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Renal failure and cardiac surgery

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https://www.readbyqxmd.com/read/28507439/infrainguinal-open-reconstruction-a-review-of-surgical-considerations-and-expected-outcomes
#1
REVIEW
Sevan R Komshian, Kimberly Lu, Steven L Pike, Jeffrey J Siracuse
Infrainguinal arterial occlusive disease can lead to potentially disabling and limb-threatening conditions. Revascularization may be indicated for claudication, rest pain, or tissue loss. Although endovascular interventions are becoming more prevalent, open surgeries such as endarterectomy and bypass are still needed and performed regularly. Open reconstruction has been associated with postoperative morbidity, both at the local and at the systemic levels. Local complications include surgical site infections (SSIs 0-5...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28492122/critical-care-admission-of-south-african-sa-surgical-patients-results-of-the-sa-surgical-outcomes-study
#2
David Lee Skinner, Kim De Vasconcellos, Robert Wise, Tonya Marianne Esterhuizen, Cate Fourie, Akhter Goolam Mahomed, P Dean Gopalan, Ivan Joubert, Hyla-Louise Kluyts, L Rudo Mathivha, Busisiwe Mrara, Jan P Pretorius, Guy Richards, Ollie Smith, Maryke Geertruida Louise Spruyt, Rupert M Pearse, Thandinkosi E Madiba, Bruce M Biccard, On Behalf Of The South African Surgical Outcomes Study Sasos Investigators
BACKGROUND: Appropriate critical care admissions are an important component of surgical care. However, there are few data describing postoperative critical care admission in resource-limited low- and middle-income countries. OBJECTIVE: To describe the demographics, organ failures, organ support and outcomes of non-cardiac surgical patients admitted to critical care units in South Africa (SA). METHODS: The SA Surgical Outcomes Study (SASOS) was a 7-day national, multicentre, prospective, observational cohort study of all patients ≥16 years of age undergoing inpatient non-cardiac surgery between 19 and 26 May 2014 at 50 government-funded hospitals...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28486627/re-exploration-due-to-bleeding-is-not-associated-with-severe-postoperative-complications
#3
Sandeep P Tambe, Hans-Henrik Kimose, Jakob Raben Greisen, Carl-Johan Jakobsen
OBJECTIVES: In cardiac surgery, postoperative bleeding remains a frequent complication with various possible adverse outcomes. Re-exploration due to bleeding is frequent in this type of patient. Sternal wound infection is an infrequent but serious and devastating complication. Whether re-exploration due to bleeding significantly affects the incidence of sternal wound infection is uncertain. There is no consensus on allowed severity of bleeding and timing of intervention. METHODS: A retrospective, observational cohort study of 15 350 consecutive patients who underwent cardiac surgical procedures from 1 April 2006 through 31 December 2013 in 3 different university hospitals in Denmark was performed...
May 8, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28484814/contemporary-approaches-to-perioperative-iv-fluid-therapy
#4
REVIEW
Paul S Myles, Sam Andrews, Jonathan Nicholson, Dileep N Lobo, Monty Mythen
BACKGROUND: Intravenous fluid therapy is required for most surgical patients, but inappropriate regimens are commonly prescribed. The aim of this narrative review was to provide evidence-based guidance on appropriate perioperative fluid management. METHOD: We did a systematic literature search of the literature to identify relevant studies and meta-analyses to develop recommendations. RESULTS: Of 275 retrieved articles, we identified 25 articles to inform this review...
May 8, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28475274/remote-ischaemic-preconditioning-for-coronary-artery-bypass-grafting-with-or-without-valve-surgery
#5
REVIEW
Carina Benstoem, Christian Stoppe, Oliver J Liakopoulos, Julia Ney, Dirk Hasenclever, Patrick Meybohm, Andreas Goetzenich
BACKGROUND: Despite substantial improvements in myocardial preservation strategies, coronary artery bypass grafting (CABG) is still associated with severe complications. It has been reported that remote ischaemic preconditioning (RIPC) reduces reperfusion injury in people undergoing cardiac surgery and improves clinical outcome. However, there is a lack of synthesised information and a need to review the current evidence from randomised controlled trials (RCTs). OBJECTIVES: To assess the benefits and harms of remote ischaemic preconditioning in people undergoing coronary artery bypass grafting, with or without valve surgery...
