, Luc De Baerdemaeker, Jurgen van Limmen, Piet Wyffels, Björn Heyse, Margot Vanderlaenen, Maud Beran, David Kahn, Audrey Prospiech, Luc Jamaer, Freya Mulders, Stefan Jacobs, Wannes Baeten, Sofie Platteau, Isabelle Maquoi, Severine Lauwick, Marc Senard, Vincent Ninane, Jean-Pierre Lecoq, Pierre Boveroux, Grégory Hans, Marcel Vercauteren, Brigitte Leva, Benoit Plichon, Vojislav Vujanovič, Ismet Suljevic, Hened Kelle, Denis Gustin, Matea Bogdanovic Dvorscak, Tamara Lupis, Jadranka Pavičić Šarić, Nataša Paklar, Dagmar Oberhofer, Ira Skok, Borana Kirigin, Ikic Visnja, Marina Kresic, Slavica Kvolik, Renatas Krobot, Vladimir Cerny, Jana Striteska, Marcela Bilska, Petr Štourač, Hana Harazim, Olga Smékalová, Martina Kosinová, Jozef Klučka, Rita Pacasová, Kim Ekelund, Indrek Rätsep, Juri Oganjan, Nadezda Smirnova, Peeter Kivik, Juri Karjagin, Alar Rokk, Alar Sõrmus, Bertrand Rozec, Jean-Christophe Rigal, Jean-Pierre Gouraud, Anne-Marie Chupin, Xavier Ambrosi, Laurent Brisard, Sylvie Decagny, Charles Marc Samama, Lionel Lidzborski, Matthieu Boisson, Anne-Laure Arcade, Gilbert Lorre, Peter Rosenberger, Hannah Merz, Ulrich Goebel, Bettina Schnitter, Hartmut Buerkle, Roland Tomasi, Vera von Dossow-Hanfstingl, Florian Brettner, Andreas Bayer, André Gottschalk, Nicolas Jakobs, Mark Coburn, Ana Kowark, Rolf Rossaint, Rita Laufenberg, Marion Ferner, Michael Schuster, Lydia Strys, Susanne Mauff, Kornel Skitek, Ewa Zielinska-Skitek, Gregor Schittek, Andreas Hoeft, Andreas Fleischer, Maria Wittmann, Florian Kessler, Anne Rohner, Peter Kranke, Christian Wunder, Johanna Jokinen, Kristin Budow, Christopher Prasser, Eva Werner, Alina Balandin, Norbert Ahrens, Kai Zacharowski, Patrick Meybohm, Kassiani Theodoraki, George Giokas, Tasoulis Marios-Konstantinos, Ageliki Pandazi, Aikaterini Kyttari, Eygenia Koursoumi, Georgios Anthopoulos, Antonis Andreou, Athanasios Rantis, Dimitrios Valsamidis, Pelagia Klimi, Konstantinos Katsanoulas, Demetrios Korfiotis, Christos Soumelidis, Fotios Papaspyros, Olga Kiskira, Tilemachos Paraskeuopoulos, Donal Buggy, Mortimer Kelleher, Liz Coghlan, Vladimir Verenkin, Anat Cattan, Francesco Bona, Felicino Debernardi, Andrea Cortegiani, Santi Maurizio Raineri, Giuseppe Accurso, Elena Gramigni, Leonardo Cenni, Laura Campiglia, Irene Lorenzi, Maria Grazia Militello, Tamara Biscioni, Andrius Macas, Daiva Apanaviciute, Darius Trepenaitis, Arunas Gelmanas, Diana Bilshiene, Jurate Sipylaite, Gabija Tomkute, Egle Kontrimaviciut, Renatas Tikuisis, Francis Borg, Ion Chesov, Serghei Cobiletchi, Victoria Moghildea, Bas Verdouw, J F van Poorten, Nick van Dasselaar, Marcus Daniel Lance, Britta de Waal, Lucienne Kropman, Peter van Noord, Benedikt Preckel, Lena Koers, Markus W Hollmann, Holger Baumann, Ankie W M M Koopman-van Gemert, Tore Reikvam, Tore Hervig, Kasper Gymoese Berthelsen, Ingvild Hausberg Sørvoll, Mirosław Czuczwar, Michał Borys, Paweł Piwowarczyk, Suzana Parente, Diogo Martins, Gloria Tareco, Ligia Reis, Joana Amaral, Daniel Ferreira, José Manuel Gonçalves Aguiar, Zélia Moreira, Filipa Lagarto, Filipa Pereira, Maria Lina Miranda, Sofia Serra, Alexandre Carrilho, José Pinto, Sandra Dias, Rita Poeria, Filipe Linda, Silvia Pica, Helder Martinho, Francisco Matias, Claudia Alves, Valentina Almeida, Margarida Marques, Emilia Martires, Piedade Gomes, Elizabete Pereira, Joana Jesus, Claudia Carreira, Carlos Seco, Carlos Bento, Helena Vieira, Luciane Pereira, Fernando Pinto, Luisa Silva, Marta Azenha, Maged Zarif, Ana Bernardino, Ana Raimundo, Ana Lopes, Melissa Fernandes, Beatriz Campos, Ana Macedo, Filipe Pinheiro, Sonia Duarte, Alexandra Saraiva, Catia Real, Marilena Alina Paunescu, Alexandru Bogdan Prodan, Mihai Stefan, Cristian Boros, Marius Tifrea, Anca Dragan, Horhota Lucian, Alida Moise, Carmen Arion-Balescu, Natalia Mincu, Viorel Gherghina, Iulia Cindea, Dan Costea, Ravzan Popescu, Dana Tomescu, Ecaterina Scarlatescu, Esenia Calancea, Ruxandra Copotoiu, Sanda Maria Copotoiu, Victoria Barsan, Dan Corneci, Rely Manolescu, Toma Diana, Denisa Nitu, Georgian Popica, Gabriela Droc, Nicoleta Jipa Lavina, Roxana Ciobanasu, Anna Maria Munteanu, Denisa Anastase, Iona Grintescu, Liliana Mirea, Alexandra Manoleli, Ciobanu Elena, Mary Nicoleta Lupu, Madalina Nina Sandu, Bicolae Bacalbasa, Florenta Calarasu, Alexey Grytsan, Andrey Gasenkampf, Alexander Kulikov, Alexander Shmigelsky, Vojislava Nescovic, Rade Vukovic, Uros Petrovic, Milic Veljovic, Dragana Unic-Stojanovic, Gordana Jovanovic, Ivana Kvrgic, Dragana Rakic, Roman Záhorec, Daniel Cintula, Tomas Veselovsky, Katarina Galkova, Jordana Stevikova, Andrea Číková, Zora Flassikova, Anna Dobisova, Jasmina Markovic Bozic, Minca Voje, Andriy Grynyuk, Alenka Spindler Yesel, Sabina Stivan, Peter Poredos, Darja Kasnik, Jasna Uranjek, Raquel Ferrandis, Sofia Machado, Liliana Henao, Tania Moreno, Ana Izquierdo, Carlos Delgado, Angela Camps, Susana Manrique, Alejandro Arbelaez, Pilar Tormos, Helena Serrano, Irene Garcia, Elvira Bisbe Vives, Luís Moltó, Tania Villar, Enrique Moret, Raquel Tolós, Esther Martínez, Misericordia Basora, Beatriz Tena, Roger Pujol, Jorge Vera Bella, Thomas Mallor, Pablo Mondero, Luis Lopez, Francisco Hidalgo, Maria Bermudez Lopez, Ana Velasco, Begona Bascuas, Victoria Moral, Diana Gómez Martinez, Alfredo Merten, J A Fernández, Nadia Diana Kinast, A Font, Maggi Genaro, Emilia Guasch, Fernando Gilsanz, Raul Martinez, Renato Schiraldi, Ever Martinez, Marta Barquero López, Alexo Lopez Alvarez, Yvan Enrique Sanchez Sanchez, Adriana Roman Fernandez, Olalla Varela Garcia, Marian Angeles Orallo Moran, Veronica Gonzalez Monzon, Óscar Sánchez López, David Sanchez Perez, Pablo Molano Diaz, Concepcion Cassinello, Maria Pilar Jubera, Maria Soler Pedrola, Julio Belmonte Cuenca, Sören Söndergaard, Till Rudolph, Kristin Åkeröy, Monir Jawad, Yousif Saeed, Sergej Safonov, Mona Andersson, Jan Wernerman, Suzanne Odeberg-Wernerman, Tommi Blom, Nesil Deger Coskunfirat, Zekiye Bigat, Suat Sanlı, O Koray Coskunfirat, Atilla Ramazanoğlu, Neval Boztug Uz, Ali Emre Camci, Omur Aksoy, Esra Saka, Oguzhan Arun, Sevda Ozkardesler, Dilek Omur, Mert Akan, Zuleyha Kazak Bengisun, Hakan Yılmaz, Perihan Ekmekci, Onur Selvi, Neslihan Alkis, Çiğdem Yıldırım, Başak Ceyda Meço, Zekeriyye Alanoğlu, Sergiy Vorotyntsev, Yevgen Yakymenko, Galina Troyan, Mohammed Alousi, Sarah James, Paula Meale, Ahmed Chishti, Matt Garner, Rita Singh, Nicola Hirschauer, Charley Higham, Andrea Bell, Alistair Cain, Chris Perry, Katy Davies, Claire Leech, Verity Calder, Shaman Jhanji, Varma Sandeep, Karen Simeson, Philip Watt, Nigel Dunk, Rosemary Ferrie, Margaret Wright, Lynn Everett, Andrew Ferguson, Laura Espie, Gail Browne, Matthew Dickinson, Ashok Nair, Deborah Clements, Peter Carvalho, Thomas Collyer, Jens Bolten, Lajos Zsisku, Attila Petri, Mohammed Ramadan, Tracey Ellimah, Martus, Peter, Laufenberg, Rita, Ferner, Marion, Schuster, Michael, Strys, Lydia, Mauff, Susanne, Skitek, Kornel, Zielinska-Skitek, Ewa, Schittek, Gregor, Hoeft, Andreas, Fleischer, Andreas, Matot, Idit, Wittmann, Maria, Kessler, Florian, Rohner, Anne, Kranke, Peter, Wunder, Christian, Jokinen, Johanna, Budow, Kristin, Prasser, Christopher, Werner, Eva, Balandin, Alina, Meier, Jens, Ahrens, Norbert, Zacharowski, Kai, Meybohm, Patrick, Theodoraki, Kassiani, Giokas, George, Marios-Konstantinos, Tasoulis, Pandazi, Ageliki, Kyttari, Aikaterini, Koursoumi, Eygenia, Anthopoulos, Georgios, Unterrainer, Axel, Andreou, Antonis, Rantis, Athanasios, Valsamidis, Dimitrios, Klimi, Pelagia, Katsanoulas, Konstantinos, Korfiotis, Demetrios, Soumelidis, Christos, Papaspyros, Fotios, Kiskira, Olga, Paraskeuopoulos, Tilemachos, Adelmann, Dieter, Buggy, Donal, Kelleher, Mortimer, Coghlan, Liz, Verenkin, Vladimir, Cattan, Anat, Bona, Francesco, Debernardi, Felicino, Cortegiani, Andrea, Raineri, Santi Maurizio, Accurso, Giuseppe, von Langen, Daniel, Gramigni, Elena, Cenni, Leonardo, Campiglia, Laura, Lorenzi, Irene, Militello, Maria Grazia, Biscioni, Tamara, Macas, Andrius, Apanaviciute, Daiva, Trepenaitis, Darius, Gelmanas, Arunas, Innerhofer, Petra, Bilshiene, Diana, Sipylaite, Jurate, Tomkute, Gabija, Kontrimaviciut, Egle, Tikuisis, Renatas, Borg, Francis, Chesov, Ion, Cobiletchi, Serghei, Moghildea, Victoria, Verdouw, Bas, Innerhofer-Pompernigg, Nicole, van Poorten, J. F., van Dasselaar, Nick, Lance, Marcus Daniel, de Waal, Britta, Kropman, Lucienne, van Noord, Peter, Preckel, Benedikt, Koers, Lena, Hollmann, Markus W., Baumann, Holger, De Hert, Stefan, Koopman-van Gemert, Ankie W. M. M., Reikvam, Tore, Hervig, Tore, Berthelsen, Kasper Gymoese, Sørvoll, Ingvild Hausberg, Czuczwar, Mirosław, Borys, Michał, Piwowarczyk, Paweł, Parente, Suzana, Martins, Diogo, De Baerdemaeker, Luc, Tareco, Gloria, Reis, Ligia, Amaral, Joana, Ferreira, Daniel, Gonçalves Aguiar, José Manuel, Moreira, Zélia, Lagarto, Filipa, Pereira, Filipa, Miranda, Maria Lina, Serra, Sofia, van Limmen, Jurgen, Carrilho, Alexandre, Pinto, José, Dias, Sandra, Poeria, Rita, Linda, Filipe, Pica, Silvia, Martinho, Helder, Matias, Francisco, Alves, Claudia, Almeida, Valentina, Wyffels, Piet, Marques, Margarida, Martires, Emilia, Gomes, Piedade, Pereira, Elizabete, Jesus, Joana, Carreira, Claudia, Seco, Carlos, Bento, Carlos, Vieira, Helena, Pereira, Luciane, Heyse, Björn, Pinto, Fernando, Silva, Luisa, Azenha, Marta, Zarif, Maged, Bernardino, Ana, Raimundo, Ana, Lopes, Ana, Fernandes, Melissa, Campos, Beatriz, Macedo, Ana, Vanderlaenen, Margot, Pinheiro, Filipe, Duarte, Sonia, Saraiva, Alexandra, Real, Catia, Paunescu, Marilena Alina, Bogdan Prodan, Alexandru, Stefan, Mihai, Boros, Cristian, Tifrea, Marius, Dragan, Anca, Beran, Maud, Lucian, Horhota, Moise, Alida, Arion-Balescu, Carmen, Mincu, Natalia, Gherghina, Viorel, Cindea, Iulia, Costea, Dan, Popescu, Ravzan, Tomescu, Dana, Scarlatescu, Ecaterina, Kahn, David, Calancea, Esenia, Copotoiu, Ruxandra, Copotoiu, Sanda Maria, Barsan, Victoria, Corneci, Dan, Manolescu, Rely, Diana, Toma, Nitu, Denisa, Popica, Georgian, Droc, Gabriela, Prospiech, Audrey, Jipa Lavina, Nicoleta, Ciobanasu, Roxana, Munteanu, Anna Maria, Anastase, Denisa, Grintescu, Iona, Mirea, Liliana, Manoleli, Alexandra, Elena, Ciobanu, Lupu, Mary Nicoleta, Sandu, Madalina Nina, Jamaer, Luc, Bacalbasa, Bicolae, Calarasu, Florenta, Grytsan, Alexey, Gasenkampf, Andrey, Kulikov, Alexander, Shmigelsky, Alexander, Nescovic, Vojislava, Vukovic, Rade, Petrovic, Uros, Veljovic, Milic, Mulders, Freya, Unic-Stojanovic, Dragana, Jovanovic, Gordana, Kvrgic, Ivana, Rakic, Dragana, Záhorec, Roman, Cintula, Daniel, Veselovsky, Tomas, Galkova, Katarina, Stevikova, Jordana, Číková, Andrea, Jacobs, Stefan, Flassikova, Zora, Dobisova, Anna, Markovic Bozic, Jasmina, Voje, Minca, Grynyuk, Andriy, Spindler Yesel, Alenka, Stivan, Sabina, Poredos, Peter, Kasnik, Darja, Uranjek, Jasna, Baeten, Wannes, Ferrandis, Raquel, Machado, Sofia, Henao, Liliana, Moreno, Tania, Izquierdo, Ana, Delgado, Carlos, Camps, Angela, Manrique, Susana, Arbelaez, Alejandro, Tormos, Pilar, Platteau, Sofie, Serrano, Helena, Garcia, Irene, Bisbe Vives, Elvira, Moltó, Luís, Villar, Tania, Moret, Enrique, Tolós, Raquel, Martínez, Esther, Basora, Misericordia, Tena, Beatriz, Maquoi, Isabelle, Pujol, Roger, Vera Bella, Jorge, Mallor, Thomas, Mondero, Pablo, Lopez, Luis, Hidalgo, Francisco, Bermudez