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https://www.readbyqxmd.com/read/29456563/does-topical-tranexamic-acid-reduce-postcoronary-artery-bypass-graft-bleeding
#1
Amir Mirmohammadsadeghi, Mohsen Mirmohammadsadeghi, Mahnaz Kheiri
Background: Postoperative bleeding is a common problem in cardiac surgery. We tried to evaluate the effect of topical tranexamic acid (TA) on reducing postoperative bleeding of patients undergoing on-pump coronary artery bypass graft (CABG) surgery. Materials and Methods: One hundred and twenty-six isolated primary CABG patients were included in this clinical trial. They were divided blindly into two groups; Group 1, patients receiving 1 g TA diluted in 100 ml normal saline poured into mediastinal cavity before closing the chest and Group 2, patients receiving 100 ml normal saline at the end of operation...
2018: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/29445593/minimally-invasive-techniques-in-thymic-surgery-a-worldwide-perspective
#2
REVIEW
Hasan Fevzi Batirel
Minimally invasive surgical techniques are important in surgical management of thymic pathologies. Traditional access techniques are being replaced with minimally invasive techniques using multiportal or uniportal approach. Adoption of minimally invasive techniques for thymic malignancies has been slow due to long term recurrence concerns. Recent studies show that minimally invasive video-assisted thoracoscopic surgery (VATS) or robotic approach to early stage thymic malignancies are associated with less intraoperative bleeding, lower rate of respiratory complications, shorter chest tube duration and shorter hospital stay...
2018: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29383943/complications-of-surgery-for-infectious-lung-cavities
#3
Gildardo Cortés-Julián, Luis C Valencia, Silviano Ríos-Pascual, Marco A de la Rosa-Abarroa, Enrique Guzmán-de Alba
Background Infectious lung cavities are a common entity for the respiratory physician. Sometimes these lesions require surgical treatment, but surgery is challenging, and complications are common. Methods Patients with infectious lung cavities amenable to surgical treatment were included in a case-control study. The control group included patients with no complications. The cases group comprised patients with any of the following complications up to 90 days after surgery: death, persistence of hemoptysis, empyema, operative blood loss > 500 mL, vascular lesion requiring repair, massive transfusion (>5 units of packed red blood cells per 48 h) or reoperation for bleeding, postoperative mechanical ventilation, intensive care unit stay > 48 h, prolonged air leak, and persistent atelectasis...
January 1, 2018: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/29382509/active-chest-tube-clearance-after-cardiac-surgery-is-associated-with-reduced-reexploration-rates
#4
Philippe Grieshaber, Nicolas Heim, Moritz Herzberg, Bernd Niemann, Peter Roth, Andreas Boening
BACKGROUND: Ineffective evacuation of intrathoracic fluid after cardiac surgery (retained blood syndrome [RBS]) might increase postoperative complications, morbidity and mortality. Active chest tube clearance technology (ATC) using an intraluminal clearing apparatus aims at increasing drainage efficiency. This study aimed to evaluate, if ATC reduces RBS in an all-comers collective undergoing scheduled cardiac surgery with cardiopulmonary bypass and full or partial median sternotomy. METHODS: In this non-randomized prospective trial, 581 consecutive patients undergoing scheduled cardiac surgery with median sternotomy between 01/2016 and 12/2016 were assigned to receive conventional chest tubes (Control) or a combination of conventional tubes and up to two ATC devices (ATC group) depending on their operation date...
January 27, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29338867/validation-of-a-definition-of-excessive-postoperative-bleeding-in-infants-undergoing-cardiac-surgery-with-cardiopulmonary-bypass
#5
Rachel S Bercovitz, Allison C Shewmake, Debra K Newman, Robert A Niebler, John P Scott, Eckehard Stuth, Pippa M Simpson, Ke Yan, Ronald K Woods
OBJECTIVE: To derive and validate an objective definition of postoperative bleeding in neonates and infants undergoing cardiac surgery with cardiopulmonary bypass. METHODS: Using a retrospective cohort of 124 infants and neonates, we included published bleeding definitions and cumulative chest tube output over different postoperative periods (eg, 2, 12, or 24 hours after intensive care unit admission) in a classification and regression tree model to determine chest tube output volumes that were associated with red blood cell transfusions and surgical re-exploration for bleeding in the first 24 hours after intensive care unit admission...
