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Renal failure and cardiac surgery

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https://www.readbyqxmd.com/read/29217234/outcomes-following-three-factor-inactive-prothrombin-complex-concentrate-versus-recombinant-activated-factor-vii-administration-during-cardiac-surgery
#1
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
#2
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/29200691/a-case-report-of-newly-diagnosed-epithelial-ovarian-carcinoma-presenting-with-spontaneous-tumor-lysis-syndrome-and-its-successful-management-with-rasburicase
#3
Deepak Kumar Shukla, Dinesh Gupta, Arun Aggarwal, Deepak Kumar
Tumor Lysis Syndrome (TLS) commonly occurs in hematological malignancies, but it is very rare in patients with a solid tumor. In cases of solid tumors, TLS usually occurs spontaneously or after the initiation of anticancer therapy, and it has a high mortality rate. This syndrome consists of a constellation of laboratory findings such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia known as laboratory TLS. When clinical complications such as seizures, acute renal failure, and cardiac dysrhythmias occur in patients with laboratory TLS, the syndrome is called clinical TLS...
July 2017: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/29184415/reversible-preoperative-renal-dysfunction-does-not-add-to-the-risk-of-postoperative-acute-kidney-injury-after-cardiac-valve-surgery
#4
Jia-Rui Xu, Ya-Min Zhuang, Lan Liu, Bo Shen, Yi-Mei Wang, Zhe Luo, Jie Teng, Chun-Sheng Wang, Xiao-Qiang Ding
Objective: To evaluate the impact of the renal dysfunction (RD) type and change of postoperative cardiac function on the risk of developing acute kidney injury (AKI) in patients who underwent cardiac valve surgery. Method: Reversible renal dysfunction (RRD) was defined as preoperative RD in patients who had not been initially diagnosed with chronic kidney disease (CKD). Cardiac function improvement (CFI) was defined as postoperative left ventricular ejection function - preoperative left ventricular ejection function (ΔEF) >0%, and cardiac function not improved (CFNI) as ΔEF ≤0%...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29174777/cardiac-surgery-outcomes-in-abdominal-solid-organ-transplant-recipients
#5
Takushi Kohmoto, Satoru Osaki, Dixon B Kaufman, Glen Leverson, Nilto DeOliveira, Shahab A Akhter, Susan Ulschmid, Lucian Lozonschi, Entela B Lushaj
BACKGROUND: Cardiovascular disease is a cause of morbidity and mortality in organ transplant recipients. Cardiac surgery after organ transplantation is not uncommon in this population. We evaluated 30-day outcomes and long-term survival of abdominal transplant recipients undergoing cardiac surgery at our institution. METHODS: In all, 138 patients with previous kidney, kidney-pancreas, and liver transplants underwent cardiac surgery from 2000 to 2016. Propensity score (ratio 1:3) matched 115 abdominal transplant with 345 patients undergoing cardiac surgery without a history of abdominal transplant...
November 23, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29158060/meta-analysis-of-the-outcome-after-postcardiotomy-venoarterial-extracorporeal-membrane-oxygenation-in-adult-patients
#6
Fausto Biancari, Andrea Perrotti, Magnus Dalén, Mariapia Guerrieri, Antonio Fiore, Daniel Reichart, Angelo M Dell'Aquila, Giuseppe Gatti, Tero Ala-Kokko, Eeva-Maija Kinnunen, Tuomas Tauriainen, Sidney Chocron, Juhani K E Airaksinen, Vito G Ruggieri, Debora Brascia
OBJECTIVE: This study was planned to pool existing data on outcome and to evaluate the efficacy of postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO) in adult patients. DESIGN: Systematic review of the literature and meta-analysis. SETTING: Multi-institutional study. PARTICIPANTS: Adult patients with acute heart failure immediately after cardiac surgery. INTERVENTIONS: VA-ECMO after cardiac surgery...
