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Renal failure and cardiac surgery

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https://www.readbyqxmd.com/read/29045740/adding-vancomycin-to-perioperative-prophylaxis-decreases-deep-sternal-wound-infections-in-high-risk-cardiac-surgery-patients
#1
Sylvia Reineke, Thierry P Carrel, Verena Eigenmann, Brigitta Gahl, Urs Fuehrer, Christian Seidl, David Reineke, Eva Roost, Magi Bächli, Jonas Marschall, Lars Englberger
OBJECTIVES: Perioperative prophylaxis with cephalosporins reduces sternal wound infections (SWIs) after cardiac surgery. However, more than 50% of coagulase-negative staphylococci, an important pathogen, are cephalosporin resistant. The aim of this study was to determine the impact of adjunctive vancomycin on SWIs in high-risk patients. METHODS: We conducted a pre- and postintervention study in an academic hospital. Preintervention (2010-2011), all patients received prophylaxis with 1...
October 16, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29028633/acute-kidney-injury-in-congenital-heart-disease
#2
Katja M Gist, David M Kwiatkowski, David S Cooper
PURPOSE OF REVIEW: Acute kidney injury (AKI) is associated with significant morbidity and mortality in patients with congenital heart disease undergoing cardiac surgery or in pediatric patients with congestive heart failure. RECENT FINDINGS: This review describes the definition and various manifestations of AKI, the impact of biomarkers on the diagnosis of AKI, the importance of fluid overload as a consequence of AKI and its long-term impact. SUMMARY: There are novel biomarkers for AKI detection that should facilitate early recognition and intervention to prevent or attenuate the effects of AKI and fluid overload...
October 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28994685/rhabdomyolysis-and-compartment-syndrome-in-a-bodybuilder-undergoing-minimally-invasive-cardiac-surgery
#3
Sebastian John Baxter, Madhusudan Rao Puchakayala, Vinayak N Bapat
Rhabdomyolysis is the result of skeletal muscle tissue injury and is characterized by elevated creatine kinase levels, muscle pain, and myoglobinuria. It is caused by crush injuries, hyperthermia, drugs, toxins, and abnormal metabolic states. This is often difficult to diagnose perioperatively and can result in renal failure and compartment syndrome if not promptly treated. We report a rare case of inadvertent rhabdomyolysis and compartment syndrome in a bodybuilder undergoing minimally invasive cardiac surgery...
October 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28977259/reintubation-of-patients-submitted-to-cardiac-surgery-a-retrospective-analysis
#4
Cíntia Yukie Shoji, Luciana Castilho de Figuereido, Eveline Maria Calixtre, Cristiane Delgado Alves Rodrigues, Antonio Luis Eiras Falcão, Pedro Paulo Martins, Ana Paula Ragonete Dos Anjos, Desanka Dragosavac
OBJECTIVES: To analyze patients after cardiac surgery that needed endotracheal reintubation and identify factors associated with death and its relation with the severity scores. METHODS: Retrospective analysis of information of 1,640 patients in the postoperative period of cardiac surgery between 2007 and 2015. RESULTS: The reintubation rate was 7.26%. Of those who were reintubated, 36 (30.3%) underwent coronary artery bypass surgery, 27 (22...
April 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28973289/early-postoperative-complications-for-elderly-patients-undergoing-single-level-decompression-for-lumbar-disc-herniation-ligamentous-hypertrophy-or-neuroforaminal-stenosis
#5
Arpan V Prabhu, Bryan A Lieber, Jenson K Henry, Nitin Agarwal, Monir Tabbosha, David O Okonkwo
BACKGROUND: Lumbar decompression for disc herniation is frequently performed on elderly patients, and this trend will continue as the population ages. Clinical reports on the complications of lumbar discectomy show good results and cost effectiveness in young or middle-aged patients. OBJECTIVE: To assess and compare the morbidity of single-level lumbar disc surgery for radicular pain in a cohort of patients greater than 80 yr of age to that of a middle-aged cohort...
July 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28967720/current-multivariate-risk-scores-in-patients-undergoing-non-cardiac-surgery
#6
Gian Francesco Mureddu
Several indexes to predict perioperative cardiovascular risk have been proposed overtime. The most widely used is the Revised Cardiac Risk Index (RCRI) developed by Lee since 1999. It predicts major cardiac outcomes from five independent clinical determinants: history of ischemic heart disease, history of cardiovascular disease, heart failure, insulin-dependent diabetes mellitus, and chronic renal failure (i.e. serum creatinine >2 mg/dl). In external validation studies, the RCRI showed high negative predictive value in all groups of age, indicating that it may be used to identify people at low risk for perioperative adverse cardiovascular events in noncardiac surgery...