Lopez, Maria, Velasco, Ana, Bascuas, Begona, Moral, Victoria, Lauwick, Severine, Gómez Martinez, Diana, Merten, Alfredo, Fernández, J. A., Kinast, Nadia Diana, Font, A., Genaro, Maggi, Guasch, Emilia, Gilsanz, Fernando, Martinez, Raul, Schiraldi, Renato, Senard, Marc, Martinez, Ever, Barquero López, Marta, Lopez Alvarez, Alexo, Sanchez Sanchez, Yvan Enrique, Roman Fernandez, Adriana, Varela Garcia, Olalla, Orallo Moran, Marian Angeles, Gonzalez Monzon, Veronica, Sánchez López, Óscar, Sanchez Perez, David, Ninane, Vincent, Molano Diaz, Pablo, Cassinello, Concepcion, Pilar Jubera, Maria, Soler Pedrola, Maria, Belmonte Cuenca, Julio, Söndergaard, Sören, Rudolph, Till, Åkeröy, Kristin, Jawad, Monir, Saeed, Yousif, Lecoq, Jean-Pierre, Safonov, Sergej, Andersson, Mona, Wernerman, Jan, Odeberg-Wernerman, Suzanne, Blom, Tommi, Deger Coskunfirat, Nesil, Bigat, Zekiye, Sanlı, Suat, Coskunfirat, O. Koray, Ramazanoğlu, Atilla, Boveroux, Pierre, Boztug Uz, Neval, Camci, Ali Emre, Aksoy, Omur, Saka, Esra, Arun, Oguzhan, Ozkardesler, Sevda, Omur, Dilek, Akan, Mert, Bengisun, Zuleyha Kazak, Yılmaz, Hakan, Hans, Grégory, Ekmekci, Perihan, Selvi, Onur, Alkis, Neslihan, Yıldırım, Çiğdem, Ceyda Meço, Başak, Alanoğlu, Zekeriyye, Vorotyntsev, Sergiy, Yakymenko, Yevgen, Troyan, Galina, Alousi, Mohammed, Vercauteren, Marcel, James, Sarah, Meale, Paula, Chishti, Ahmed, Garner, Matt, Singh, Rita, Hirschauer, Nicola, Higham, Charley, Bell, Andrea, Cain, Alistair, Perry, Chris, Leva, Brigitte, Davies, Katy, Leech, Claire, Calder, Verity, Jhanji, Shaman, Sandeep, Varma, Simeson, Karen, Watt, Philip, Dunk, Nigel, Ferrie, Rosemary, Wright, Margaret, Plichon, Benoit, Everett, Lynn, Ferguson, Andrew, Espie, Laura, Browne, Gail, Dickinson, Matthew, Nair, Ashok, Clements, Deborah, Carvalho, Peter, Collyer, Thomas, Bolten, Jens, Vujanovič, Vojislav, Zsisku, Lajos, Petri, Attila, Ramadan, Mohammed, Ellimah, Tracey, Suljevic, Ismet, Kelle, Hened, Gustin, Denis, Bogdanovic Dvorscak, Matea, Lupis, Tamara, Pavičić Šarić, Jadranka, Paklar, Nataša, Oberhofer, Dagmar, Skok, Ira, Kirigin, Borana, Visnja, Ikic, Kresic, Marina, Kvolik, Slavica, Krobot, Renatas, Cerny, Vladimir, Striteska, Jana, Bilska, Marcela, Filipescu, Daniela, Štourač, Petr, Harazim, Hana, Smékalová, Olga, Kosinová, Martina, Klučka, Jozef, Pacasová, Rita, Ekelund, Kim, Rätsep, Indrek, Oganjan, Juri, Smirnova, Nadezda, Kozek-Langenecker, Sibylle, Kivik, Peeter, Karjagin, Juri, Rokk, Alar, Sõrmus, Alar, Rozec, Bertrand, Rigal, Jean-Christophe, Gouraud, Jean-Pierre, Chupin, Anne-Marie, Ambrosi, Xavier, Brisard, Laurent, Llau Pitarch, Juan V., Decagny, Sylvie, Samama, Charles Marc, Lidzborski, Lionel, Boisson, Matthieu, Arcade, Anne-Laure, Lorre, Gilbert, Rosenberger, Peter, Merz, Hannah, Goebel, Ulrich, Schnitter, Bettina, Mallett, Susan, Buerkle, Hartmut, Tomasi, Roland, von Dossow-Hanfstingl, Vera, Brettner, Florian, Bayer, Andreas, Gottschalk, André, Jakobs, Nicolas, Coburn, Mark, Kowark, Ana, Rossaint, Rolf, Grusser L., Keszei A., Coburn M., Rossaint R., Ziemann S., Kowark A, Daniela Filipescu, Sibylle Kozek-Langenecker, Juan V Llau Pitarch, Susan Mallett, Peter Martus, Idit Matot, Jens Meier, Axel Unterrainer, Dieter Adelmann, Daniel von Langen, Petra Innerhofer, Nicole Innerhofer-Pompernigg, Stefan De Hert, Luc De Baerdemaeker, Jurgen van Limmen, Piet Wyffels, Björn Heyse, Margot Vanderlaenen, Maud Beran, David Kahn, Audrey Prospiech, Luc Jamaer, Freya Mulders, Stefan Jacobs, Wannes Baeten, Sofie Platteau, Isabelle Maquoi, Severine Lauwick, Marc Senard, Vincent Ninane, Jean-Pierre Lecoq, Pierre Boveroux, Grégory Hans, Marcel Vercauteren, Brigitte Leva, Benoit Plichon, Vojislav Vujanovič, Ismet Suljevic, Hened Kelle, Denis Gustin, Matea Bogdanovic Dvorscak, Tamara Lupis, Jadranka Pavičić Šarić, Nataša Paklar, Dagmar Oberhofer, Ira Skok, Borana Kirigin, Ikic Visnja, Marina Kresic, Slavica Kvolik, Renatas Krobot, Vladimir Cerny, Jana Striteska, Marcela Bilska, Petr Štourač, Hana Harazim, Olga Smékalová, Martina Kosinová, Jozef Klučka, Rita Pacasová, Kim Ekelund, Indrek Rätsep, Juri Oganjan, Nadezda Smirnova, Peeter Kivik, Juri Karjagin, Alar Rokk, Alar Sõrmus, Bertrand Rozec, Jean-Christophe Rigal, Jean-Pierre Gouraud, Anne-Marie Chupin, Xavier Ambrosi, Laurent Brisard, Sylvie Decagny, Charles Marc Samama, Lionel Lidzborski, Matthieu Boisson, Anne-Laure Arcade, Gilbert Lorre, Peter Rosenberger, Hannah Merz, Ulrich Goebel, Bettina Schnitter, Hartmut Buerkle, Roland Tomasi, Vera von Dossow-Hanfstingl, Florian Brettner, Andreas Bayer, André Gottschalk, Nicolas Jakobs, Mark Coburn, Ana Kowark, Rolf Rossaint, Rita Laufenberg, Marion Ferner, Michael Schuster, Lydia Strys, Susanne Mauff, Kornel Skitek, Ewa Zielinska-Skitek, Gregor Schittek, Andreas Hoeft, Andreas Fleischer, Maria Wittmann, Florian Kessler, Anne Rohner, Peter Kranke, Christian Wunder, Johanna Jokinen, Kristin Budow, Christopher Prasser, Eva Werner, Alina Balandin, Norbert Ahrens, Kai Zacharowski, Patrick Meybohm, Kassiani Theodoraki, George Giokas, Tasoulis Marios-Konstantinos, Ageliki Pandazi, Aikaterini Kyttari, Eygenia Koursoumi, Georgios Anthopoulos, Antonis Andreou, Athanasios Rantis, Dimitrios Valsamidis, Pelagia Klimi, Konstantinos Katsanoulas, Demetrios Korfiotis, Christos Soumelidis, Fotios Papaspyros, Olga Kiskira, Tilemachos Paraskeuopoulos, Donal Buggy, Mortimer Kelleher, Liz Coghlan, Vladimir Verenkin, Anat Cattan, Francesco Bona, Felicino Debernardi, Andrea Cortegiani, Santi Maurizio Raineri, Giuseppe Accurso, Elena Gramigni, Leonardo Cenni, Laura Campiglia, Irene Lorenzi, Maria Grazia Militello, Tamara Biscioni, Andrius Macas, Daiva Apanaviciute, Darius Trepenaitis, Arunas Gelmanas, Diana Bilshiene, Jurate Sipylaite, Gabija Tomkute, Egle Kontrimaviciut, Renatas Tikuisis, Francis Borg, Ion Chesov, Serghei Cobiletchi, Victoria Moghildea, Bas Verdouw, J F van Poorten, Nick van Dasselaar, Marcus Daniel Lance, Britta de Waal, Lucienne Kropman, Peter van Noord, Benedikt Preckel, Lena Koers, Markus W Hollmann, Holger Baumann, Ankie W M M Koopman-van Gemert, Tore Reikvam, Tore Hervig, Kasper Gymoese Berthelsen, Ingvild Hausberg Sørvoll, Mirosław Czuczwar, Michał Borys, Paweł Piwowarczyk, Suzana Parente, Diogo Martins, Gloria Tareco, Ligia Reis, Joana Amaral, Daniel Ferreira, José Manuel Gonçalves Aguiar, Zélia Moreira, Filipa Lagarto, Filipa Pereira, Maria Lina Miranda, Sofia Serra, Alexandre Carrilho, José Pinto, Sandra Dias, Rita Poeria, Filipe Linda, Silvia Pica, Helder Martinho, Francisco Matias, Claudia Alves, Valentina Almeida, Margarida Marques, Emilia Martires, Piedade Gomes, Elizabete Pereira, Joana Jesus, Claudia Carreira, Carlos Seco, Carlos Bento, Helena Vieira, Luciane Pereira, Fernando Pinto, Luisa Silva, Marta Azenha, Maged Zarif, Ana Bernardino, Ana Raimundo, Ana Lopes, Melissa Fernandes, Beatriz Campos, Ana Macedo, Filipe Pinheiro, Sonia Duarte, Alexandra Saraiva, Catia Real, Marilena Alina Paunescu, Alexandru Bogdan Prodan, Mihai Stefan, Cristian Boros, Marius Tifrea, Anca Dragan, Horhota Lucian, Alida Moise, Carmen Arion-Balescu, Natalia Mincu, Viorel Gherghina, Iulia Cindea, Dan Costea, Ravzan Popescu, Dana Tomescu, Ecaterina Scarlatescu, Esenia Calancea, Ruxandra Copotoiu, Sanda Maria Copotoiu, Victoria Barsan, Dan Corneci, Rely Manolescu, Toma Diana, Denisa Nitu, Georgian Popica, Gabriela Droc, Nicoleta Jipa Lavina, Roxana Ciobanasu, Anna Maria Munteanu, Denisa Anastase, Iona Grintescu, Liliana Mirea, Alexandra Manoleli, Ciobanu Elena, Mary Nicoleta Lupu, Madalina Nina Sandu, Bicolae Bacalbasa, Florenta Calarasu, Alexey Grytsan, Andrey Gasenkampf, Alexander Kulikov, Alexander Shmigelsky, Vojislava Nescovic, Rade Vukovic, Uros Petrovic, Milic Veljovic, Dragana Unic-Stojanovic, Gordana Jovanovic, Ivana Kvrgic, Dragana Rakic, Roman Záhorec, Daniel Cintula, Tomas Veselovsky, Katarina Galkova, Jordana Stevikova, Andrea Číková, Zora Flassikova, Anna Dobisova, Jasmina Markovic Bozic, Minca Voje, Andriy Grynyuk, Alenka Spindler Yesel, Sabina Stivan, Peter Poredos, Darja Kasnik, Jasna Uranjek, Raquel Ferrandis, Sofia Machado, Liliana Henao, Tania Moreno, Ana Izquierdo, Carlos Delgado, Angela Camps, Susana Manrique, Alejandro Arbelaez, Pilar Tormos, Helena Serrano, Irene Garcia, Elvira Bisbe Vives, Luís Moltó, Tania Villar, Enrique Moret, Raquel Tolós, Esther Martínez, Misericordia Basora, Beatriz Tena, Roger Pujol, Jorge Vera Bella, Thomas Mallor, Pablo Mondero, Luis Lopez, Francisco Hidalgo, Maria Bermudez Lopez, Ana Velasco, Begona Bascuas, Victoria Moral, Diana Gómez Martinez, Alfredo Merten, J A Fernández, Nadia Diana Kinast, A Font, Maggi Genaro, Emilia Guasch, Fernando Gilsanz, Raul Martinez, Renato Schiraldi, Ever Martinez, Marta Barquero López, Alexo Lopez Alvarez, Yvan Enrique Sanchez Sanchez, Adriana Roman Fernandez, Olalla Varela Garcia, Marian Angeles Orallo Moran, Veronica Gonzalez Monzon, Óscar Sánchez López, David Sanchez Perez, Pablo Molano Diaz, Concepcion Cassinello, Maria Pilar Jubera, Maria Soler Pedrola, Julio Belmonte Cuenca, Sören Söndergaard, Till Rudolph, Kristin Åkeröy, Monir Jawad, Yousif Saeed, Sergej Safonov, Mona Andersson, Jan Wernerman, Suzanne Odeberg-Wernerman, Tommi Blom, Nesil Deger Coskunfirat, Zekiye Bigat, Suat Sanlı, O Koray Coskunfirat, Atilla Ramazanoğlu, Neval Boztug Uz, Ali Emre Camci, Omur Aksoy, Esra Saka, Oguzhan Arun, Sevda Ozkardesler, Dilek Omur, Mert Akan, Zuleyha Kazak Bengisun, Hakan Yılmaz, Perihan Ekmekci, Onur Selvi, Neslihan Alkis, Çiğdem Yıldırım, Başak Ceyda Meço, Zekeriyye Alanoğlu, Sergiy Vorotyntsev, Yevgen Yakymenko, Galina Troyan, Mohammed Alousi, Sarah James, Paula Meale, Ahmed Chishti, Matt Garner, Rita Singh, Nicola Hirschauer, Charley Higham, Andrea Bell, Alistair Cain, Chris Perry, Katy Davies, Claire Leech, Verity Calder, Shaman Jhanji, Varma Sandeep, Karen Simeson, Philip Watt, Nigel Dunk, Rosemary Ferrie, Margaret Wright, Lynn Everett, Andrew Ferguson, Laura Espie, Gail Browne, Matthew Dickinson, Ashok Nair, Deborah Clements, Peter Carvalho, Thomas Collyer, Jens Bolten, Lajos Zsisku, Attila Petri, Mohammed Ramadan, Tracey Ellimah, Anesthesiology, ACS - Diabetes & metabolism, APH - Quality of Care, ACS - Heart failure & arrhythmias, APH - Global Health, and ACS - Microcirculation
Subjects: Clinical Oncology, Male, Science, Clinical Decision-Making, Cancer Treatment, Surgical and Invasive Medical Procedures, Geographical Locations, Diagnostic Medicine, Outcome Assessment, Health Care, Medicine and Health Sciences, Humans, Blood Transfusion, Prospective Studies, Aged, Aged, 80 and over, Intraoperative Care, Multidisciplinary, Transfusion Medicine, Anemia, Hematology, Clinical Laboratory Sciences, Health Care, Europe, Surgical Oncology, Oncology, Age Groups, Elective Surgical Procedures, People and Places, Medicine, Population Groupings, Female, Geriatric Care, Clinical Medicine, Erythrocyte Transfusion, Research Article
Abstract: PLOS ONE 17(1), e0262110 (2022). doi:10.1371/journal.pone.0262110, Published by PLOS, San Francisco, California, US
Published: 2022
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10. European Association of Cardiothoracic Anesthesiology and Intensive Care Pediatric Cardiac Anesthesia Fellowship Curriculum: First Edition