December 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29332420/activated-factor-7-versus-4-factor-prothrombin-complex-concentrate-for-critical-bleeding-post-cardiac-surgery
#6
Sarah L Mehringer, Zachary Klick, Jonathan Bain, Elizabeth B McNeely, Sreekumar Subramanian, Lawrence J Pass, Davis Drinkwater, V Seenu Reddy
BACKGROUND: Recombinant and plasma-derived factor products, such as activated factor seven (rFVIIa) and four-factor prothrombin complex concentrate (4-factor PCC), have been used off-label for bleeding after cardiac surgery, but little evidence has been published regarding their efficacy and safety. OBJECTIVE: To determine whether there is a difference in chest tube output in patients who have received 4-factor PCC or rFVIIa for critical postoperative bleeding associated with cardiovascular surgery...
January 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29311500/thoracoscopic-thymectomy-using-a-subxiphoid-approach-for-anterior-mediastinal-tumors
#7
Hiroki Numanami, Motoki Yano, Masayuki Yamaji, Rumiko Taguchi, Chihiro Furuta, Ryoichi Nakanishi, Masayuki Haniuda
PURPOSE: Video-assisted thoracic surgery (VATS) techniques have been widely used for resection of mediastinal tumors. This study investigated the usefulness of the subxiphoid approach in thoracoscopic thymectomy. METHODS: In all, 36 patients with anterior mediastinal tumor underwent thymectomy using the subxiphoid approach in two Japanese institutions. These patients were retrospectively reviewed and analyzed. RESULTS: There were 16 females and 20 males with a mean age of 57 years...
January 9, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29297974/three-dimensional-3d-computed-tomography-bronchography-and-angiography-combined-with-3d-video-assisted-thoracic-surgery-vats-versus-conventional-2d-vats-anatomic-pulmonary-segmentectomy-for-the-treatment-of-non-small-cell-lung-cancer
#8
Xiao-Wei She, Yun-Bin Gu, Chun Xu, Chang Li, Cheng Ding, Jun Chen, Jun Zhao
BACKGROUND: Compared to the pulmonary lobe, the anatomical structure of the pulmonary segment is relatively complex and prone to variation, thus the risk and difficulty of segmentectomy is increased. We compared three-dimensional computed tomography bronchography and angiography (3D-CTBA) combined with 3D video-assisted thoracic surgery (3D-VATS) to perform segmentectomy to conventional two-dimensional (2D)-VATS for the treatment of non-small cell lung cancer (NSCLC). METHODS: We retrospectively reviewed the data of randomly selected patients who underwent 3D-CTBA combined with 3D-VATS (3D-CTBA-VATS) or 2D-VATS at the Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University Hospital, from January 2014 to May 2017...
January 3, 2018: Thoracic Cancer
https://www.readbyqxmd.com/read/29284881/postoperative-chylothorax-of-unclear-etiology-in-a-patient-with-right-sided-subclavian-central-venous-catheter-placement
#9
Samie Asghar, Faisal Shamim
A young male underwent decompressive craniotomy for an intracerebral bleed. A right-sided subclavian central venous catheter was placed in the operating room after induction of anesthesia. Postoperatively, he was shifted to Intensive Care Unit (ICU) for mechanical ventilation due to low Glasgow coma scale. He had an episode of severe agitation and straining on the tracheal tube in the evening same day. On the 2nd postoperative day in ICU, his airway pressures were high, and chest X-ray revealed massive pleural effusion on right side...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29221312/port-access-thoracoscopic-bisubsegmentectomy-of-right-upper-lobe-posterior-and-anterior-segments
#10
Hirohisa Kato, Hiroyuki Oizumi, Jun Suzuki, Akira Hamada, Hikaru Watarai, Kenta Nakahashi, Mitsuaki Sadahiro
A 64-year-old woman was admitted to our hospital with a 16-mm non-solid tumor with pure ground-glass nodule (GGN) contents in the posterior segment near the anterior segment of her right upper lung lobe that was suspicious of adenocarcinoma in situ (AIS). Three-dimensional computed tomography (3DCT) simulation was performed to identify the subsegmental artery and vein pre- or intra-operatively. Port-access thoracoscopic bisubsegmentectomy of the right upper lobe was performed. A frozen section revealed AIS...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29217234/outcomes-following-three-factor-inactive-prothrombin-complex-concentrate-versus-recombinant-activated-factor-vii-administration-during-cardiac-surgery
#11
Patrick C Harper, Mark M Smith, Nathan J Brinkman, Melissa A Passe, Darrell R Schroeder, Sameh M Said, Gregory A Nuttall, William C Oliver, David W Barbara
OBJECTIVE: To compare outcomes following inactive prothrombin complex concentrate (PCC) or recombinant activated factor VII (rFVIIa) administration during cardiac surgery. DESIGN: Retrospective propensity-matched analysis. SETTING: Academic tertiary-care center. PARTICIPANTS: Patients undergoing cardiac surgery requiring cardiopulmonary bypass who received either rFVIIa or the inactive 3-factor PCC. INTERVENTIONS: Outcomes following intraoperative administration of rFVIIa (263) or factor IX complex (72) as rescue therapy to treat bleeding...