July 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28965456/adolescent-idiopathic-scoliosis-risk-factors-for-complications-and-the-effect-of-hospital-volume-on-outcomes
#7
Richard P Menger, Piyush Kalakoti, Andrew J Pugely, Anil Nanda, Anthony Sin
OBJECTIVE Adolescent idiopathic scoliosis (AIS) is the most common form of scoliosis. Limited literature exists defining risk factors associated with outcomes during initial hospitalization in these patients. In this study, the authors investigated patient demographics, clinical and hospital characteristics impacting short-term outcomes, and costs in adolescent patients undergoing surgical deformity correction for idiopathic scoliosis. Additionally, the authors elucidate the impact of hospital surgical volume on outcomes for these patients...
October 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28951984/remote-ischemic-preconditioning-protects-human-neural-stem-cells-from-oxidative-stress
#8
Ayako Motomura, Mikiko Shimizu, Akira Kato, Kazuya Motomura, Akane Yamamichi, Hiroko Koyama, Fumiharu Ohka, Tomohide Nishikawa, Yusuke Nishimura, Masahito Hara, Tetsuya Fukuda, Yasuhiko Bando, Toshihide Nishimura, Toshihiko Wakabayashi, Atsushi Natsume
In previous clinical trials, we showed that remote ischemic preconditioning (rIPC) reduced myocardial damage in children undergoing treatment for congenital heart defects and postoperative renal failure in patients undergoing abdominal aortic aneurysm surgery. In rabbit experiments, pre-treatment with plasma and plasma dialysate (obtained using 15-kDa cut-off dialysis membrane) from donor rabbits subjected to rIPC similarly protected against cardiac infarction. However, the protective substances containing in rIPC plasma have been unknown...
September 26, 2017: Apoptosis: An International Journal on Programmed Cell Death
https://www.readbyqxmd.com/read/28930049/experience-with-the-syncardia-total-artificial-heart-in-a-canadian-centre
#9
Anthony Nguyen, Michel Pellerin, Louis P Perrault, Michel White, Anique Ducharme, Normand Racine, Michel Carrier
BACKGROUND: The SynCardia total artificial heart (TAH) provides complete circulatory support by replacing both native ventricles. Accepted indications include bridge to transplantation and destination therapy. We review our experience with TAH implantation during a period when axial flow pump became available. METHODS: We retrospectively analyzed the demographics, clinical characteristics and survival of all patients receiving the TAH. RESULTS: From September 2004 to November 2016, 13 patients (12 men, mean age 45 ± 13 yr) received the TAH for refractory cardiogenic shock secondary to idiopathic (56%) or ischemic (17%) cardiomyopathy and to other various causes (33%)...
October 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28889829/neutrophil-gelatinase-associated-lipocalin-reflects-inflammation-and-is-not-a-reliable-renal-biomarker-in-neonates-and-infants-after-cardiopulmonary-bypass-a-prospective-case-control-study
#10
Karl Reiter, Gunter Balling, Vittorio Bonelli, Jelena Pabst von Ohain, Siegmund Lorenz Braun, Peter Ewert, Bettina Ruf
Introduction Acute kidney injury is a frequent complication after cardiac surgery with cardiopulmonary bypass in infants. Neutrophil gelatinase-associated lipocalin has been suggested to be a promising early biomarker of impending acute kidney injury. On the other hand, neutrophil gelatinase-associated lipocalin has been shown to be elevated in systemic inflammatory diseases without renal impairment. In this secondary analysis of data from our previous study on acute kidney injury after infant cardiac surgery, our hypothesis was that neutrophil gelatinase-associated lipocalin may be associated with surgery-related inflammation...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28883853/cardiac-surgery-related-cardio-renal-syndrome-assessed-by-conventional-and-novel-biomarkers-under-or-overestimated-diagnosis
#11
Jowita Biernawska, Joanna Bober, Katarzyna Kotfis, Anna Bogacka, Edyta Barnik, Maciej Żukowski
INTRODUCTION: Serum creatinine is a 'gold standard' criterion of recognizing and staging of acute kidney injury (AKI) despite it being a suboptimal, delayed indicator. The interpretation of increased values of biomarkers imposes great difficulty regarding cardiac surgery procedures performed with cardiopulmonary bypass and may lead to under- or overestimated diagnosis. The aim of this study was to evaluate the clinical utility of the sole serum creatinine or urine neutrophil gelatinase-associated lipocalin (NGAL) concentration used for identification of patients with AKI after cardiac surgery...