Author: Ricard Navarro-Ripoll, Marc Vives, Steffen Rex, P. Matute, R. Peter Alston, Theofili Kousi, Simon J. Howell, Mona Momeni, Hossam El-Ashmawi, Fawzia Aboulfetouh, M. Granell, Aniruddha R. Janai, Gabor Erdoes, Caetano Nigro Neto, Alberto Hernandez Martinez, Sascha Treskatsch, Gianluca Paternoster, Theofani Antoniou, Anna Flo Forner, Kirstin Wilkinson, Giovanni Landoni, Joost M.A.A. van der Maaten, Joachim Erb, Philippe Gaudard, Philippe Burtin, E Schindler, Andrea Székely, Alain Vuylsteke, Laszlo L. Szegedi, Vera von Dossow, Jens Fassl, Chirojit Mukherjee, Mohamed R. El-Tahan, Fabio Guarracino, Dominique Bettex, Maria Benedetto, Dieter Van Beersel, Jan-Uwe Schreiber, Patrick Wouters, Dragana Unic-Stojanovic, Mansoura University [Egypt], University of Bern, University Medical Center Groningen [Groningen] (UMCG), University Hospital Southampton NHS Foundation Trust, Onassis Cardiac Surgery Center [Athens] (OCSC), Ruhr University Bochum (RUB), Instituto de Cardiologia Dante Pazzanese (IDPC), University Hospital Bonn, Semmelweis University [Budapest], University of Leipzig [Leipzig, Allemagne], University Department of Fundamental and Applied Medical Sciences and Clinical Department of Anesthesiology and Perioperative Medicine, Ghent, Belgium, Azienda Ospedaliera Universitaria Pisana, Clinique du Millénaire - Oc Santé [Montpellier], Oc Santé [Montpellier], University of Belgrade [Belgrade], Maastricht University Medical Centre (MUMC), Maastricht University [Maastricht], Hospital Clinic [Barcelona, Spain], Misr University for Science & Technology (MUST), Technische Universität Dresden = Dresden University of Technology (TU Dresden), University hospital of Zurich [Zurich], Sant'Orsola-Malpighi Hospital [Bologna, Italy], Hôpital Erasme [Bruxelles] (ULB), Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Royal Infirmary of Edinburgh, IRCCS San Raffaele Scientific Institute [Milan, Italie], University General Hospital of Valencia, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Charité Campus Benjamin Franklin, University Hospitals Leuven [Leuven], Royal Papworth Hospital, Cambridge Biomedical Campus, Cambridge, United Kingdom., University of Leeds, Hospital Universitario de Bellvitge, University Hospital Basel [Basel], Hospital Dr Josep Trueta, Cairo University, Department of Anesthesia & Intensive Care, Helios Clinic for Cardiac Surgery, Karlsruhe, Germany., Hospital Clinico San Carlos, Hospital Clínico San Carlos, Cliniques Universitaires Saint-Luc [Bruxelles], Université Catholique de Louvain = Catholic University of Louvain (UCL), UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service d'anesthésiologie, El-Tahan, M. R., Erdoes, G., van der Maaten, J., Wilkinson, K., Kousi, T., Antoniou, T., von Dossow, V., Neto, C. N., Schindler, E., Szekely, A., Forner, A. F., Wouters, P. F., Guarracino, F., Burtin, P., Unic-Stojanovic, D., Schreiber, J. -U., Matute, P., Aboulfetouh, F., Navarro-Ripoll, R., Fassl, J., Bettex, D., Benedetto, M., Szegedi, L., Alston, R. P., Landoni, G., Granell, M., Gaudard, P., Treskatsch, S., Van Beersel, D., Vuylsteke, A., Howell, S., Janai, A. R., Martinez, A. H., Erb, J. M., Vives, M., El-Ashmawi, H., Rex, S., Mukherjee, C., Paternoster, G., Momeni, M., MUMC+: MA Anesthesiologie (9), and RS: MHeNs - R3 - Neuroscience
Subjects: medicine.medical_specialty, Critical Care, [SDV]Life Sciences [q-bio], education, MEDLINE, Subspecialty, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Pediatric anesthesiology, Anesthesiology, Intensive care, Anesthesia, Cardiac Procedures, Medicine, Humans, Fellowships and Scholarships, 610 Medicine & health, Child, Curriculum, Cardiothoracic anesthesiology, business.industry, General surgery, 030208 emergency & critical care medicine, 3. Good health, Cardiac Anesthesia, Anesthesiology and Pain Medicine, Perioperative care, cardiovascular system, Cardiology and Cardiovascular Medicine, business
Abstract: International audience; Pediatric cardiac anesthesia is a subspecialty of cardiac and pediatric anesthesiology dedicated to the perioperative care of patients with congenital heart disease. Members of the Congenital and Education Subcommittees of the European Association of Cardiothoracic Anaesthesiology and Intensive Care (EACTAIC) agreed on the necessity to develop an EACTAIC pediatric cardiac anesthesia fellowship curriculum. This manuscript represents a consensus on the composition and the design of the EACTAIC Pediatric Cardiac Anesthesia Fellowship program. This curriculum provides a basis for the training of future pediatric cardiac anesthesiologists by clearly defining the theoretical and practical requirements for fellows and host centers.
Published: 2021
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11. Influenza immunization and COVID-19—can viral structure be responsible for the effect?

