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Renal failure and cardiac surgery

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https://www.readbyqxmd.com/read/28331172/an-anti-coagulation-conundrum-implantation-of-total-artificial-heart-in-a-patient-with-heparin-induced-thrombocytopenia-type-ii
#1
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
#2
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
#3
George J Dugbartey, Maarten C Hardenberg, Wendelinde F Kok, Ate Boerema, Hannah V Carey, James Staples, Robert H Henning, Hjalmar 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 thought to be a key event triggering loss of cellular homeostasis, and potentially cell death...
March 21, 2017: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/28299450/the-prevalence-of-post-thyroidectomy-chronic-asthenia-a-prospective-cohort-study
#4
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
#5
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
https://www.readbyqxmd.com/read/28259602/perioperative-strokes-and-early-outcomes-in-mitral-valve-surgery-a-nationwide-analysis
#6
Reshmi Udesh, Amol Mehta, Thomas G Gleason, Lawrence Wechsler, Parthasarathy D Thirumala
OBJECTIVE: To demonstrate the role of perioperative stroke as an independent risk factor for in-hospital morbidity and mortality after mitral valve surgery and review the trends in the early outcomes of mitral valve surgery over the past decade. DESIGN: Using data from the National Inpatient Sample database for analysis, all patients who underwent isolated mitral valve procedures were identified using International Classification of Diseases-Ninth Revision codes...
December 7, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28258686/ischaemic-preconditioning-for-the-reduction-of-renal-ischaemia-reperfusion-injury
#7
REVIEW
Theo P Menting, Kimberley E Wever, Denise Md Ozdemir-van Brunschot, Daan Ja Van der Vliet, Maroeska M Rovers, Michiel C Warle
BACKGROUND: Ischaemia reperfusion injury can lead to kidney dysfunction or failure. Ischaemic preconditioning is a short period of deprivation of blood supply to particular organs or tissue, followed by a period of reperfusion. It has the potential to protect kidneys from ischaemia reperfusion injury. OBJECTIVES: This review aimed to look at the benefits and harms of local and remote ischaemic preconditioning to reduce ischaemia and reperfusion injury among people with renal ischaemia reperfusion injury...
March 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28249082/are-non-newtonian-effects-important-in-hemodynamic-simulations-of-patients-with-autogenous-fistula
#8
S M Javid Mahmoudzadeh Akherat, Kevin Cassel, Michael Boghosian, Promila Dhar, Mary Hammes
Given the current emphasis on accurate computational fluid dynamics (CFD) modeling of cardiovascular flows, which incorporates realistic blood vessel geometries and cardiac waveforms, it is necessary to revisit the conventional wisdom regarding the influences of non-Newtonian effects. In this study, patient-specific reconstructed 3D geometries, whole blood viscosity data, and venous pulses postdialysis access surgery are used as the basis for the hemodynamic simulations of renal failure patients with native fistula access...
April 1, 2017: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/28241354/effect-of-fibrinogen-concentrate-on-intraoperative-blood-loss-among-patients-with-intraoperative-bleeding-during-high-risk-cardiac-surgery-a-randomized-clinical-trial
#9
RANDOMIZED CONTROLLED TRIAL
Süleyman Bilecen, Joris A H de Groot, Cor J Kalkman, Alexander J Spanjersberg, George J Brandon Bravo Bruinsma, Karel G M Moons, Arno P Nierich
Importance: Fibrinogen concentrate might partly restore coagulation defects and reduce intraoperative bleeding. Objective: To determine whether fibrinogen concentrate infusion dosed to achieve a plasma fibrinogen level of 2.5 g/L in high-risk cardiac surgery patients with intraoperative bleeding reduces intraoperative blood loss. Design, Setting, and Participants: A randomized, placebo-controlled, double-blind clinical trial conducted in Isala Zwolle, the Netherlands (February 2011-January 2015), involving patients undergoing elective, high-risk cardiac surgery (ie, combined coronary artery bypass graft [CABG] surgery and valve repair or replacement surgery, the replacement of multiple valves, aortic root reconstruction, or reconstruction of the ascending aorta or aortic arch) with intraoperative bleeding (blood volume between 60 and 250 mL suctioned from the thoracic cavity in a period of 5 minutes) were randomized to receive either fibrinogen concentrate or placebo...
