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Renal failure and cardiac surgery

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https://www.readbyqxmd.com/read/28101755/does-n-terminal-pro-brain-type-natriuretic-peptide-predict-cardiac-complications-after-hip-fracture-surgery
#1
Hiroki Ushirozako, Tsuyoshi Ohishi, Tomotada Fujita, Daisuke Suzuki, Kazufumi Yamamoto, Tomohiro Banno, Hiroyuki Takase, Yukihiro Matsuyama
BACKGROUND: Elderly patients with hip fracture are at risk for cardiac complications. N-terminal pro-brain type natriuretic peptide (NT-proBNP) has been shown to predict cardiac complications in surgical patients; however, to our knowledge, only two studies have evaluated the utility of this test in patients with hip fracture. We believe it is important to assess a more accurate cutoff value of NT-proBNP with exclusion of patients with renal failure. QUESTIONS/PURPOSES: To assess the association between preoperative NT-proBNP and cardiac complications after hip fracture surgery...
January 18, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28089174/neonatal-acute-kidney-injury-severity-and-recovery-prediction-and-the-role-of-serum-and-urinary-biomarkers
#2
Deirdre U Sweetman
Neonatal acute kidney injury is common, in part due to incomplete renal maturation and also due to frequent exposure to risk factors for acute kidney injury such as perinatal asphyxia, extracorporeal-membrane-oxygenation, cardiac surgery, sepsis, prematurity and nephrotoxicity. However the current method by which acute kidney injury is diagnosed is sub-optimal and not universally accepted which impairs the accurate estimation of the true incidence of neonatal acute kidney injury. Serum Cystatin-C, urinary NGAL, KIM-1 and IL-18 are promising neonatal acute kidney injury biomarkers however the diagnosis of acute kidney injury remains serum creatinine/urine output-based in many studies...
January 11, 2017: Early Human Development
https://www.readbyqxmd.com/read/28075435/cardiac-biomarkers-predict-1-year-mortality-in-elderly-patients-undergoing-hip-fracture-surgery
#3
Spyridon Katsanos, Andreas F Mavrogenis, Nikolaos Kafkas, Celestino Sardu, Vasileios Kamperidis, Panagiota Katsanou, Dimitrios Farmakis, John Parissis
This prospective study included 152 elderly patients (mean age, 80 years; range, 72-88 years) with a hip fracture treated surgically. Comorbidities were evaluated, and B-type natriuretic peptide was measured at baseline and at postoperative days 4 and 5 in addition to troponin I. Major cardiac events were recorded, and 1-year mortality was assessed. Comorbidity models with the important multivariate predictors of 1-year mortality were analyzed. Overall, 9 patients (6%) experienced major cardiac events postoperatively during their hospitalization...
January 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28069013/decreased-physical-activity-is-a-predictor-for-a-complicated-recovery-post-cardiac-surgery
#4
Charlotte van Laar, Simone T TImman, Luc Noyez
BACKGROUND: Physical activity (PA) reduces the risk of cardiovascular disease and physically active survivors of a cardiac event are at lower risk of recurrent events. We hypothesized that patients with a decreased PA, undergoing cardiac surgery, are at higher risk for a postoperative complicated recovery (PCR). METHODS: Three thousand three hundred eighty two patients undergoing elective cardiac surgery between January 2007 and December 2013 were included. The group was divided into three subgroups: group A, aged ≤ 65 years (N = 1329); group B, aged > 65 years and ≤ 75 years (N = 1250); and group C aged >75 years (N = 803)...
January 7, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28063123/minimally-invasive-surgery-should-be-the-standard-of-care-for-paraesophageal-hernia-repair
#5
Francisco Schlottmann, Paula D Strassle, Timothy M Farrell, Marco G Patti
BACKGROUND: It is unclear if minimally invasive surgery (MIS) has been universally embraced for paraesophageal hernia (PEH) repair. The aims of this study were: (a) to assess the national utilization of MIS for PEH repair and (b) to compare the perioperative outcomes between MIS and open procedures METHODS: A retrospective population-based analysis was performed using the National Inpatient Sample for the period 2000-2013. Adult patients (≥18 years old) who underwent PEH repair were included...