Author: Dragana Unic Stojanovic, Ivan Ilic, and Goran Loncar
Subjects: Microbiology (medical), 0303 health sciences, 2019-20 coronavirus outbreak, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 030302 biochemistry & molecular biology, General Medicine, Infectious and parasitic diseases, RC109-216, Biology, Virology, Viral Structure, Influenza immunization, 03 medical and health sciences, Infectious Diseases, A Letter to the Editor, 030304 developmental biology
Published: 2021

12. Application of cerebral oxymetry in carotid surgery (Cerebral oximetry and carotid surgery)

Author: Dragana Unic-Stojanovic
Subjects: business.industry, Anesthesia, Medicine, business, Cerebral oximetry, Carotid surgery
Published: 2018
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13. European Association of Cardiothoracic Anesthesiology (EACTA) Cardiothoracic and Vascular Anesthesia Fellowship Curriculum: First Edition

Author: R. Peter Alston, Dragana Unic-Stojanovic, P. Matute, Fabio Guarracino, Kirstin Wilkinson, Rajni Singh, Vera von Dossow, Simon J. Howell, Joachim Erb, Laszlo L. Szegedi, Mohamed R. El-Tahan, Manfred D. Seeberger, Jan-Uwe Schreiber, Jiménez Mj, M. Granell, Paul Diprose, Alberto Hernandez Martinez, Theofani Antoniou, Joost M.A.A. van der Maaten, Gabor Erdoes, Giovanni Landoni, Alain Vuylsteke, Andrea Székely, Nandor Marczin, Gianluca Paternoster, Philippe Gaudard, Chirojit Mukherjee, Patrick Wouters, Marc Vives, Philippe Burtin, Peter M. Rosseel, Dominique Bettex, University of Bern [Bern, Switzerland] (University Hospital Bern ), Royal Papworth Hospital, Cambridge Biomedical Campus, Cambridge, United Kingdom., Department of Anesthesia and Pain Medicine, Maastricht UMC, Maastricht, The Netherlands, Royal Infirmary of Edinburgh, St. James's, University of Leeds, St. James's University Hospital, Leeds, United Kingdom, University Department of Fundamental and Applied Medical Sciences and Clinical Department of Anesthesiology and Perioperative Medicine, Ghent, Belgium, Department of Anesthesia and Critical Care Medicine, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy., University of Belgrade [Belgrade], Department of Anesthesia and Intensive Care, Hospital Universitari Bellvitge, Barcelona, Grupo Policlinica, Ibiza, Spain, Department of Anesthesia and Critical Care, Hospital Dr. Josep Trueta, Girona, Spain, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Department of Anesthesia, University of Basel (Unibas), Vita-Salute San Raffaele University and Center for Translational Genomics and Bioinformatics, Department of Anesthesia & Intensive Care, Helios Clinic for Cardiac Surgery, Karlsruhe, Germany., Servicio de Anestesiología y Reanimación, Hospital Clínic, University of Barcelona, Barcelona, Spain, Departments of Anesthesia and Intensive Care, University Hospital Brussels, Brussels, Belgium, Department of Anesthesia, Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Harefield, Middlesex, United Kingdom., Erdoes, G., Vuylsteke, A., Schreiber, J. -U., Alston, R. P., Howell, S. J., Wouters, P. F., Guarracino, F., Unic-Stojanovic, D., Martinez, A. H., Vives, M., Gaudard, P., Burtin, P., Bettex, D., Granell, M., Szekely, A., van der Maaten, J., Antoniou, T., Jimenez, M. J., Szegedi, L., Seeberger, M., Erb, J. M., Singh, R., von Dossow, V., Matute, P., Rosseel, P., Marczin, N., Landoni, G., Wilkinson, K., Diprose, P., Mukherjee, C., Paternoster, G., El-Tahan, M. R., MUMC+: MA Anesthesiologie (9), and RS: MHeNs - R3 - Neuroscience
Subjects: medicine.medical_specialty, thoracic, cardiac, [SDV]Life Sciences [q-bio], education, Certification, 030204 cardiovascular system & hematology, anesthesia, 03 medical and health sciences, 0302 clinical medicine, vascular, Anesthesiology, 030202 anesthesiology, Health care, Anesthesia, Cardiac Procedures, Humans, Medicine, Fellowships and Scholarships, Curriculum, Cardiothoracic anesthesiology, Training period, training, business.industry, fellowship, Perioperative, Vascular surgery, 3. Good health, Anesthesiology and Pain Medicine, Anesthesia, Cardiology and Cardiovascular Medicine, business
Abstract: This special article summarizes the design and certification process of the European Association of Cardiothoracic Anesthesiology (EACTA) Cardiothoracic and Vascular Anesthesia (CTVA) Fellowship Program.The CTVA fellowship training includes a two-year curriculum at an EACTA-accredited educational facility. Before fellows are accepted into the program, they must meet a number of requirements, including evidence of a valid license to practice medicine, a specialist degree examination in anesthesiology, and appropriate language skills as required in the host centers. The CVTA Fellowship Program has 2 sequential and complementary levels of training-both with a modular structure that allows for individual planning and also takes into account the differing national healthcare needs and requirements of the 36 countries represented in EACTA. The basic training period focuses on the anesthetic management of patients undergoing cardiac, thoracic, and vascular surgery and related procedures. The advanced training period is intended to deepen and to extend the clinical and nontechnical skills that fellows have acquired during the basic training.The goal of the EACTA fellowship is to produce highly trained and competent perioperative physicians who are able to care for patients undergoing cardiac, thoracic, and vascular anesthesia. (C) 2019 Elsevier Inc. All rights reserved.
Published: 2019
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14. Neuroaxial anaesthesia in the presence of back tattoos (neuroaxial anaesthesia)

Author: Dragana Unic-Stojanovic
Subjects: business.industry, neuroaxial anaesthesia, back risk, lcsh:RD78.3-87.3, 03 medical and health sciences, epidural, 0302 clinical medicine, 030202 anesthesiology, lcsh:Anesthesiology, Anesthesia, Medicine, tattoos, 030212 general & internal medicine, business
Abstract: Introduction: Neuroaxial anaesthesia is used for pain control during or after surgery, to treat chronic pain states or to decrease labor and delivery pain in the parturient population. In recent years body tattooing on unusual sites such as the lumbar area have increased in popularity, and may be associated with problems during performing neuroaxial anaesthesia technique. Until now, there were no systematic reviews nor randomized control studies that investigated, primarily, the performance of neuroaxial anaesthesia through a tattoo. Case report: We report a case of a 35-year-old lady who was admitted to our hospital for veins surgery. Preanaesthetic back examination revealed an extensive tattoo covering the entire of her lumbar region with no possibility of performing neuroaxial anaesthesia without penetrating pigment containing skin. It was decided to perform surgery under general anaesthesia. Discussion and conclusions: The main safety concern in performing neuraxial anaesthesia through a tattoo is in the presence of the pigment of the tattoo in the intrathecal or the epidural spaces. Although to date, there are no reported complications from inserting an epidural or spinal needle through the tattoo, this could be because in the past, fewer patients had tattoos involving the midline of the lower back. Also, complications may take time to develop and it may be too early to see these complications which may occur later in time. Therefore, because of safety concerns of introducing pigment into the intrathecal or epidural spaces with the use of hollow needles through tattoos during neuraxial anaesthesia, and no specific guidelines to follow, a safe individual approach should be attempted based on risk/benefit assessment for patient and experience of the anaesthesiologist.
Published: 2017

15. Central venous pressure up date: What is it good for?

Author: Dragana Unic-Stojanovic and Miomir Jovic
Subjects: medicine.medical_specialty, business.industry, Internal medicine, Central venous pressure, Cardiology, Medicine, General Medicine, business
Abstract: Central venous pressure is a very common clinical measurement, but it is frequently misunderstood and misused. As with all hemodynamic measurements, it is important to understand its basic principles. Use of CVP for the estimating of cardiac preload and volume status requires an understanding of its determinants. Actually, CVP and cardiac output are determined by the interaction of two function curves: the cardiac function curve and the return curve. There are no data to support the widespread practice of using central venous pressure (CVP) to guide fluid therapy. But, CVP is readily available in many patients. The fact that an isolated measurement of CVP does not predict the response to a fluid bolus does not reduce its importance as a hemodynamic variable. CVP may be usefull taken in the context of the whole clinical picture and over time.
Published: 2017
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16. Anesthesia for transcatheter aortic valve implantation: A case report (anesthesia for TAVI)