May 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28462447/predictive-power-of-the-nsqip-risk-calculator-for-early-post-operative-outcomes-after-whipple-experience-from-a-regional-center-in-northern-ontario
#6
Henry Y Jiang, Erica L Kohtakangas, Kengo Asai, Jeffrey B Shum
BACKGROUND: NSQIP Risk Calculator was developed to allow surgeons to inform their patients about their individual risks for surgery. Its ability to predict complication rates and length of stay (LOS) has made it an appealing tool for both patients and surgeons. However, the NSQIP Risk Calculator has been criticized for its generality and lack of detail towards surgical subspecialties, including the hepatopancreaticobiliary (HPB) surgery. We wish to determine whether the NSQIP Risk Calculator is predictive of post-operative complications and LOS with respect to Whipple's resections for our patient population...
May 2, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28449477/continuous-administration-of-recombinant-human-b-type-natriuretic-peptide-can-improve-heart-and-renal-function-in-patients-after-cardiopulmonary-bypass-surgery
#7
Shiguan Le, Jian Xiao, Wei Li, Jing Wang, Qing Wang, Wang Xi, Jibin Xu, Zhinong Wang
BACKGROUND: Any cardiac surgery under cardiopulmonary bypass (CPB) will induce ischemia-reperfusion injury and systematic inflammatory response, which may lead to exacerbation. Conventional therapy strategy is to use inotropes, diuretics and vasodilator drugs, yet, the therapeutic effects of which need to be improved. Recombinant human B-type natriuretic peptide (rhBNP) has been shown to be efficacious in the treatment of acute decompensated heart failure and acute myocardial infarction...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28432158/risk-score-for-cardiac-surgery-in-active-left-sided-infective-endocarditis
#8
Carmen Olmos, Isidre Vilacosta, Gilbert Habib, Luis Maroto, Cristina Fernández, Javier López, Cristina Sarriá, Erwan Salaun, Salvatore Di Stefano, Manuel Carnero, Sandrine Hubert, Carlos Ferrera, Gabriela Tirado, Afonso Freitas-Ferraz, Carmen Sáez, Javier Cobiella, Juan Bustamante-Munguira, Cristina Sánchez-Enrique, Pablo Elpidio García-Granja, Cecile Lavoute, Benjamin Obadia, David Vivas, Ángela Gutiérrez, José Alberto San Román
OBJECTIVE: To develop and validate a calculator to predict the risk of in-hospital mortality in patients with active infective endocarditis (IE) undergoing cardiac surgery. METHODS: Thousand two hundred and ninety-nine consecutive patients with IE were prospectively recruited (1996-2014) and retrospectively analysed. Left-sided patients who underwent cardiac surgery (n=671) form our study population and were randomised into development (n=424) and validation (n=247) samples...
April 21, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28423123/n-acetylcysteine-versus-dopamine-to-prevent-acute-kidney-injury-after-cardiac-surgery-in-patients-with-preexisting-moderate-renal-insufficiency
#9
Omer Faruk Savluk, Fusun Guzelmeric, Yasemin Yavuz, Deniz Cevirme, Emre Gurcu, Halide Ogus, Tulay Orki, Tuncer Kocak
Objective: Acute kidney injury after cardiac surgery is associated with mortality and morbidity. Therefore, strategies to prevent acute kidney injury are very important. The aim of this placebo-controlled randomized double-blind study was to compare the prophylactic efficacy of N-Acetylcysteine and dopamine administration in patients with pre-existing moderate renal insufficiency who were undergoing cardiopulmonary bypass. Methods: This study included 135 patients with pre-existing moderate renal insufficiency who were scheduled for coronary artery bypass grafting surgery...
January 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28419746/factors-for-postoperative-complications-following-pressure-ulcer-operation-stepwise-multiple-logistic-regression-analysis
#10
Hyun Ho Han, Jun Gul Ko, Jong Won Rhie
Patients with pressure ulcers are generally older, have a long hospital stay and often have a variety of comorbidities. The decision to perform surgery for pressure ulcer management can be difficult because of concerns about the risk of postoperative complications. The aim of this study was to analyse the relationship between comorbid conditions and surgical outcomes in order to guide patient selection for pressure ulcer surgery. In 57 patients, data on age, defect size, operating time, hospital stay, body mass index, surgical site, mobility state, cardiac ischaemic history, diabetes, renal failure, ventilator dependency, tracheostomy state, use of haemodilution therapy and cancer were evaluated using stepwise multiple logistic regression analysis to determine the relationships between variables...