February 21, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28239994/aortic-stenosis-in-dialysis-patients
#10
REVIEW
Yousif Ahmad, Michael F Bellamy, Christopher S R Baker
Aortic valve stenosis occurs 10-20 years earlier in patients on dialysis compared with the general population. This is likely related to the exposure of the valve to a milieu that predisposes to calcification as well as increased shear stress across the valve. Objective assessment of stenosis severity is largely made using echocardiography though accurate interpretation requires an understanding of the potential pitfalls of the technique and the influence of cardiac output upon the gradient measured across the valve...
February 26, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28237986/relationship-among-mortality-of-patients-with-acute-kidney-injury-after-cardiac-surgery-fluid-balance-and-ultrafiltration-of-renal-replacement-therapy-an-observational-study
#11
Buyun Wu, Jian Sun, Si Liu, Xiangbao Yu, Yamei Zhu, Huijuan Mao, Changying Xing
BACKGROUND/AIMS: The study aimed to investigate the relationship among mortality of patients with cardiac surgery-associated acute kidney injury (CSA-AKI), fluid balance, and ultrafiltration of renal replacement therapy (RRT). METHODS: From January 2009 to October 2015, hospitalized patients with CSA-AKI receiving continuous or prolonged intermittent RRT were screened. The effects of fluid balance and ultrafiltration of RRT on clinical outcome were analyzed. RESULTS: The 30-day mortality of all the 63 patients in the study was 58...
February 25, 2017: Blood Purification
https://www.readbyqxmd.com/read/28225801/perioperative-hemoglobin-area-under-the-curve-is-an-independent-predictor-of-renal-failure-after-cardiac-surgery-results-from-a-spanish-multicenter-retrospective-cohort-study
#12
Paula Duque-Sosa, Diego Martínez-Urbistondo, Gemma Echarri, Raquel Callejas, María Josefa Iribarren, Gregorio Rábago, Pablo Monedero
Perioperative anemia is an important risk factor for cardiac surgery-associated acute kidney injury (CSA-AKI). Nonetheless, the severity of the anemia and the time in the perioperative period in which the hemoglobin level should be considered as a risk factor is conflicting. The present study introduces the concept of perioperative hemoglobin area under the curve (pHb-AUC) as a surrogate marker of the evolution of perioperative hemoglobin concentration. Through a retrospective analysis of prospectively collected data, we assessed this new variable as a risk factor for the development of acute kidney injury after cardiac surgery in 966 adult patients who underwent cardiac surgery with cardiopulmonary bypass, at twenty-three academic hospitals in Spain...
2017: PloS One
https://www.readbyqxmd.com/read/28222690/ngal-expression-during-cardiopulmonary-bypass-does-not-predict-severity-of-postoperative-acute-kidney-injury
#13
Martin G Friedrich, Ioannis Bougioukas, Johanna Kolle, Christian Bireta, Fawad A Jebran, Marius Placzek, Theodor Tirilomis
BACKGROUND: Renal injury is a serious complication after cardiac surgery and therefore, early detection and much more prediction of postoperative kidney injury is desirable. Neutrophil gelatinase-associated lipocalin (NGAL) is a predictive biomarker of acute kidney injury and may increase after cardiopulmonary bypass (CPB). However, time correlation of NGAL expression and severity of renal injury is still unclear. The aim of our study was to investigate CPB-related urine NGAL (uNGAL) secretion in correlation to postoperative renal function...
February 21, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28176949/prophylactic-furosemide-infusion-decreasing-early-major-postoperative-renal-dysfunction-in-on-pump-adult-cardiac-surgery-a-randomized-clinical-trial
#14
Solmaz Fakhari, Fariba Mirzaei Bavil, Eissa Bilehjani, Sona Abolhasani, Moussa Mirinazhad, Bahman Naghipour
INTRODUCTION: Acute renal dysfunction is a common complication of cardiac surgery. Furosemide is used in prevention, or treatment, of acute renal dysfunction. This study was conducted to evaluate the protective effects of intra- and early postoperative furosemide infusion on preventing acute renal dysfunction in elective adult cardiac surgery. METHODS: Eighty-one patients, candidates of elective cardiac surgery, were enrolled in this study in either the furosemide (n=41) or placebo (n=40) group...