Author: Petar Vukovic, Predrag Milojevic, Dragana Unic-Stojanovic, Marija Zecevic, and Miomir Jovic
Subjects: lcsh:RD78.3-87.3, medicine.medical_specialty, Transcatheter aortic, Transcatheter Aortic Valve Implantation, lcsh:Anesthesiology, business.industry, Anesthesia, medicine, business, Aortic Stenosis, Surgery
Abstract: Introduction: Aortic Valve Implantation (TAVI) is less invasive and becomes an alternative therapy reserved for patients with high operative risk. Hemodynamic stability is the main objective of anesthetic management during TAVI. Local anesthesia or general anesthesia are both valid alternatives and can be applied according to the patient's characteristics and procedural instances. Case Report: We report a 80-year-old woman who was admitted to our hospital for worsening dyspnea caused by severe aortic stenosis. TAVI was performed under local anesthesia and light sedation without complications. Conclusion: Successful TAVI requires a multidisciplinary team of which cardiac anesthesiologists are a crucial part.
Published: 2017
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17. Suspected hepatotoxicity effect of amiodarone (amiodarone and liver)

Author: Petar Vukovic, Milja Tanasic, Miomir Jovic, and Dragana Unic-Stojanovic
Subjects: medicine.medical_specialty, hepatotoxicity, business.industry, Amiodarone, arrhythmia, Gastroenterology, lcsh:RD78.3-87.3, lcsh:Anesthesiology, Internal medicine, medicine, business, amiodarone, cardiac surgery, medicine.drug
Abstract: Introduction: Acute hepatotoxicity is a rare but potentially fatal complication of amiodarone use. We report a case of liver injury after intravenous amiodarone administration in a patient with atrial fibrillation after heart surgery. Case report: A 62-year-old man with a history of dissection of the ascending aortic aneurysm presented for emergency ascending aorta surgery. Patient underwent a routine aortic ascending surgery. On the 3rd postoperative day, the patient developed rapid atrial fibrillation, which was treated with intravenous amiodarone. Because of hypotension, 12 h later, phenylephrine and norepinephrine were included. The patient's lactate had increased to 3.8 mmol/ L, the international normalized ratio increased to 3.12, alanine aminotransferase rose to 4401 IU/L, aspartate aminotransferase rose to 7355 IU/L, lactate dehydrogenase rose to 30043 IJ/L and creatinine increased from 96 to 190 μg/l. Amiodarone was discontinued. Urine output decreased. On the 5th postoperative day, rhythm converted to the sinus rhythm. Liver parameters significantly improved and returned to normal. On the 13th postoperative day, patient was discharged to a rehabilitation facility. Conclusion: Amiodarone is used to treat life-threatening arrhythmias in the setting of acutely decompensated heart failure. In the presence of hepatic congestion, the intravenous preparation of amiodarone may cause acute liver injury and liver function should be monitored closely in critically ill patients.
Published: 2017

18. Surgical Treatment of Proximal Segmental Occlusion of the Internal Carotid Artery

Author: Srdjan Babic, Nikola Aleksic, Predrag Gajin, Goran Vucurevic, Nenad Ilijevski, Predrag Matic, Predrag Stevanovic, Mihailo Neskovic, Milorad Sevkovic, Dragana Unic-Stojanovic, Djordje Radak, Dragoslav Nenezic, Petar Popov, and Slobodan Tanaskovic
Subjects: medicine.medical_specialty, Article Subject, medicine.medical_treatment, lcsh:Surgery, Context (language use), Carotid endarterectomy, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, medicine.artery, Occlusion, medicine, Radiology, Nuclear Medicine and imaging, Stroke, Endarterectomy, Intracerebral hemorrhage, medicine.diagnostic_test, business.industry, lcsh:RD1-811, medicine.disease, 3. Good health, Surgery, Angiography, Internal carotid artery, business, 030217 neurology & neurosurgery, Research Article
Abstract: Purpose. To present the feasibility, safety, and efficacy of carotid endarterectomy in patients with type II internal carotid artery occlusions, including the long-term outcomes. Methods. From March 2008 to August 2015, 74 consecutive patients (48 men with a mean age of 65.1 ± 8.06 years) underwent carotid endarterectomy because of internal carotid artery (ICA) segmental occlusions. These were verified with preoperative carotid duplex scans (CDS) and CT angiography (CTA). Also, brain CT scanning was performed in all these patients. The indication for treatment was made jointly by a vascular surgeon, neurologist, and an interventional radiologist in a multidisciplinary team (MDT) context. After successful treatment, all the patients were followed-up at 1, 3, 6, and 12 months, then every 6 months thereafter. Results. The most common symptom at presentation was transient ischaemic attack (TIA) in 49 patients (66.2%), followed by stroke in the past six months in the 17 remaining patients (23%). Revascularisation of the ICA with endarterectomy techniques was performed successfully in all the patients with an average clamp time of 11.9 min. All the procedures were performed under general anaesthesia in combination with a superficial cervical block. The early complication rate was 8.1% and included two cardiac events (2.7%) (one rhythm disorder and one acute coronary syndrome), three TIAs (4.1%), and one intracerebral hemorrhage (1.3%). Only one patient with the intracerebral hemorrhage died 5 days after surgery giving a postoperative mortality of 1.3% for this series. During the follow-up period (mean 50.4 ± 31.3 months), the primary patency rates at 1, 3, 5, and 7 years were 98.4%, 94.9%, 92.9%, and 82.9%, respectively. Likewise, the survival rates were 98.7%, 96.8%, 89%, and 77.6%, respectively. Ultrasound Doppler controls during follow-up detected 8 ICA restenoses; however, only 3 of these patients required further endovascular treatment. Conclusions. Carotid endarterectomy of internal carotid artery (ICA) segmental occlusion is a safe and effective procedure associated with acceptable risk and good long-term results. Therefore, the current guidelines which do not recommend carotid endarterectomy in this patient group should be reassessed, with the requirement for ongoing large-scale randomized controlled trials to compare CEA with best medical therapy in this patient cohort.
Published: 2019

19. An epidural catheter removal after recent percutaneous coronary intervention and coronary artery stenting: Epidural catheter and antiaggregation therapy

Author: Srdjan Babic, Jelena Lesanovic, Dragana Unic-Stojanovic, Nikola Joksic, and Miomir Jovic
Subjects: medicine.medical_specialty, medicine.drug_class, medicine.medical_treatment, Low molecular weight heparin, antiplatelet therapy, lcsh:RD78.3-87.3, Epidural hematoma, epidural catheter, medicine, Myocardial infarction, cardiovascular diseases, ST depression, business.industry, Percutaneous coronary intervention, drug-eluting stents, medicine.disease, Clopidogrel, Epidural space, 3. Good health, Surgery, Discontinuation, medicine.anatomical_structure, lcsh:Anesthesiology, Anesthesia, medicine.symptom, business, medicine.drug
Abstract: Introduction: Anticoagulation and antiplatelet therapy in the presence of the epidural catheter is still controversial. It is well known that dual antiplatelet therapy is indicated for 12 months after the placement of drug-eluting stents (DES). Removal of an epidural catheter during that period is related to an increased risk of stent occlusion in case of discontinuation of platelet function inhibitors or, on the other hand, increased risk of epidural hematoma associated with neurological deficit if suppressed platelet function is still present. Case Report: Here we present a case of a 63-year-old man who was admitted to Institute for Cardiovascular Diseases Dedinje for elective aortic surgery. Before the induction, an epidural catheter was inserted at the Th10-Th11 epidural space. Uneventful surgery was performed under the combined epidural and general anesthesia. On the 2nd postoperative day, the patient sustained a ST depression myocardial infarction treated with percutaneous coronary intervention with DES placement, while epidural catheter was still in place. Dual antiplatelet therapy with 600mg of clopidogrel, 100 mg of acetilsalicylic acid (ASA) and low molecular weight heparin (LMWH) were started during the procedure. The next day, clopidogrel (75 mg) and ASA (100 mg) were continued as well as LMWH. The decision to remove the epidural catheter was made on the 9th postoperative day, after platelet aggregation assays were performed. Six hours after catheter removal the patient again received clopidogrel, ASA and LMWH. There were no signs of epidural hematoma. Conclusion: This case shows that point-of-care testing with platelet aggregation assays may be useful in increasing the margin of safety for epidural catheter removal during dual antiplatelet therapy.
Published: 2016

20. Optimal perioperative fluid management: What is the strategy?

Author: Dragana Unic-Stojanovic
Subjects: liberal, Inotrope, medicine.medical_specialty, Volume overload, Hemodynamics, 030204 cardiovascular system & hematology, surgery, lcsh:RD78.3-87.3, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Hypovolemia, medicine, Intravascular volume status, restrictive, colloid, Intensive care medicine, business.industry, Organ dysfunction, Blood flow, Perioperative, crystalloid, fluid management, lcsh:Anesthesiology, Anesthesia, medicine.symptom, business
Abstract: Fluid therapy is a core concept in the management of perioperative patients for maintenance of intravascular volume and organ perfusion. The aim of perioperative fluid therapy is to keep patients at all times in the optimal volume loading, due to both hypovolemia and volume overload may cause organ dysfunction. Intravenous fluid is a drug and because of that, timing and dose is important. 'Liberal' or 'restrictive' strategies and crystalloid or colloid solutions are the unsolved controversies. The term 'restriction' is commonly interpreted to imply hypovolemia, whereas it may simply represent avoidance of the fluid excess seen in the 'liberal' group. The aim of goal-directed fluid therapy is to guide fluid and pharmacological (inotrope) therapy, by using flow-directed hemodynamic parameters, to maintain adequate tissue blood flow, circulating volume, and oxygen delivery. In order to minimize the complications related to fluid administration, preventive strategies and prompt treatments are of utmost importance.
Published: 2016
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21. Acute aortic dissection in patient with suspected pheochromocytoma

Author: Petar Vukovic, Miomir Jovic, Željko Bojović, Nikola Joksic, Jelena Lesanovic, and Dragana Unic-Stojanovic
Subjects: Aortic dissection, Aorta, medicine.medical_specialty, business.industry, Bentall procedure, cocaine, Perioperative, medicine.disease, pheochromocytoma, 3. Good health, Surgery, surgery, lcsh:RD78.3-87.3, Pheochromocytoma, Dissection, Phentolamine, Anterior chest, lcsh:Anesthesiology, hypertensive crisis, medicine.artery, medicine, aortic dissection, business, medicine.drug
Abstract: Introduction: Aortic dissection is one of the most fatal vascular emergencies. Almost 40% of the patients do not reach hospital in time while more than quarter die in the first 24 hours after the dissection begins. Case Report: A 37-year old man was admitted to our hospital with severe anterior chest pain which had lasted for over a week. Suspected aortic dissection was rapidly confirmed using imaging modalities - MDCT chest scan and TTE, followed by an urgent surgical management - Bentall procedure. MDCT chest scan also discovered adrenal incidentaloma defined as malignant, pheochromocytoma like mass. Due to the critical state of the patient, there was not enough time for further endocrinologic testing. Discussion and conclusion: When treating patients with pheochromocytoma and acute aortic disection, it is crucial to obtain a stable hemodynamic state before the surgery, since they can trigger a severe hypertensive crisis due to high levels of cathecholamines induced chronic vasoconctriction. The most vulnerable periods are the induction of anesthesia and perioperative hemodynamic oscillations, so treating patients with short acting alpha- 1 adrenergic blocking agents preoperatively has proven to be helpful - Phentolamine. Both dissection of aorta and pheochromocytoma present challenges for anesthesiologists and early recognition of symptoms is essential in establishing the diagnosis and reducing the mortality rate.
Published: 2016
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22. Perioperative management of postdural puncture headache: Postdural puncture headache