September 1, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29154418/measuring-non-polyaminated-lipocalin-2-for-cardiometabolic-risk-assessment
#7
Kangmin Yang, Han-Bing Deng, Andy W C Man, Erfei Song, Jialiang Zhang, Cuiting Luo, Bernard M Y Cheung, Kwok-Yung Yuen, Pia Søndergaard Jensen, Akhmadjon Irmukhamedov, Atlanta G I M Elie, Paul M Vanhoutte, Aimin Xu, Jo G R De Mey, Yu Wang
AIMS: Lipocalin-2 is a pro-inflammatory molecule characterized by a highly diversified pattern of expression and structure-functional relationships. In vivo, this molecule exists as multiple variants due to post-translational modifications and/or protein-protein interactions. Lipocalin-2 is modified by polyamination, which enhances the clearance of this protein from the circulation and prevents its excessive accumulation in tissues. On the other hand, animal studies suggest that non-polyaminated lipocalin-2 (npLcn2) plays a causal role in the pathogenesis of obesity-associated medical complications...
November 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/29152949/effects-of-valproic-acid-on-sympathetic-activity-and-left-ventricularmyocardial-remodelling-in-rats-during-pressure-overload
#8
Yang Liu, Siyu Li, Zhigang Zhang, Zhanjun Lv, Huijie Jiang, Xiao Tan, Fengquan Liu
Background/aim: Pressure overload induces cardiac remodelling and results in heart failure. Enhanced sympathetic outflow participates in the development of cardiac remodelling for the duration of pressure overload as an independent factor. Valproic acid has recently been shown to reduce neuronal injury and have antiinflammatory and antiapoptotic effects as a histone deacetylase inhibitor. We speculate that the drug plays a specific role in alleviating cardiac remodelling by inhibiting sympathetic activity. Materials and methods: Surgery of partial abdominal aortic constriction was performed on male Sprague-Dawley rats...
November 13, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29150842/the-effect-of-6-hydroxyethyl-starch-130-0-4-on-acute-kidney-injury-in-paediatric-cardiac-surgery-a-prospective-randomised-trial
#9
H-W Oh, J-H Lee, H-C Kim, E-H Kim, I-K Song, H-S Kim, J-T Kim
We have evaluated the effect of a colloid solution on acute kidney injury in paediatric cardiac surgery. A total of 195 patients were ramdomly divided into an hydroxyethyl starch group and a control group. In the starch group, 6% hydroxyethyl starch 130/0.4 (Volulyte® ) was used as the primary fluid for volume resuscitation but was limited to 30 ml.kg-1 . In the control group, only crystalloid fluid was used during the peri-operative period. The incidence of acute kidney injury, peri-operative transfusion, clinical outcomes and laboratory data were compared...
November 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29149189/perioperative-body-weight-change-is-associated-with-in-hospital-mortality-in-cardiac-surgical-patients-with-postoperative-acute-kidney-injury
#10
Chih-Chung Shiao, Ya-Ting Huang, Tai-Shuan Lai, Tao-Min Huang, Jian-Jhong Wang, Chun-Te Huang, Pei-Chen Wu, Che-Hsiung Wu, I-Jung Tsai, Li-Jung Tseng, Chih-Hsien Wang, Tzong-Shinn Chu, Kwan-Dun Wu, Vin-Cent Wu
BACKGROUND: Postoperative acute kidney injury (AKI) is common following cardiac surgery (CS). Body weight (BW) may be an amenable variable by representing the summation of the nutritional and the fluid status. However, the predictive role of perioperative BW changes in CS patients with severe postoperative AKI is never explored. This study aimed to evaluate this association. METHODS: This study was conducted using a prospectively collected multicenter cohort, NSARF (National Taiwan University Hospital Study Group on Acute Renal Failure) database...
2017: PloS One
https://www.readbyqxmd.com/read/29135158/-the-role-of-pharmacological-preconditioning-in-renal-ischemic-and-reperfusion-injury
#11
D A Kostina, T G Pokrovskaya, Yu V Olefir, A N Yavorskii, V V Elagin
Renal ischemic and reperfusion injury resulting in acute renal failure is a multidisciplinary problem at the junction of pathophysiology, transplantology, urology, nephrology, cardiac surgery and pharmacology. One of renal protection strategies is using the phenomenon of preconditioning. Preconditioning is one of the ways to adopt a tissue to repeated short-term effects of damaging factors to induce an enhanced tolerance to the long period of hypoxia and/or ischemia. There are multiple cellular and molecular mechanisms of the renal protective effects of preconditioning stimuli, but the key effectors and signaling molecules are ATP-dependent potassium channels, nitric oxide synthase, nitric oxide, and mitochondrial pore...