January 6, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28052866/renal-denervation-in-male-rats-with-heart-failure-improves-ventricular-sympathetic-nerve-innervation-and-function
#6
Maximilian Ichabod Pinkham, Michael T Loftus, Satya Amirapu, Sarah-Jane Guild, Gina Quill, William R Woodward, Beth A Habecker, Carolyn J Barrett
Heart failure is characterized by the loss of sympathetic innervation to the ventricles, contributing to impaired cardiac function and arrhythmogenesis. We hypothesized that renal denervation (RDx) would reverse this loss. Male Wistar rats underwent myocardial infarction (MI) or sham surgery and progressed into heart failure for four weeks before receiving bilateral RDx or sham RDx. After a further three weeks, left ventricular (LV) function was assessed and ventricular sympathetic nerve fibre density determined via histology...
January 4, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28039238/effect-of-beta-blockers-on-perioperative-outcomes-in-vascular-and-endovascular-surgery-a-systematic-review-and-meta-analysis
#7
S Hajibandeh, S Hajibandeh, S A Antoniou, F Torella, G A Antoniou
BACKGROUND: To investigate the role of perioperative beta-blocker use in vascular and endovascular surgery. METHODS: We performed a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards. The review protocol was registered with International Prospective Register of Systematic Reviews (registration number:CRD42016038111). We searched electronic databases to identify all randomized controlled trials and observational studies investigating outcomes of patients undergoing vascular and endovascular surgery with or without perioperative beta blockade...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28027819/mortality-and-readmission-of-outcomes-after-discharge-from-the-surgical-intensive-care-unit-to-long-term-acute-care-hospitals
#8
Michelle C Nguyen, David S Strosberg, Teresa S Jones, Ankur Bhakta, Edward L Jones, Michael R Lyaker, Cindy A Byrd, Carly Sobol, Daniel S Eiferman
BACKGROUND: Patients with prolonged hospitalizations in the surgical intensive care unit often have ongoing medical needs that require further care at long-term, acute-care hospitals upon discharge. Setting expectations for patients and families after protracted operative intensive care unit hospitalization is challenging, and there are limited data to guide these conversations. The purpose of this study was to determine patient survival and readmission rates after discharge from the surgical intensive care unit directly to a long-term, acute-care hospital...
December 24, 2016: Surgery
https://www.readbyqxmd.com/read/28017176/levosimendan-as-a-treatment-for-acute-renal-failure-associated-with-cardiogenic-shock-after-hip-fracture
#9
Fabiola Quinteros Hinojosa, Margarita Revelo, Alexander Salazar, Genaro Maggi, Renato Schiraldi, Nicolas Brogly, Fernando Gilsanz
Inotropic drugs are part of the treatment of heart failure; however, inotropic treatment has been largely debated due to the increased incidence of adverse effects and increased mortality. Recently levosimendan, an inotropic positive agent, has been proved to be effective in acute heart failure, reducing the mortality and improving cardiac and renal performance. We report the case of a 75-year-old woman with history of heart and renal failure and hip fracture. Levosimendan was used in preoperative preparation as an adjuvant therapy, to improve cardiac and renal function and to allow surgery...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28009947/root-replacement-for-graft-infection-using-an-all-biologic-xenopericardial-conduit
#10
Sabina P W Guenther, Angela Reichelt, Sven Peterss, Maximilian Luehr, Erik Bagaev, Christian Hagl, Maximilian A Pichlmaier, Nawid Khaladj
BACKGROUND: The management of graft infection following ascending aortic replacement (AAR) and/or aortic valve replacement (AVR) with destruction of the root remains a challenge. Besides technical issues, the choice of graft material is controversial. The study aim was to investigate the initial results of aortic root replacement (ARR) as redo-surgery for infection using the xenopericardial all-biologic conduit (BioIntegral) as an alternative to a homograft or prosthetic material. METHODS: Between February 2013 and January 2015, a total of 18 consecutive patients (16 males, two females; mean age 61 ± 14 years) were reoperated on for infection at a mean of 55 ± 61 months (range: 3 to 219 months) following previous AVR (n = 6), supracoronary aortic replacement (SAR, n = 2), AVR + SAR (n = 1), root replacement (n = 7), and root reconstruction (n = 2)...