Author: Dragana Unic-Stojanovic and Marija Zecevic
Subjects: Epidural blood patch, medicine.medical_specialty, medicine.diagnostic_test, Side effect, Lumbar puncture, business.industry, Dura mater, Epidural space, 3. Good health, Surgery, lcsh:RD78.3-87.3, medicine.anatomical_structure, postdural puncture headache, lcsh:Anesthesiology, Anesthesia, epidural blood patch, medicine, Headaches, medicine.symptom, Complication, business, spinal anesthesia, Neck stiffness
Abstract: Introduction: Postdural puncture headache (PDPH) is a complication of puncture of the dura mater. It is a common side effect of spinal anesthesia, lumbar puncture and occasionally, may accidentally occur in epidural anesthesia. The headache is defined as a bilateral headache that develops within 7 days after lumbar puncture and disappears within 14 days. It has been described in some cases that headaches can last from a few mounts to even years. Factors that increase the risk of PDPH is young age, female sex and pregnancy. Incidence is strongly related to the needle size and type. Case Report: We report a case of a 49-year-old man who was admitted to our Institute for elective veins surgery. We choose spinal anesthesia for this operation and use 25 gauged spinal needle. Patient was hemodynamically stable during the whole surgery without headache and he was discharged home at 1st post operative day. However, after two days, patient came to the hospital complaining of severe headache in frontal and occipital areas, followed by neck stiffness. Our first approach in treatment was conservative therapy. Recumbent positioning, oral and intravenous fluid, 500 mg coffeine iv. bid and morphine 4 qid. The headache persisted for the next 2 days, despite conservative therapy. Our next approach was epidural blood patch like effective treatment for PDPH. First we placed patient in the lateral position and inserted epidural needle at the level L3 - L4. Then we injected 15 ml of autologes blood into epidural space. His headache resolved within one hour of procedure, he denied any further headache one month after discharge. Conclusion: In our case, it was shown that lumbar puncture is an important cause of iatrogenic morbidity in the form of postdural puncture headache. Incidence of headache can be resolved by using thinner needle. When the headache does not respond to conservative therapy, epidural blood patch is a reasonable and effective treatment. Surgical closure is the last option.
Published: 2016
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23. Perioperative pulmonary embolism

Author: Dragana Unic-Stojanovic
Subjects: Tachycardia, complications, business.industry, Perioperative, anesthesia, medicine.disease, 3. Good health, Hypoxemia, Pulmonary embolism, Computed tomographic, lcsh:RD78.3-87.3, Increased risk, lcsh:Anesthesiology, Supportive psychotherapy, Anesthesia, medicine, pulmonary thromboembolism, In patient, medicine.symptom, business
Abstract: All perioperative patients are at increased risk of pulmonary thromboembolism (PTE). The most common findings of PTE in patients undergoing general anesthesia are hypotension, tachycardia, hypoxemia, and decreased end-tidal CO2 air. Computed tomographic scanning is the preferred definitive diagnostic study, but transesophageal echocardiography may be valuable in making a presumptive diagnosis in the operating room. Early diagnosis allows supportive therapy and anticoagulation.
Published: 2016
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24. Complete thrombosis of the ductus arteriosus could be the option to be alive in the seventh decade of life without specific symptoms

Author: Slobodan Tomic, Slobodan Micovic, Dragana Unic-Stojanovic, and Aleksandra T Nikolic
Subjects: Male, medicine.medical_specialty, business.industry, General surgery, MEDLINE, Thrombosis, Ductus Arteriosus, Middle Aged, medicine.disease, medicine.anatomical_structure, Text mining, Ductus arteriosus, medicine, Humans, Cardiology and Cardiovascular Medicine, business
Published: 2017

25. High thoracic epidural anesthesia in patients with synchronous carotid endarterectomy and off-pump coronary artery revascularization

Author: Dragana Unic-Stojanovic, Ivan Ilic, Predrag Milojevic, Vojislava Neskovic, and Zoran Slavkovic
Subjects: Anesthesia, Epidural, Male, medicine.medical_specialty, medicine.medical_treatment, Coronary Artery Bypass, Off-Pump, Coronary Artery Disease, Carotid endarterectomy, Anesthesia, General, Revascularization, Thoracic Vertebrae, law.invention, Cohort Studies, law, postoperative complications, medicine, Humans, Carotid Stenosis, Pharmacology (medical), Contraindication, Aged, Endarterectomy, Mechanical ventilation, lcsh:R5-920, Endarterectomy, Carotid, business.industry, Middle Aged, medicine.disease, Intensive care unit, coronary artery bypass, Surgery, comorbidity, Stenosis, Treatment Outcome, Respiratory failure, Anesthesia, Female, lcsh:Medicine (General), business
Abstract: Background/Aim. In order to reduce the risk of cerebrovascular insults (CVI), the latest recommendations suggest that carotid endarterectomy (CEA) is strongly indicated in patients scheduled for coronary surgery when significant carotid artery stenosis is symptomatic and/or bilateral. The best results are obtained in small studies with CEA performed immediately prior to off-pump coronary bypass (OPCAB). We present 16 consecutive patients who underwent synchronous CEA and OPCunder general anesthesia combined with high thoracic epidural anesthesia (TEA) in order to evaluate the safety and potential benefits of such anesthetic management. Methods. A total of 16 consecutive patients scheduled for simultaneous CEA and OPCwith no contraindication for TEA were enrolled in the study. All the patients were anesthetized with TEA combined with general anesthesia. Early extubation was planed in all the patients for early assessment of neurological outcome. Demographics, comorbidity, quality of postoperative recovery, duration of mechanical ventilation, successful early extubation, outcome, length of Intensive Care Unit (ICU) and hospital stay were recorded. Results. Only two patients did not fulfill the criteria for early extubation. The average duration of mechanical ventilation for patients who fulfilled criteria for early extubation was 87.9 ± 85.0 (0-255) min. Five (31.25%) patients were extubated in the operating theater at the end of surgery. There were no deaths, nor neurological complications of TEA. Seven (43.7%) patients had at least one of the postoperative complications considered significant. None of them had CVI. None of the early extubated patients was reintubated or had postoperative respiratory failure. Conclusion. Our study revealed that a combination of general anesthesia with TEA appears to be good choice in synchronous CEA and OPCdue to advantages of early extubation and early neurological assessment. Larger studies are necessary to determine real benefits on both short and long-term outcomes of such anesthetic management in synchronous CEA and OPCAB.
Published: 2013
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26. Mid-regional pro-adrenomedulin as a marker of perioperative mortality in non-cardiac surgery

Author: Nenad Jovanovic, Dejan Markovic, Dragana Unic-Stojanovic, Radmilo Jankovic, Mladjan Golubović, Velimir Peric, Nemanja Stepanovic, Dragana Stanojević, Biljana Stosic, Milan Lazarević, and Dragan Milić
Subjects: medicine.medical_specialty, lcsh:R5-920, business.industry, Perioperative, 030204 cardiovascular system & hematology, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, nema, 0302 clinical medicine, Internal medicine, Non cardiac surgery, Cardiology, medicine, Pharmacology (medical), business, lcsh:Medicine (General)
Abstract: nema
Published: 2018

27. REGIONAL ANAESTHESIA AND ACUTE PAIN

Author: Dragana Unic-Stojanovic, Camilo Año, Alejandro Lucchelli, Gustavo Carradori, Rodriguez Perez Jose Maria, Carla Farré, Carlos E. Lorda, Carolina Henao, Yoram Shapira, Martin McNally, Fauzia Nawaz, Lee Krahe, Fauzia Khan, Michael Burns, Nurdan Özdemir Fatma, Opas Puchissa, Peter Chee Seong Tan, Garcia Rojo Blas, Andrey L. Melnikov Steinar, Anjolie Chhabra, Buzz Shephard, Tomas E. Lambertus, Edgar Omero, Jason Chou, Tobias Piegeler, Jayashree Simha, Susana Pacreu, Athanasia Tsaroucha, Elisabet Andersson, Takashi Suto, Mauro Gili, Valasubramaniam Mahadevan, Miguel Moreno, Aylin Incesu, Pavan Gurha, José Aguirre, Francisco Riberi, Norzalina Esa, Imran Ahmed, V Mehta, Sanoussi Samuela, Richard Minshall, Belen Posso, Hyun Seung Kim, Orozco Montes Javier, Jesús Carazo, Mubeen Khan, Maria E. Interiano, Svetlana Galitzine, Stefano Scalia Catenacci, Raveendranath Wadhwani, Naila Asad, Nicole Naccache, Ralf E. Gebhard, Chaibou M Sani, Eduardo Sadatsune, Rita Jawish, Maria Isabel Vasquez, Dominguez Serrano Nuria, Grant Mills, Francisco Gómez Armenta, Jong-Hun Ji Sang, Rafael Esturi, Senthil Nadarajan, Jamie Vivian, Ömer Yanarates, Vera Tesic, Altun Demet, Shobha Rani, Pablo Lassalle, Argyro Fassoulaki, Ivan Lisnyy, Serdar Kaymak, S. S. Nethra, Ena Miller, Roberto Contreras, Antonio Carlos Shimano, Tanvir Butt, Somi Ramachary Desikan, Gulden Ugur, Bon Nyeo Koo, Jose M. Galbis, Juan Carlos Elvira, William Knox, Gina Votta Velis, Maria Carolina Cabrera Schulmeyer, Yuryy Kuchin, Alexandr Zlotnik, Serena Calcinati, Youn-Woo Lee, Ulrich Johannes Spreng, Bertram Baenziger, Thitima Chinachoti, Coskun Fusun Bozkirli, Howard Palte, Jaime De la Maza, Miriam Estors, Yon Hee Shim, Mercedes Lluch Fernández, Izuru Nose, D. Devikarani, Andeia Andeia Paraskeva, Sirous Momenzadeh, Cezary Kosiñski, Ae Ryoung Lee, Sivendiran Mahalingam, Beatrice Beck-Schimmer, Fatma Nur Kaya, Oguz Kýlýçkaya, Edward R. Mariano, Daniel Abell, Adrian Pearce, Farrukh Afzal, Cheng Ong, Rodrigo Costa, Anuradha Borle, Joao Abrao, Karl Otto Geier, Franco Ravera, Soo Joo Choi, Azlina Abbas Azhar, Soha Bazyar, Abarchi Habibou, Juan Fernández Candil, Fernando Cacheiro, Suzie Ward, Saju Sharafudeen, Luiz Falcao, Agata Kacka, Nicolas Altolaguirre, Ivan Ilic, Guillermo Reeves, Raveenthiran Rasiah, Eduard Stahovskiy, Rajiv Kumar, Akbar Shah Romila, Encarna Miñana, Inmaculada Herrador Montiel, Ravindra Wadhwani, Ji Young Kim, Diego Guardabassi, Hee Pyoung Park, Ji Young Yoo, M. Nuri Deniz, Amlesh Seth, Christopher Pollitt, Cristián Manuello, Jung-Won Hwang, Cleverson R. Fernandes, Shigeru Saito, Binod Gautam, Dusica Vucurevic, Pablo Morgillo, Elialba Cascudo, Hisham Jabbour, Jessica Zavesky, Vasanth Rao Kadam, M. P. S. Lokesh, Asoumane Toudou Nouhou, Jose E. LLopis, Asadollah Saadatniaki, Nicolás Gastón Moreno, Eduardo Cardieri, Franco Frenquelli, Dariush Abtahi, Liliana Suárez Aguilar, Marco Antonio Jogaib, Vescovo Anibal, Yun T. Romy, Tarik Purtuloglu, Cristián Ovalle, Oscar Aguirre, Mohammad Ali, Hanafi Sidik, Evangelina Gagliardo, Seyed Saed Jahanbakhsh, Chee Kean Chen, Edward Kim, Perumal Tamilselvan, P. Siddalingeshwara, Jaime Ordoñez, Raúl Trotta, Virginia Funes, Leonardo Ferraro, Belgin Yavaşcaoğlu Oya Kutlay, Stephan M. Jakob, Bjørgo Ulf E. Kongsgaard, Adriana Demoner, Alessandro Buda, Duck Hwan Choi, Tomasz Lazowwski, Hicham AbouZeid, Maria Tardelli, Young-Tae Jeon, Mabhidli Mduduzi Mashinini, Roberto Flores, Fernando J. Sanchez, Liliana Vaula, Bruno Gatto Chiara, Young Hee Shin, B Stevens, Vegard Dahl, Ludmila Klimchuk, Jung-Hee Rhyu, Steven Gayer, Ulka Paralkar, Carlos Bollini, Ylmazlar Burak Demira, Shu Ching Teo, Aliya Ahmed, Daniel Espada Lahoz, Angela Maria Rios, Hasmizy Bin Muhammad, Gutierrez-Meca Maestre Maria Dolores, Aida Amirzhanova, Oliver Baehre, Nicholas Christelis, Khalil Jabbour, Daniel Rothen, Amisha Burumdayal, Kevin Kline, Scaglioni Maria, Seema Randive, Masaru Tobe, Pablo Ingelmo, Gabriel Cortés, Agzam Zhumadilov, Jean-Marie Parel, Guillermina Harvey, Manee Raksakietisak, Aziza Hussain, Moran Debbie Miller, Aikaterini Melemeni, Jong Bum Choi, Paul F. White, Rodrigo Okubo, Hanuman K. Murthy, Robyn S. Weisman, K. Gunashekar, Blasko Smiljanic, Mariusz Piotrowski, Matthew Irwin, Amarpal Bhalla, Dominguez Ximena, Sani Rachid, Sian Griffiths, Rajeshwari Subramaniam, Maria Patricia Gonzalez, Irimar de Paula Posso, Ana Maria Pagliaro, A.C. Lundgren, Ercan Kurt, Piotr Sarwiñski, Vicente Muedra, Diego García-Girona, Nora Hasiah Idris, Merican Naveenthiran Thevanthiran, Ali Sýzlan, Jairo Moyano, Perrín Turenne Hugo, Fabian Astore, Angkana Luingnateetape, M Dilkes, Eun Park, Mariano Souza, S. S. Harsoor, J. Gregg Melton, Sang-Hwan Do, Magdalena Sinczak, Goran Tockov, Alexandre Takeda, K. Brijesh, George Mathew, C. Kumaresan, José Luis Furno, Brendan Carvalho, Miomir Jovic, Alex Ramsden, Elvan Erhan, Gonzalo M. Rivas, Andres Missair, Aysun Yildiz, Tomasz Lazowski, Ortega Ortega, Gundappa Parameswara, Van Wijk Roelof John, María Angélica Iglesias Tinnirello, Hitoshi Shimada, Kimiko Takekawa, SangMook Lee, Rachel Farmer, Nur Kaya Aysun, Hideaki Obata, Renato Passos, and Jimena Palleiro
Subjects: Anesthesiology and Pain Medicine, business.industry, Anesthesia, Medicine, Regional anaesthesia, business, Acute pain
Published: 2012
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28. Effects of epidural analgesia using different concentrations of bupivacaine during combined general and epidural anesthesia