October 2017: Urologii︠a︡
https://www.readbyqxmd.com/read/29130845/restrictive-or-liberal-red-cell-transfusion-for-cardiac-surgery
#12
C David Mazer, Richard P Whitlock, Dean A Fergusson, Judith Hall, Emilie Belley-Cote, Katherine Connolly, Boris Khanykin, Alexander J Gregory, Étienne de Médicis, Shay McGuinness, Alistair Royse, François M Carrier, Paul J Young, Juan C Villar, Hilary P Grocott, Manfred D Seeberger, Stephen Fremes, François Lellouche, Summer Syed, Kelly Byrne, Sean M Bagshaw, Nian C Hwang, Chirag Mehta, Thomas W Painter, Colin Royse, Subodh Verma, Gregory M T Hare, Ashley Cohen, Kevin E Thorpe, Peter Jüni, Nadine Shehata
BACKGROUND: The effect of a restrictive versus liberal red-cell transfusion strategy on clinical outcomes in patients undergoing cardiac surgery remains unclear. METHODS: In this multicenter, open-label, noninferiority trial, we randomly assigned 5243 adults undergoing cardiac surgery who had a European System for Cardiac Operative Risk Evaluation (EuroSCORE) I of 6 or more (on a scale from 0 to 47, with higher scores indicating a higher risk of death after cardiac surgery) to a restrictive red-cell transfusion threshold (transfuse if hemoglobin level was <7...
November 30, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29120929/risk-factors-for-opioid-induced-respiratory-depression-and-failure-to-rescue-a-review
#13
Kapil Gupta, Arun Prasad, Mahesh Nagappa, Jean Wong, Lusine Abrahamyan, Frances Chung
PURPOSE OF REVIEW: The primary objective of this review is to identify the risk factors for opioid-induced respiratory depression (OIRD) in the postoperative period. RECENT FINDINGS: In the postoperative period, OIRD has often been reported resulting in morbidity and mortality. The risk factors which predispose surgical patients to increased risk of OIRD are not clearly defined. A literature search was performed for adult surgical patients who were prescribed opioids during their hospital stay and any available reports on postoperative respiratory depression/respiratory events...
November 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29104127/incidence-risk-factors-and-prognostic-impact-of-re-exploration-for-bleeding-after-cardiac-surgery-a-retrospective-cohort-study
#14
Lucas B Ohmes, Antonino Di Franco, T Sloane Guy, Christopher Lau, Monica Munjal, William Debois, Zhongyi Li, Karl H Krieger, Alexandra N Schwann, Jeremy R Leonard, Leonard N Girardi, Mario Gaudino
BACKGROUND: Postoperative re-exploration for bleeding (RB) is a frequent complication following cardiac surgery. We aim to assess incidence, risk factors, and prognostic significance of RB in a large cohort of cardiac patients. MATERIALS AND METHODS: We reviewed prospectively collected data for all patients who underwent cardiac surgery at our institution from 2007 to 2015. Logistic regression analysis was used to identify independent predictors of RB and specific outcomes...
November 7, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29103675/heart-valve-surgery-performed-by-trainee-surgeons-meta-analysis-of-clinical-outcomes
#15
REVIEW
Akshat Saxena, Sohaib A Virk, Sebastian R A Bowman, Richmond Jeremy, Paul G Bannon
BACKGROUND: Cardiac surgical units must balance trainee education with the duty to provide optimal patient care. This is particularly challenging with valvular surgery, given the lower volume and increased complexity of these procedures. The present meta-analysis was conducted to assess the impact of trainee operator status on clinical outcomes following valvular surgery. METHODS: Medline, Embase and CENTRAL databases were systematically searched for studies reporting clinical outcomes according to the training status of the primary operator (consultant or trainee)...