July 2016: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/28009797/what-s-new-in-congenital-scoliosis
#11
Joshua M Pahys, James T Guille
BACKGROUND: Congenital scoliosis is a failure of vertebral formation, segmentation, or a combination of the 2 arising from abnormal vertebral development during weeks 4 to 6 of gestation. The associated spinal deformity can be of varying severity and result in a stable or progressive deformity based on the type and location of the anomalous vertebra(e). Bracing for congenital scoliosis is rarely indicated, while recent reports have demonstrated the utility of serial derotational casting for longer curves with multiple anomalous vertebrae as an effective "time buying strategy" to delay the need for surgery...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28007064/the-society-of-thoracic-surgeons-congenital-heart-surgery-database-public-reporting-initiative
#12
REVIEW
Jeffrey P Jacobs
Three basic principles provide the rationale for the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database (CHSD) public reporting initiative: (1) Variation in congenital and pediatric cardiac surgical outcomes exist. (2) Patients and their families have the right to know the outcomes of the treatments that they will receive. (3). It is our professional responsibility to share this information with them in a format they can understand. The STS CHSD public reporting initiative facilitates the voluntary transparent public reporting of congenital and pediatric cardiac surgical outcomes using the STS CHSD Mortality Risk Model...
January 2017: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
https://www.readbyqxmd.com/read/28000751/suppression-of-nlrp3-inflammasome-activation-ameliorates-chronic-kidney-disease-induced-cardiac-fibrosis-and-diastolic-dysfunction
#13
Antoinette Bugyei-Twum, Armin Abadeh, Kerri Thai, Yanling Zhang, Melissa Mitchell, Golam Kabir, Kim A Connelly
Cardiac fibrosis is a common finding in patients with chronic kidney disease. Here, we investigate the cardio-renal effects of theracurmin, a novel formulation of the polyphenolic compound curcumin, in a rat model of chronic kidney disease. Briefly, Sprague-Dawley rats were randomized to undergo sham or subtotal nephrectomy (SNx) surgery. At 3 weeks post surgery, SNx animals were further randomized to received theracurmin via once daily oral gavage or vehicle for 5 consecutive weeks. At 8 weeks post surgery, cardiac function was assessed via echocardiography and pressure volume loop analysis, followed by LV and renal tissue collection for analysis...
December 21, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27999040/population-pharmacokinetics-of-cefazolin-before-during-and-after-cardiopulmonary-bypass-to-optimize-dosing-regimens-for-children-undergoing-cardiac-surgery
#14
Pieter A J G De Cock, Hussain Mulla, Sarah Desmet, Filip De Somer, Brett C McWhinney, Jacobus P J Ungerer, Annelies Moerman, Sabrina Commeyne, Johan Vande Walle, Katrien Francois, Johan G C Van Hasselt, Peter De Paepe
OBJECTIVES: The objective of this study was to characterize cefazolin serum pharmacokinetics in children before, during and after cardiopulmonary bypass (CPB), in order to derive an evidence-based dosing regimen. PATIENTS AND METHODS: This study included children who received cefazolin before surgical incision, before cessation of CPB and after surgery. Blood samples of total and unbound cefazolin concentrations were collected before, during and after CPB. The cefazolin concentration-time profiles were analysed using population pharmacokinetic modelling and predictors for interindividual variability in pharmacokinetic parameters were investigated...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27994259/the-relationship-between-intra-operative-transfusions-and-nadir-hematocrit-on-post-operative-outcomes-after-cardiac-surgery
#15
Joshua B Goldberg, Kenneth G Shann, David Fitzgerald, John Fuller, Theron A Paugh, Timothy A Dickinson, Gaetano Paone, Richard L Prager, Donald S Likosky
Uncertainty exists regarding the optimal strategy for the management of anemia in the setting of cardiac surgery. We sought to improve our understanding of the role of intra-operative hematocrit (HCT) and transfusions on peri-operative outcomes following cardiac surgery. A total of 18,886 patients undergoing on-pump cardiac surgery were identified from a multi-institutional registry including surgical and perfusion data. Patients were divided into four groups based on their intra-operative nadir HCT (<21 or ≥21) and whether or not they received intra-operative red blood cell (+RBC or -RBC) transfusions...