Author: Dragana Unic-Stojanovic, Ivan Ilic, and Vojislava Neskovic
Subjects: Anesthesia, Epidural, Male, Methyl Ethers, medicine.medical_specialty, medicine.drug_class, Hemodynamics, Blood Pressure, Anesthesia, General, Sevoflurane, Heart Rate, Heart rate, medicine, Humans, Anesthetics, Local, Bupivacaine, business.industry, Local anesthetic, General Medicine, Middle Aged, Surgery, Blood pressure, Anesthesia, Anesthetics, Inhalation, Anesthetic, Female, business, Aortic Aneurysm, Abdominal, medicine.drug, Abdominal surgery
Abstract: Introduction. Thoracic epidural analgesia, combined with general anesthesia, is an established anesthetic choice for abdominal aortic surgery. However, there are controversies about the level of anesthesia as well as the dose and concentration of the local anesthetic used. The aim of the study was to compare the effects of two different concentrations of epidural bupivacaine on sevoflurane requirements and hemodynamic parameters during aortic surgery under combined epidural/general anesthesia. Methods and Material. Sixty patients scheduled for abdominal aortic surgery were randomly divided into two groups according to the concentration of local anesthetic used for epidural anesthesia: - Group 1- low concentration - where 0.125% bupivacaine was used, and - Group 2 - high concentration - where 0.5% bupivacaine was used at the beginning and then the concentration was reduced to 0.25%. Anesthesia was maintained with sevoflurane, the dose was adjusted to achieve the target entropy of 40-60. The measurements included the inspired sevoflurane concentrations, blood pressure, and heart rate at the beginning and every 5 min during the surgery. Results. Both groups had similar heart rate and blood pressure, but the inspired sevoflurane concentration was significantly higher and more variable in patients where bupivacaine 0.125% was used. Vasopressors were used more often and in higher doses in the 0.5% bupivacaine group, and in the same group the blood loss and fluid requirements were reduced. Conclusion. When 0.5% bupivacaine is used in combined thoracic epidural/ general anesthesia for aortic surgery, the sevoflurane concentrations are lower and less variable. In addition, the blood loss and fluid requirements are reduced.
Published: 2012
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29. Hybrid procedure for a descending thoracic and subclavian artery aneurysm in a patient with previous abdominal aortic surgery: Case report

Author: Slobodan Tanaskovic, Dragana Unic-Stojanovic, Djordje Radak, Srdjan Babic, Miomir Jovic, and Dragan Sagic
Subjects: medicine.medical_specialty, Subclavian Artery, lcsh:Medicine, Aortic aneurysm, Blood Vessel Prosthesis Implantation, Aneurysm, medicine.artery, medicine, Thoracic aorta, Humans, thoracic aorta aneurysm, Aorta, Abdominal, cardiovascular diseases, Subclavian artery, hybrid procedure, Aorta, Aortic Aneurysm, Thoracic, business.industry, Abdominal aorta, lcsh:R, Endovascular Procedures, thoracic endovascular aortic repair (TEVAR), General Medicine, Middle Aged, medicine.disease, Abdominal aortic aneurysm, 3. Good health, Surgery, Aortic Dissection, surgical procedures, operative, Descending aorta, cardiovascular system, Female, Radiology, business, Tomography, X-Ray Computed
Abstract: Introduction. Hybrid procedures represent staged or simultaneous endovascular and open surgical techniques in the treatment of complex pathologies of the thoracic and abdominal aorta. We are presenting a patient with previous abdominal aortic surgery in whom hybrid vascular procedure for descending aorta and left subclavian artery aneurysm was performed. Case Outline. A 63-year-old female patient was admitted for computed tomography angiography. Descending aorta aneurysm (7.6 cm) as well as aneurysm of the left subclavian artery (LSA) was noted. Eight years ago she underwent abdominal aortic aneurysm resection and aortoiliac bypass. Standard TEVAR (thoracic endovascular aortic repair) procedure couldn’t be done due to small dimensions of previous “Y” graft (12.6 mm), so first we did LSA transposition and after three days hybrid procedure. After “Y” graft exposure, anastomosis between the corps of “Y” graft and tubular graft 10 mm was created and through this conduit thoracic stent-graft was placed followed by complete “Y” graft replacement. After 6 months angiography showed regular postoperative findings. Conclusion. Combined surgical and endovascular procedures in thoracic aorta pathology treatment could be useful solutions with favorable outcome. [Projekat Ministarstva nauke Republike Srbije, br. 41002]
Published: 2015

30. Anesthesia for carotid endarterectomy: where do we stand at present?

Author: Dragana Unic-Stojanovic
Subjects: surgery, carotid endarterectomy, anesthesia, general, regional, outcome
Abstract: Carotid endarterectomy (CEA) is a surgical procedure performed to reduce the incidence of embolic and thrombotic stroke. Although only a preventive procedure, CEA carries the risk of perioperative complications. There is constant searching for an optimal anesthetic technique. There are pros and cons for both anesthetic techniques used: regional (RA) and general anesthesia (GA). A large number of studies have compared RA and GA techniques in CEA surgery patients. The primary outcome was the proportion of patients with stroke, myocardial infarction, or death. However, neither the GALA trial nor the pooled analysis was adequately powered to reliably detect an effect of type of anesthesia on mortality. It may therefore be appropriate to consider other additional parameters (stress response, incidence of postoperative delirium and cognitive impairment, functional recovery, total surgery time, intensive care unit requirement, hospital stay, hospital costs and patients satisfaction) when comparing the outcomes of the two techniques. Although, the debate continues as to whether regional anesthesia or general anesthesia is safer, the choice of anesthetic technique is a complex decision and surgical teams should be able to offer both RA and GA. The individual approach is the ideal choice and should be determined at the discretion of the surgeon, anesthetist and patient depending on the clinical situation and own preferences.
Published: 2015

31. Direct Ischemic Postconditioning After Carotid Endarterectomy in the Prevention of Postoperative Cerebral Ischemic Complications—Observational Case–Control Study

Author: Nenad Ilijevski PhD, Igor Atanasijević MD, Branko Lozuk PhD, Predrag Gajin PhD, Predrag Matić PhD, Srđan Babić PhD, Dragan Sagić PhD, Dragana Unić-Stojanović PhD, and Slobodan Tanasković PhD
Subjects: Diseases of the circulatory (Cardiovascular) system, RC666-701, Therapeutics. Pharmacology, RM1-950
Abstract: Introduction: Ischemic postconditioning (IPCT) represents one of the several therapeutic strategies to attenuate ischemic reperfusion injury (IR) after carotid endarterectomy (CEA). We here present the first in-human study of IPCT in carotid surgery. Methods: The study represents an observational case-control study, with the data collected in our Institution carotid database. From December 2015 to December 2020, a total of 300 patients were included in our study; IPCT group consisted of 148 patients in whom ischemic postconditioning was performed while control group consisted of 152 patients in whom IPCT was not performed. Indications for IPCT technique were: severe unilateral internal carotid artery (ICA) stenosis (>90%), severe bilateral ICA stenosis (>80%), severe ICA stenosis (>80%) with contralateral ICA occlusion and ICA subocclusion. IPCT was performed by applying 6 cycles of 30 sec reperfusion (declamping of ICA)/30 sec ischemia (clamping of ICA) after finishing the procedure and initial declamping. Two groups of patients were compared in terms of occurrence of intrahospital and early postoperative stroke, TIA (transient ischemic attack) and neurologic morbidity. Results: Cumulative incidence of intrahospital postoperative stroke or TIA was significantly higher in the control group (5.3% vs 0.7%, P = .036). According to carotid plaque characteristics, patients in the IPCT group had significantly more frequent presence of heterogenous plaque, as well as ulcerated plaque, which was associated with the absence of postoperative stroke and significantly lower cumulative rate of TIA/stroke when compared to the control group (43.9% vs 8% and 47.3% vs 1.5%). During the follow-up period of 1 month after the surgery, there were no cases of stroke, TIA and deaths due to neurological causes in both groups of patients. Conclusion: Our results showed that IPCT significantly reduced the incidence of postoperative cerebral ischemic complications after CEA in high-risk patients for IR injury when compared to the control group.
Published: 2022
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32. The current role of surgery in treating adult patients with patent ductus arteriosus