April 17, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28408734/mycophenolate-mofetil-and-pulmonary-fibrosis-after-kidney-transplantation-a-case-report
#11
Kazuhiro Takahashi, Pauline Go, Chad H Stone, Mohamed Safwan, Krishna G Putchakayala, William J Kane, Lauren E Malinzak, Dean Y Kim, Jason E Denny
BACKGROUND Mycophenolate mofetil (MMF) induced lung disease has been described in only a few isolated reports. We report a case of fatal respiratory failure associated with MMF after kidney transplantation. CASE REPORT A 50-year-old Hispanic male with a history of end-stage renal disease secondary to hypertension underwent deceased donor kidney transplantation. His preoperative evaluations were normal except for a chest x-ray which showed bilateral interstitial opacities. Tacrolimus and MMF were started on the day of surgery...
April 14, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28381430/impact-of-sleep-disordered-breathing-on-short-term-post-operative-outcome-after-elective-coronary-artery-bypass-graft-surgery-a-prospective-observational-study
#12
Sven Rupprecht, Torsten Schultze, Andreas Nachtmann, Ardawan Julian Rastan, Torsten Doenst, Matthias Schwab, Otto W Witte, Sebastian Rohe, Isabelle Zwacka, Heike Hoyer
Sleep disordered breathing (SDB) is common in patients with coronary disease, but its impact on post-operative recovery after coronary artery bypass graft surgery (CABG) is unclear. We therefore determined the effects of SDB on post-operative outcome after elective CABG.In this prospective two-centre study, 219 patients due to receive elective CABG underwent cardiorespiratory polygraphy for SDB prior to surgery and were monitored for post-operative complications. The primary end-point was a composite of 30-day mortality or major post-operative complications (cardiac, respiratory, surgical, infectious, acute renal failure or stroke)...
April 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28369234/postoperative-atrial-fibrillation-following-cardiac-surgery-a-persistent-complication
#13
Jason W Greenberg, Timothy S Lancaster, Richard B Schuessler, Spencer J Melby
Postoperative atrial fibrillation (POAF) is a common, expensive and potentially morbid complication following cardiac surgery. POAF occurs in around 35% of cardiac surgery cases and has a peak incidence on postoperative day 2. Patients who develop POAF incur on average $10 000-$20 000 in additional hospital treatment costs, 12-24 h of prolonged ICU time, and an additional 2 to 5 days in the hospital. POAF has been identified as an independent predictor of numerous adverse outcomes, including a 2- to 4-fold increased risk of stroke, reoperation for bleeding, infection, renal or respiratory failure, cardiac arrest, cerebral complications, need for permanent pacemaker placement, and a 2-fold increase in all-cause 30-day and 6-month mortality...
March 27, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28355763/-late-reoperations-after-repaired-stanford-type-a-aortic-dissection
#14
F H Huang, L P Li, C H Su, W Qin, M Xu, L M Wang, Y S Jiang, Z B Qiu, L Q Xiao, C Zhang, H W Shi, X Chen
Objective: To summarize the experience of reoperations on patients who had late complications related to previous aortic surgery for Stanford type A dissection. Methods: From August 2008 to October 2016, 14 patients (10 male and 4 female patients) who underwent previous cardiac surgery for Stanford type A aortic dissection accepted reoperations on the late complications at Department of Thoracic and Cardiovascular Surgery, Nanjing Hospital Affiliated to Nanjing Medical University. The range of age was from 41 to 76 years, the mean age was (57±12) years...