December 2016: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/27992675/readmissions-after-adult-congenital-heart-surgery-frequency-and-risk-factors
#16
Yuli Y Kim, Wei He, Thomas E MacGillivray, Oscar J Benavidez
OBJECTIVE: Despite their clinical importance, 30-day readmission after adult congenital heart surgery has been understudied. They sought to determine the frequency of unplanned readmissions after adult congenital heart surgery and to identify any potential associated risk factors. DESIGN: Retrospective cohort study using State Inpatient Databases for Washington, New York, Florida, and California from 2009 to 2011. SETTING: Federal and nonfederal acute care hospitals...
December 19, 2016: Congenital Heart Disease
https://www.readbyqxmd.com/read/27989537/delayed-cardiac-tamponade-a-rare-but-life-threatening-complication-of-catheter-ablation
#17
Elizabeth Yetter, Jared Brazg, Diane Del Valle, Laura Mulvey, Eitan Dickman
Delayed cardiac tamponade (DCT) is a rare and life-threatening complication of catheter ablation performed as a treatment of atrial fibrillation, with few cases described in the medical literature. We present the case of a 57year-old man presenting with DCT 61days following a catheter ablation procedure. To the best of our knowledge, this is the most delayed case of cardiac tamponade (CT) following catheter ablation described in the literature. We also discuss the importance of point of care ultrasound (POCUS) in the diagnosis and treatment of CT...
November 17, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27965964/pulmonary-perfusion-and-ventilation-during-cardiopulmonary-bypass-are-not-associated-with-improved-postoperative-outcomes-after-cardiac-surgery
#18
Yiliam F Rodriguez-Blanco, Angela Gologorsky, Tomas Antonio Salerno, Kaming Lo, Edward Gologorsky
OBJECTIVES: Clinical trials of either pulmonary perfusion or ventilation during cardiopulmonary bypass (CBP) are equivocal. We hypothesized that to achieve significant improvement in outcomes both interventions had to be concurrent. DESIGN: Retrospective case-control study. SETTINGS: Major academic tertiary referral medical center. PARTICIPANTS: Two hundred seventy-four consecutive patients who underwent open heart surgery with CBP 2009-2013...
2016: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/27938898/the-impact-of-a-multidisciplinary-blood-conservation-protocol-on-patient-outcomes-and-cost-after-cardiac-surgery
#19
Niv Ad, Sari D Holmes, Jay Patel, Deborah J Shuman, Paul S Massimiano, Elmer Choi, David Fitzgerald, Linda Halpin, Lisa M Fornaresio
OBJECTIVE: Although associations between transfusion and inferior outcomes have been documented, there is a lack of blood transfusion standardization in cardiac surgery. At the Inova Heart and Vascular Institute, a multidisciplinary, criterion-driven algorithm for transfusion management was implemented. We examined the effect of our blood conservation protocol on transfusion rates and outcomes after cardiac surgery and on stability of transfusion over time. METHODS: Patients undergoing first-time cardiac surgery from 2006 (full year before protocol) were compared with those in 2009 (after protocol) and propensity score matched to improve balance...
November 16, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/27938886/the-society-of-thoracic-surgeons-mitral-valve-repair-replacement-plus-coronary-artery-bypass-grafting-composite-score-a-report-of-the-society-of-thoracic-surgeons-quality-measurement-task-force
#20
J Scott Rankin, Vinay Badhwar, Xia He, Jeffrey P Jacobs, James S Gammie, Anthony P Furnary, Frank L Fazzalari, Jane Han, Sean M O'Brien, David M Shahian
BACKGROUND: The Society of Thoracic Surgeons (STS) Quality Measurement Task Force has developed a composite performance measure for mitral repair/replacement (MVRR) with concomitant coronary artery bypass grafting (CABG). METHODS: Data were acquired from the STS Adult Cardiac Surgery Database for 26,463 patients undergoing MVRR + CABG operations between July 1, 2011, and June 30, 2014. Established STS risk models were applied, along with modifications enabling the inclusion of patients with concomitant closures of atrial septal defects and patent foramen ovale, surgical ablation for atrial fibrillation, and tricuspid valve repair (TVR)...
December 6, 2016: Annals of Thoracic Surgery
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