October 27, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29071091/the-use-of-the-renalguard-system-in-cardiac-surgery-with-cardiopulmonary-bypass-a-first-in-man-prospective-observational-feasibility-pilot-study
#16
Heyman Luckraz, Ramesh Giri, Benmjamin Wrigley, Anne-Marie Hennessy, Johann Nicholas, Alan Nevill
OBJECTIVES: As proof of concept, this prospective, observational study assessed the feasibility and early clinical outcomes of performing on-pump cardiac surgery with the RenalGuard system. BACKGROUND: Acute kidney injury (AKI) is reported in up to 30% of patients undergoing cardiac surgery and is a recognised independent predictor of both morbidity and mortality. Forced diuresis with the RenalGuard system reduces the incidence of AKI during percutaneous coronary intervention procedures but its use in cardiac surgery has not been explored...
2017: Open Heart
https://www.readbyqxmd.com/read/29069040/predictive-validity-of-the-acs-nsqip-surgical-risk-calculator-in-geriatric-patients-undergoing-lumbar-surgery
#17
Xiao Wang, Yanting Hu, Binjiang Zhao, Yue Su
The risk calculator of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) has been shown to be useful in predicting postoperative complications. In this study, we aimed to evaluate the predictive value of the ACS-NSQIP calculator in geriatric patients undergoing lumbar surgery.A total of 242 geriatric patients who underwent lumbar surgery between January 2014 and December 2016 were included. Preoperative clinical information was retrospectively reviewed and entered into the ACS-NSQIP calculator...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29055710/remote-ischemic-preconditioning-in-high-risk-cardiovascular-surgery-patients-a-randomized-controlled-trial
#18
Nicole S Coverdale, Andrew Hamilton, Dimitri Petsikas, R Scott McClure, Paul Malik, Brian Milne, Tarit Saha, David Zelt, Peter Brown, Darrin M Payne
Remote ischemic preconditioning (RIPC) may reduce biomarkers of ischemic injury after cardiovascular surgery. However, it is unclear whether RIPC has a positive impact on clinical outcomes. We performed a blinded, randomized controlled trial to determine if RIPC resulted in fewer adverse clinical outcomes after cardiac or vascular surgery. The intervention consisted of 3 cycles of RIPC on the upper limb for 5 minutes alternated with 5 minutes of rest. A sham intervention was performed on the control group. Patients were recruited who were undergoing (1) high-risk cardiac or vascular surgery or (2) cardiac or vascular surgery and were at high risk of ischemic complications...
September 11, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29049838/predicting-long-term-survival-after-coronary-artery-bypass-graft-surgery
#19
Md N Karim, Christopher M Reid, Mollah Huq, Samuel L Brilleman, Andrew Cochrane, Lavinia Tran, Baki Billah
OBJECTIVES: To develop a model for predicting long-term survival following coronary artery bypass graft surgery. METHODS: This study included 46 573 patients from the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZCTS) registry, who underwent isolated coronary artery bypass graft surgery between 2001 and 2014. Data were randomly split into development (23 282) and validation (23 291) samples. Cox regression models were fitted separately, using the important preoperative variables, for 4 'time intervals' (31-90 days, 91-365 days, 1-3 years and >3 years), with optimal predictors selected using the bootstrap bagging technique...
October 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29049688/risk-of-de-novo-dialysis-after-elective-cardiac-surgery-according-to-preoperative-renal-dysfunction
#20
Raul A Borracci, Miguel Rubio, Julio Baldi, Jose L Barisani
OBJECTIVES: The aim was to estimate the risk of dialysis postoperative de novo dialysis in patients undergoing elective cardiac surgery, according to varying degrees of pre-existing renal dysfunction, and to compare the outcomes with the expected prevalence of dialysis based on several risk scores. METHODS: A retrospective analysis was performed over a 5-year period (2012-16) from a series of 1332 adult patients who underwent elective cardiac surgery. Patients were divided into 3 estimated creatinine clearance (eCrCl) groups: eCrCl >60 ml/min, eCrCl from 50 ml/min to 60 ml/min and eCrCl ≤49 ml/min...
August 16, 2017: Interactive Cardiovascular and Thoracic Surgery
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