2017: Research and Reports in Urology
https://www.readbyqxmd.com/read/28143401/acute-kidney-injury-induces-high-sensitivity-troponin-measurement-changes-after-cardiac-surgery
#15
Amr S Omar, Khaled Mahmoud, Samy Hanoura, Hany Osman, Praveen Sivadasan, Suraj Sudarsanan, Yasser Shouman, Rajvir Singh, Abdulaziz AlKhulaifi
BACKGROUND: The value of cardiac troponin as a risk assessment tool for cardiac disease in the setting of end-stage renal diseases (ESRD) is not equivalent to its value in those with normal renal function. This consideration had not been studied in settings of acute kidney injury (AKI). We aim to explore the diagnostic value of high sensitive troponin T (hsTnT) in the settings of cardiac surgery-induced AKI. METHODS: Single center observational retrospective study...
January 31, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28142133/perioperative-hemodynamic-instability-and-fluid-overload-are-associated-with-increasing-acute-kidney-injury-severity-and-worse-outcome-after-cardiac-surgery
#16
Anja Haase-Fielitz, Michael Haase, Rinaldo Bellomo, Paolo Calzavacca, Anke Spura, Hassina Baraki, Ingo Kutschka, Christian Albert
PURPOSE: The study aimed to investigate patients' characteristics, fluid and hemodynamic management, and outcomes according to the severity of cardiac surgery-associated acute kidney injury (CSA-AKI). METHODS: In a single-center, prospective cohort study, we enrolled 282 adult cardiac surgical patients. In a secondary analysis, we assessed preoperative patients' characteristics, physiological variables, and medication for intra- and postoperative fluid and hemodynamic management and outcomes according to CSA-AKI stages by the Renal risk, Injury, Failure, Loss, End-stage renal disease (RIFLE) classification...
January 31, 2017: Blood Purification
https://www.readbyqxmd.com/read/28132820/comparative-analysis-of-perioperative-outcomes-and-costs-between-laparoscopic-and-open-antireflux-surgery
#17
Francisco Schlottmann, Paula D Strassle, Marco G Patti
BACKGROUND: Laparoscopic antireflux surgery (LARS) has proven to be as effective as open antireflux surgery (OARS), but it is associated with a shorter hospital stay and a faster recover. The aims of this study were to assess the national use of LARS in the US and to compare the perioperative outcomes between laparoscopic and open antireflux procedures in a national cohort. STUDY DESIGN: A retrospective population-based analysis was performed using the National Inpatient Sample for the period 2000 to 2013...
March 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28131774/high-sensitivity-troponin-release-profile-after-cardiac-surgery
#18
Phuong L Markman, John-Paul Tantiongco, Jayme S Bennetts, Robert A Baker
BACKGROUND: Postoperative serum troponin levels and perioperative myocardial infarction (MI) rates correlate with mortality and morbidity following cardiac surgery. The objective of this study was to document the release profile of high sensitivity troponin T (hsTnT) following different cardiac operations. METHODS: Patients undergoing one of five different isolated cardiac surgical procedures (eligible preoperative hsTnT <29ng/L, serum creatinine < 0.2mmol/L) were recruited prospectively...
December 23, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28129899/-predictors-of-prolonged-icu-stay-following-elective-adult-cardiac-surgery-monocentric-retrospective-study-on-5%C3%A2-and-half-years
#19
M Meziane, A Koundi, A Meskine, M Bensghir, A Hatim, R Ahtil, M Ait Houssa, A Boulahya, C Haimeur, M Drissi
AIM: The aim of our study was to identify predictors for prolonged ICU stay following elective adult cardiac surgery under cardiopulmonary bypass. PATIENTS AND METHODS: A retrospective study was conducted during 5 years and a half period. Were included, patients age≥18 years old, underwent elective cardiac surgery under cardiopulmonary bypass. Patients who died within 48hours of surgery were excluded. Prolonged ICU stay was defined as stay in the ICU for 48hours or more...
January 24, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28127473/hemadsorption-with-adult-cytosorb%C3%A2-in-a-low-weight-pediatric-case
#20
Catalin Gabriel Cirstoveanu, Ileana Barascu, Samantha Mc Kenzie Stancu
Cytokine adsorber (CytoSorb) has been used successfully as adjunctive treatment for adult patients with elevated cytokine levels in the setting with severe sepsis and septic shock and to reduce blood myoglobin, unconjugated bilirubin, and conjugated bilirubin. In this article we present the case of a nine-month-old male infant who was admitted to the NICU due to sepsis after cardiac surgery, Fallot tetralogy, and multisystem organ failure (MSOF) including liver failure and renal failure which was successfully treated by a combination of continuous hemodiafiltration (HDF) and hemadsorption with CytoSorb...
2017: Case Reports in Critical Care
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