July 12, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29210786/selective-serotonin-reuptake-inhibitors-and-serotonin-norepinephrine-reuptake-inhibitors-are-not-associated-with-bleeding-or-transfusion-in-cardiac-surgical-patients
#12
Mark M Smith, Bradford B Smith, Brian D Lahr, Gregory A Nuttall, William J Mauermann, Timothy J Weister, Joseph A Dearani, David W Barbara
BACKGROUND: Selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) use is known to alter platelet activation and aggregation leading to impairment in hemostasis. Previous studies are ambiguous with regard to bleeding, transfusion, and perioperative complications in patients undergoing cardiac surgery. The purpose of this study was to evaluate the risk of perioperative bleeding, transfusion, morbidity, and mortality in cardiac surgical patients taking SSRI/SNRIs compared with propensity-matched controls...
November 22, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29078698/needlescopic-assisted-uniportal-video-assisted-thoracoscopic-pulmonary-anatomical-segmentectomy
#13
Shun-Mao Yang, Wen-Ting Wu, Yu-Hsuan Liu, Huan-Jang Ko
BACKGROUND: Pulmonary segmentectomy can be an oncologic equivalent of lobectomy for small non-small cell lung cancer. Uniportal video-assisted thoracoscopic surgery (VATS) has recently showed favorable surgical outcomes, but remains technical demanding, especially in a complex procedure like anatomic segmentectomy. This manuscript demonstrates the surgical techniques for uniportal VATS segmentectomies with the assistance of additional needlescopic instruments. METHODS: Data of 22 consecutive patients who underwent 24 needlescopic-assisted uniportal VATS segmentectomies between December 2016 and June 2017 was analyzed...
2017: Journal of Visualized Surgery
https://www.readbyqxmd.com/read/29076100/thoracoscopic-management-of-blebs-resection-with-out-primary-pleurodesis
#14
Karina Miura da Costa, Amulya Kumar Saxena
OBJECTIVES: To review the literature for justification of thoracoscopic management of blebs in children. METHODS: PubMed database was reviewed for articles in English, Portuguese and Spanish using the key words "thoracoscopy", "bleb" and "child". Data was collected for age, gender, type of surgery performed, operating time, conversions, complications, recurrences, follow-up and mortality. RESULTS: Eleven studies with total 266 patients were included (27 bilateral cases; n = 293 surgeries)...
October 27, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28967418/recombinant-factor-viia-use-in-acute-type-a-aortic-dissection-repair-a-multicenter-propensity-score-matched-report-from-the-nordic-consortium-for-acute-type-a-aortic-dissection
#15
Igor Zindovic, Johan Sjögren, Anders Ahlsson, Henrik Bjursten, Simon Fuglsang, Arnar Geirsson, Richard Ingemansson, Emma C Hansson, Ari Mennander, Christian Olsson, Emily Pan, Susann Ullén, Tomas Gudbjartsson, Shahab Nozohoor
BACKGROUND: Surgery for acute type A aortic dissection (ATAAD) is often complicated by excessive bleeding. Recombinant factor VIIa (rFVIIa) effectively treats refractory bleeding associated with ATAAD surgery; however, adverse effects of rFVIIa in these patients have not been fully assessed. Here we evaluated rFVIIa treatment in ATAAD surgery using the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) database. METHODS: This was a multicenter, propensity score-matched, retrospective study...