April 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28338553/consequences-of-hybrid-procedure-addition-to-robotic-assisted-direct-coronary-artery-bypass
#15
Feras Khaliel, Vincenzo Giambruno, Michael W A Chu, Kumar Sridhar, Patrick Teefy, Bob B Kiaii
OBJECTIVE: Patients postcoronary artery revascularization surgery often receives blood product transfusion, which could delay their intensive care unit and hospital discharge. We investigated our robotic-assisted direct coronary artery bypass (RADCAB) transfusion rate to determine whether performing the minimal invasive coronary surgery with percutaneous coronary intervention in one stage would increase the incidence of blood transfusion, morbidity, and length of stay. METHODS: Between November 2003 and November 2015, 483 consecutive patients underwent RADCAB surgery...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28331172/an-anti-coagulation-conundrum-implantation-of-total-artificial-heart-in-a-patient-with-heparin-induced-thrombocytopenia-type-ii
#16
Theodore J Cios, Yuliana Salamanca-Padilla, Dmitri Guvakov
BACKGROUND Heparin-induced thrombocytopenia (HIT) is a rare but life-threatening complication of heparin administration. It can present a major clinical dilemma for physicians caring for patients requiring life-saving urgent or emergent cardiac surgery. Studies have been published examining the use of alternative anticoagulants for patients undergoing cardiopulmonary bypass (CPB), however, evidence does not clearly support any particular approach. Presently, there are no large-scale, prospective randomized studies examining the impact of alternative anticoagulants on clinical outcomes for HIT-positive patients requiring cardiac surgery...
March 23, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28329459/nineteen-years-of-adult-congenital-heart-surgery-in-a-single-center
#17
Madurra Perinpanayagam, Signe H Larsen, Kristian Emmertsen, Marianne B Møller, Vibeke E Hjortdal
BACKGROUND: Adults with congenital heart disease are a growing population. We describe surgical interventions, short- and long-term mortality and morbidity, and risk factors for adverse events in a population-based cohort. METHODS: Patients over or equal to 18 years with congenital heart disease who underwent cardiac surgery at Aarhus University Hospital, Denmark, from 1994 to 2012 were included in the study. Diagnoses, surgical procedures, postoperative complications, and survival were identified in hospital databases, medical records, and the Danish Civil Registration System...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28322600/renal-mitochondrial-response-to-low-temperature-in-non-hibernating-and-hibernating-species
#18
George J Dugbartey, Maarten C Hardenberg, Wendelinde F Kok, Ate S Boerema, Hannah V Carey, James F Staples, Robert H Henning, Hjalmar R Bouma
SIGNIFICANCE: Therapeutic hypothermia is commonly applied to limit ischemic injury in organ transplantation, during cardiac and brain surgery and after cardiopulmonary resuscitation. In these procedures, the kidneys are particularly at risk for ischemia/reperfusion injury (IRI), likely due to their high rate of metabolism. Although hypothermia mitigates ischemic kidney injury, it is not a panacea. Residual mitochondrial failure is believed to be a key event triggering loss of cellular homeostasis, and potentially cell death...
April 26, 2017: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/28299450/the-prevalence-of-post-thyroidectomy-chronic-asthenia-a-prospective-cohort-study
#19
Gregorio Scerrino, Giuseppina Melfa, Cristina Raspanti, Andrea Attard, Sergio Mazzola, Roberto Gullo, Sebastiano Bonventre, Marco Attard, Gianfranco Cocorullo, Gaspare Gulotta
PURPOSE: Chronic asthenia (CA) is complained by some patients that have undergone thyroid surgery. We evaluate its impact in patients undergoing unilateral or bilateral thyroidectomy, the trend during a 1-year follow-up, and the possible risk factors. METHODS: A prospective, cohort study was carried out on 263 patients scheduled for thyroidectomy from 2012 and 2014. Exclusion criteria were as follows: Graves' disease, malignancies requiring radioiodine therapy, post-surgical hypoparathyroidism, laryngeal nerve palsy, abnormal pre- and post-operative thyroid hormone levels, and BMI outside the normal range...
March 15, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28275064/obesity-increases-risk-adjusted-morbidity-mortality-and-cost-following-cardiac-surgery
#20
Ravi K Ghanta, Damien J LaPar, Qianzi Zhang, Vishal Devarkonda, James M Isbell, Leora T Yarboro, John A Kern, Irving L Kron, Alan M Speir, Clifford E Fonner, Gorav Ailawadi
BACKGROUND: Despite the epidemic rise in obesity, few studies have evaluated the effect of obesity on cost following cardiac surgery. We hypothesized that increasing body mass index (BMI) is associated with worse risk-adjusted outcomes and higher cost. METHODS AND RESULTS: Medical records for 13 637 consecutive patients who underwent coronary artery bypass grafting (9702), aortic (1535) or mitral (837) valve surgery, and combined valve-coronary artery bypass grafting (1663) procedures were extracted from a regional Society of Thoracic Surgeons certified database...
March 8, 2017: Journal of the American Heart Association
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