Author: Bosko P, Djukanovic, Slobodan, Micovic, Ivan, Stojanovic, Dragana, Unic-Stojanovic, Sinisa, Birovljev, and Petar M, Vukovic
Subjects: Adult, Male, Cardiopulmonary Bypass, Time Factors, Age Factors, Middle Aged, Young Adult, Treatment Outcome, Hypothermia, Induced, Heart Arrest, Induced, Humans, Female, Cardiac Surgical Procedures, Tomography, X-Ray Computed, Ductus Arteriosus, Patent, Serbia
Abstract: Surgical closure of patent ductus arteriosus (PDA) is still required in selected adult patients. We analyzed the morphology of the anomaly and coexisting pathological findings in adult patients who were recently referred to our institute for surgical PDA repair.Six adult PDA patients who were not considered candidates for percutaneous closure underwent surgical PDA correction. In three patients with isolated PDA, computed tomographic scan revealed short, wide, and distorted ductus. In the remainder three patients, concomitant heart or aortic disease was found. Transpulmonary approach under total cardiopulmonary bypass or hypothermic circulatory arrest was performed.In all patients, a Dacron patch was used to close the duct. The balloon occlusion technique with normothermic cardiopulmonary bypass was performed in four patients. In one of these patients, the balloon occlusion was not feasible because of unfavorable ductal anatomy, and PDA was closed in short hypothermic circulatory arrest. In two patients with aortic aneurysm, PDA closure and aortic reconstruction were performed in deep hypothermic circulatory arrest. No significant complications occurred during postoperative course. After the mean follow-up period of 48 months, neither ductal reopening nor aneurysmal degeneration of remnant ductal tissue was found.Surgical PDA closure in adults remains the treatment of choice in wide, deformed PDAs unsuitable for percutaneous closure and PDAs associated with surgical aortic or heart disease.
Published: 2013

33. Abnormal central venous oxygen saturation in cardiac surgery patients: a prospective, observational study

Author: M Filipovic, Predrag Milojevic, Dragana Unic-Stojanovic, Petar Vukovic, Miomir Jovic, and Dusko Nezic
Subjects: Pulmonary and Respiratory Medicine, medicine.medical_specialty, business.industry, Incidence (epidemiology), Central venous pressure, General Medicine, Disease, Intensive care unit, Surgery, Cardiac surgery, law.invention, Cardiothoracic surgery, law, Internal medicine, Cardiology, medicine, Oral Presentation, Observational study, Cardiology and Cardiovascular Medicine, business, Perfusion
Abstract: Background Central (ScVO2) and mixed venous oxygen saturation (SvO2) and blood lactate are useful measurement tools for evaluating the degree of hypoperfusion in patients with different disease processes. The aim was to study incidence of both low as well as high ScvO2 and assessed their relationship to markers of tissue hypoxia, course and outcome in patients undergoing elective cardiac surgery.
Published: 2013
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34. Blood transfusion in cardiac surgery--does the choice of anesthesia or type of surgery matter?

Author: Predrag Milojevic, Zoran Slavkovic, Dragana Unic-Stojanovic, and Vojislava Neskovic
Subjects: Anesthesia, Epidural, Male, medicine.medical_specialty, Blood transfusion, perioperative care, medicine.medical_treatment, Blood Loss, Surgical, Coronary Artery Bypass, Off-Pump, Anesthesia, General, Revascularization, law.invention, Coronary artery bypass surgery, Randomized controlled trial, law, medicine, Humans, Pharmacology (medical), Anesthesia, Blood Transfusion, Coronary Artery Bypass, cardiac surgical procedures, lcsh:R5-920, business.industry, Extracorporeal circulation, Perioperative, Middle Aged, Surgery, Cardiac surgery, Anesthetic, Female, business, lcsh:Medicine (General), medicine.drug
Abstract: Background/Aim. In spite of the evidence suggesting a significant morbidity associated with blood transfusions, the use of blood and blood products remain high in cardiac surgery. To successfully minimize the need for blood transfusion, a systematic approach is needed. The aim of this study was to investigate the influence of different anesthetic techniques, general vs combine epidural and general anesthesia, as well as different surgery strategies, on-pump vs off-pump, on postoperative bleeding complications and the need for blood transfusions during perioperative period. Methods. Eighty-two consecutive patients scheduled for coronary artery bypass surgery were randomized according to surgical and anesthetic techniques into 4 different groups: group 1 (patients operated on off-pump, under general anesthesia); group 2 (patients operated on off-pump, with combined general and high thoracic epidural anesthesia); group 3 (patients operated on using standard revascularization technique, with the use of extracorporeal circulation, under general anesthesia), and group 4 (patients operated on using standard revascularization technique, with the use of extracorporeal circulation, with combined general and high thoracic epidural anesthesia). Indications for transfusion were based on clinical judgment, but a restrictive policy was encouraged. Bleeding was considered significant if it required transfusion of blood or blood products, or reopening of the chest. The quantity of transfused blood or blood products was specifically noted. Results. None of the patients was transfused blood or blood products during the surgery, and as many as 70/81 (86.4%) patients were not transfused at all during hospital stay. No difference in postoperative bleeding or blood transfusion was noted in relation to the type of surgery and anesthetic technique applied. If red blood cells were transfused, postoperative bleeding was the most influential parameter for making clinical decision. Conclusion. No influence of off-pump surgery or epidural anesthesia on blood transfusion requirements during a perioperative period was confirmed by this study. It seems, however, that encouraging lower hemoglobin triggers in clinical decision-making could result in less transfusions during surgery or hospital stay.
Published: 2013

35. Anesthesia for carotid endarterectomy: where do we stand at present?

Author: Tamara Gojkovic, Ljiljana Ranković, Predrag Matic, Dragana Unic-Stojanovic, Miomir Jovic, and Djordje Radak
Subjects: business.industry, Incidence (epidemiology), medicine.medical_treatment, Carotid endarterectomy, Perioperative, Critical Care and Intensive Care Medicine, medicine.disease, Intensive care unit, law.invention, Fight-or-flight response, law, Anesthesia, Anesthetic, Emergency Medicine, medicine, Myocardial infarction, business, Stroke, medicine.drug
Abstract: Carotid endarterectomy (CEA) is a surgical procedure performed to reduce the incidence of embolic and thrombotic stroke. Although only a preventive procedure, CEA carries the risk of perioperative complications. There is constant searching for an optimal anesthetic technique. There are pros and cons for both anesthetic techniques used: regional (RA) and general anesthesia (GA). A large number of studies have compared RA and GA techniques in CEA surgery patients. The primary outcome was the proportion of patients with stroke, myocardial infarction, or death. However, neither the GALA trial nor the pooled analysis was adequately powered to reliably detect an effect of type of anesthesia on mortality. It may therefore be appropriate to consider other additional parameters (stress response, incidence of postoperative delirium and cognitive impairment, functional recovery, total surgery time, intensive care unit requirement, hospital stay, hospital costs and patients satisfaction) when comparing the outcomes of the two techniques.Although, the debate continues as to whether regional anesthesia or general anesthesia is safer, the choice of anesthetic technique is a complex decision and surgical teams should be able to offer both RA and GA. The individual approach is the ideal choice and should be determined at the discretion of the surgeon, anesthetist and patient depending on the clinical situation and own preferences.
Published: 2015
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35 results on '"Dragana Unic-Stojanovic"'

1. Effects of Remote Ischaemic Preconditioning on the Internal Thoracic Artery Nitric Oxide Synthase Isoforms in Patients Undergoing Coronary Artery Bypass Grafting

2. Pneumonia in medical professionals during COVID-19 outbreak in cardiovascular hospital

3. Influenza immunization and COVID-19—can viral structure be responsible for the effect?

4. European Association of Cardiothoracic Anesthesiology and Intensive Care (EACTAIC) Fellowship Curriculum: Second Edition

5. A complete versus inducible ischemia-guided revascularization after a culprit-only primary percutaneous coronary intervention in multivessel coronary artery disease: A pilot study

6. SYNTAX SCORE II VERSION 2020: EXTERNAL VALIDATION OF PATIENTS TREATED BY CORONARY ARTERY BYPASS GRAFTING IN A SINGLE LARGE VOLUME CARDIO-SURGICAL CENTER

7. Updates on Wound Infiltration Use for Postoperative Pain Management: A Narrative Review

8. Results of simultaneous application of hyperbaric oxygen and negative pressure wound therapy in diabetic foot ulcers treatment

9. Intraoperative transfusion practices and perioperative outcome in the European elderly: A secondary analysis of the observational ETPOS study

10. European Association of Cardiothoracic Anesthesiology and Intensive Care Pediatric Cardiac Anesthesia Fellowship Curriculum: First Edition

11. Influenza immunization and COVID-19—can viral structure be responsible for the effect?

12. Application of cerebral oxymetry in carotid surgery (Cerebral oximetry and carotid surgery)

13. European Association of Cardiothoracic Anesthesiology (EACTA) Cardiothoracic and Vascular Anesthesia Fellowship Curriculum: First Edition

14. Neuroaxial anaesthesia in the presence of back tattoos (neuroaxial anaesthesia)

15. Central venous pressure up date: What is it good for?

16. Anesthesia for transcatheter aortic valve implantation: A case report (anesthesia for TAVI)

17. Suspected hepatotoxicity effect of amiodarone (amiodarone and liver)

18. Surgical Treatment of Proximal Segmental Occlusion of the Internal Carotid Artery

19. An epidural catheter removal after recent percutaneous coronary intervention and coronary artery stenting: Epidural catheter and antiaggregation therapy

20. Optimal perioperative fluid management: What is the strategy?

21. Acute aortic dissection in patient with suspected pheochromocytoma

22. Perioperative management of postdural puncture headache: Postdural puncture headache

23. Perioperative pulmonary embolism

24. Complete thrombosis of the ductus arteriosus could be the option to be alive in the seventh decade of life without specific symptoms

25. High thoracic epidural anesthesia in patients with synchronous carotid endarterectomy and off-pump coronary artery revascularization

26. Mid-regional pro-adrenomedulin as a marker of perioperative mortality in non-cardiac surgery

27. REGIONAL ANAESTHESIA AND ACUTE PAIN

28. Effects of epidural analgesia using different concentrations of bupivacaine during combined general and epidural anesthesia

29. Hybrid procedure for a descending thoracic and subclavian artery aneurysm in a patient with previous abdominal aortic surgery: Case report

30. Anesthesia for carotid endarterectomy: where do we stand at present?

31. Direct Ischemic Postconditioning After Carotid Endarterectomy in the Prevention of Postoperative Cerebral Ischemic Complications—Observational Case–Control Study

32. The current role of surgery in treating adult patients with patent ductus arteriosus

33. Abnormal central venous oxygen saturation in cardiac surgery patients: a prospective, observational study

34. Blood transfusion in cardiac surgery--does the choice of anesthesia or type of surgery matter?

35. Anesthesia for carotid endarterectomy: where do we stand at present?

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35 results on '"Dragana Unic-Stojanovic"'

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