August 24, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28957995/early-outcomes-of-robotic-versus-uniportal-video-assisted-thoracic-surgery-for-lung-cancer-a-propensity-score-matched-study
#16
Su Yang, Wei Guo, Xingshi Chen, Han Wu, Hecheng Li
OBJECTIVES: Both robotic-assisted thoracic surgery (RATS) and uniportal video-assisted thoracic surgery (UVATS) are minimally invasive surgical techniques used for treatment of lung cancer. However, no research studies comparing early outcomes between RATS and UVATS have been reported. METHODS: Non-small-cell lung cancer patients treated with RATS or UVATS at our institution from January 2015 to September 2016 were enrolled. Early outcomes were compared after propensity score-matched analysis using 4 factors: age, gender, tumour size and operative procedure...
August 30, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28950378/stopping-versus-continuing-acetylsalicylic-acid-before-coronary-artery-bypass-surgery-a-systematic-review-and-meta-analysis-of-14-randomized-controlled-trials-with-4499-patients
#17
Michel Pompeu Barros Oliveira Sá, Artur Freire Soares, Rodrigo Gusmão Albuquerque Miranda, Mayara Lopes Araújo, Alexandre Motta Menezes, Frederico Pires Vasconcelos Silva, Ricardo Carvalho Lima
This study aimed to evaluate the efficacy and safety of continuing versus stopping aspirin [acetylsalicylic acid (ASA)] preoperatively in patients undergoing coronary artery bypass graft surgery. MEDLINE, EMBASE, CENTRAL/Cochrane Controlled Trials Register (CCTR), ClinicalTrials.gov, Scientific Electronic Library Online (SciELO), Literatura Latino Americana em Ciências da Saúde (LILACS), Google Scholar and reference lists of relevant articles were searched for randomized controlled trials that reported efficacy outcomes of myocardial infarction and mortality, and safety outcomes of blood loss, packed red blood cell transfusion and surgical re-exploration were compared between groups...
November 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28891836/feasibility-and-safety-of-flexible-bronchoscopy-performed-via-tracheal-tubes-in-patients-with-tracheostomies-a-retrospective-single-center-experience
#18
Gustavo Ferrer, Chi Chan Lee, Sameer Shaharyar, Osman Perez, Molly Moor, Frank Gomez, Fanny Tse, Hamid Feiz, Mauricio Danckers
BACKGROUND: Flexible bronchoscopy (FB) is commonly performed to assess, diagnose, and treat patients with respiratory disease, and is typically performed via transnasal or transoral approaches. FB can be performed via tracheal tubes in patients with tracheostomies; however, the safety and technical feasibility has not been established. The present study evaluates the safety and feasibility of performing FB via tracheal tubes. MATERIALS AND METHODS: A total of 45 patients underwent 56 procedures involving FB via tracheal tubes at a single institution from November 2013 to November 2014 and were included in this retrospective case series...
October 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28878572/dabigatran-reversal-with-idarucizumab-in-a-patient-undergoing-heart-transplantation-first-european-report
#19
António Tralhão, Carlos Aguiar, Jorge Ferreira, Maria José Rebocho, Emília Santos, Dinis Martins, José Pedro Neves
BACKGROUND: Dabigatran is a direct thrombin inhibitor with a favorable effectiveness and safety profile when compared to vitamin K antagonists, both in randomized trials and real world registries of atrial fibrillation patients. Yet, physicians' fear of high bleeding risk scenarios in daily clinical practice still precludes a more widespread use of oral anticoagulation. We hereby report a successful case of dabigatran reversal with the novel monoclonal antibody fragment idarucizumab in a patient undergoing heart transplantation...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28869231/how-a-mild-influenza-b-infection-can-kill-a-case-of-pulmonary-hemorrhage
#20
Nathalie Abi Hatem, Sabrina Campbell, Deepa Kuchelan, Jennifer Bowers, Edmundo Rubio
Viral influenza is a seasonal infection associated with significant morbidity and mortality. Rapidly fatal hemorrhagic pneumonia has been described in previously healthy individuals with β-hemolytic Streptococcus pneumoniae in a small series of patients, but it is not common in patients coinfected with influenza B and β-hemolytic Streptococcus, particularly since influenza B is considered less pathogenic than influenza A. However, despite being uncommon, this coinfection seems to be associated with high morbidity and mortality, particularly in healthy individuals...
September 2017: Lung India: Official Organ of Indian Chest Society
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