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Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia Annals of Cardiac Anaesthesia
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Table of Contents
LETTER TO EDITOR  
Year : 2011  |  Volume : 14  |  Issue : 2  |  Page : 167-168
To evaluate the heart or not in emergency neurosurgical head-injured patients with ST elevation: Authors' reply


1 Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Neuroanaesthesiology, All India Institute of Medical Sciences, New Delhi, India

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Date of Web Publication25-May-2011
 

How to cite this article:
Bhagat H, Chauhan H, Dash HH. To evaluate the heart or not in emergency neurosurgical head-injured patients with ST elevation: Authors' reply. Ann Card Anaesth 2011;14:167-8

How to cite this URL:
Bhagat H, Chauhan H, Dash HH. To evaluate the heart or not in emergency neurosurgical head-injured patients with ST elevation: Authors' reply. Ann Card Anaesth [serial online] 2011 [cited 2019 Oct 16];14:167-8. Available from: http://www.annals.in/text.asp?2011/14/2/167/81585


The Editor,

The authors [1] have reviewed the impact of neurogenic cause of myocardial injury on the patient's outcome. Moreover, they have looked into the probable measures which may benefit this group of patients. Though not totally substantiated, the views are still important.

However, the following points need to be emphasized.

  1. The need to determine the cause of ST elevation in head injured patients is important. Nevertheless, the time factor for emergency surgery cannot be undermined in neurotrauma patients. The risk benefit ratio of cardiac evaluation versus emergency surgery needs to be taken into cognizance. The protocol for cardiac evaluation will depend on the expertise and facility available at particular institution.
  2. Invasive monitoring is of paramount importance as a guide to maintain stable hemodynamics.
  3. There is a need for careful selection of pharmacologic agents for induction and maintenance of anesthesia with a goal to achieve optimal cerebral perfusion pressure.
  4. Preoperative cardiac evaluation may aid in diagnosis and perioperative management of head injured patients. However, the importance of such an exercise on the overall outcome is yet to be determined in patients with traumatic brain injury.


 
   References Top

1.Jain A, Dogra N, Mangal K. To evaluate the heart or not in emergency neurosurgical head-injured patients with ST elevation. Ann Card Anaesth 2010;13:268-9  Back to cited text no. 1
    

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Correspondence Address:
Hemant Bhagat
Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-9784.81585

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