August 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28874169/transfemoral-versus-transapical-approach-for-transcatheter-aortic-valve-implantation-hospital-outcome-and-risk-factor-analysis
#12
Enrico Ferrari, Eric Eeckhout, Sanjiv Keller, Olivier Muller, Piergiorgio Tozzi, Denis Berdajs, Ludwig Karl von Segesser
BACKGROUND: Transcatheter aortic valve implantation is indicated in high-risk patients with aortic stenosis. We compared the clinical outcome of 180 consecutive patients who underwent transapical (TA) and transfemoral (TF) procedures in a single centre. METHODS: Ninety consecutive TA (TA-group) and 90 consecutive TF (TF-group) were performed from 2009 to 2014. Clinical variables were prospectively collected and retrospectively analysed for hospital outcomes and to identify risk factors for hospital mortality, vascular complications and stroke...
September 6, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28868314/cause-of-death-following-surgery-for-acute-type-a-dissection-evidence-from-the-canadian-thoracic-aortic-collaborative
#13
R Scott McClure, Maral Ouzounian, Munir Boodhwani, Ismail El-Hamamsy, Michael W A Chu, Zlatko Pozeg, Francois Dagenais, Khokan C Sikdar, Jehangir J Appoo
BACKGROUND: Surgery confers the best chance of survival following acute Type A dissection (ATAD), yet perioperative mortality remains high. Although perioperative risk factors for mortality have been described, information on the actual causes of death is sparse. In this study, we aimed to characterize the inciting events causing death during surgical repair of ATAD. METHODS: Nine centers participated in the study. We included all patients who died following surgical repair for ATAD between January 2007 and December 2013...
April 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28864160/incidence-and-outcomes-of-heparin-induced-thrombocytopenia-in-patients-undergoing-vascular-surgery
#14
Rabail Chaudhry, Robert Wegner, John F Zaki, Greesha Pednekar, Alex Tse, Naveen Kukreja, Navneet Grewal, George W Williams
OBJECTIVE: The National Inpatient Sample (NIS) from years 2010 through 2012 was utilized to determine the incidence, predictive risk factors, and outcomes of heparin-induced thrombocytopenia (HIT) in patients undergoing vascular surgery. DESIGN: Retrospective population-based study. SETTING: Data from the National Inpatient Sample (NIS) (2011 through 2013) using specific International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure codes corresponding with vascular surgery...
October 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28858859/independent-risk-factors-and-2-year-outcomes-of-acute-kidney-injury-after-surgery-for-congenital-heart-disease
#15
Daishi Hirano, Akira Ito, Akifumi Yamada, Daisuke Kakegawa, Saori Miwa, Chisato Umeda, Kosuke Chiba, Yoichi Takemasa, Ai Tokunaga, Hiroyuki Ida
BACKGROUND: Data are limited regarding risk factors for acute kidney injury (AKI) following cardiac surgery in children with congenital heart disease (CHD). This observational study was performed to examine temporal trends in AKI incidence according to the Pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease (pRIFLE) criteria, identify independent risk factors for AKI after cardiac surgery, and examine associations between AKI and long-term mortality. METHODS: We retrospectively evaluated 418 patients (259 males, 159 females; median age, 5 months) who underwent cardiac surgery for CHD between April 2007 and August 2013...
2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28856354/severity-weighting-of-postoperative-adverse-events-in-orthopedic-surgery
#16
Daniel D Bohl, Junyoung Ahn, Adam M Lukasiewicz, Andre M Samuel, Matthew L Webb, Bryce A Basques, Nicholas S Golinvaux, Kern Singh, Jonathan N Grauer
Studies of adverse events (AEs) after orthopedic surgery commonly use composite AE outcomes. An example of such an outcome is any AE. These types of outcomes treat AEs with different clinical significance (eg, death, urinary tract infection) similarly. We conducted a study to address this shortcoming in research methodology by creating a single severity-weighted outcome that can be used to characterize the overall severity of a given patient's postoperative course. All orthopedic faculty members at 2 academic institutions were invited to complete a severity-weighting exercise in which AEs were assigned a percentage severity of death...
July 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28833518/post-sternotomy-mediastinitis-in-the-modern-era
#17
Siew S C Goh
BACKGROUND: Post-sternotomy mediastinitis is associated with significant mortality and morbidity. Despite surgical advances in cardiac surgery and improvements in perioperative care, mediastinitis remains a devastating post-operative complication. This study provides a comprehension review of post-sternotomy mediastinitis in the modern era, and discusses the incidence, risk factors, microbiology, prevention, and management of this complication. METHODS: This review was based on a PubMed/MEDLINE literature search up until 9th March 2017 for publications relevant to mediastinitis post-cardiac surgery...
August 22, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28828765/fast-track-extubation-in-adult-patients-on-pump-open-heart-surgery-at-a-tertiary-care-hospital
#18
Mohammad Irfan Akhtar, Hasanat Sharif, Mohammad Hamid, Khalid Samad, Fazal Hameed Khan
Background: Fast-track cardiac surgery programs have been established as the standard of cardiac surgical care. Studies have shown that early extubation in elective cardiac surgery patients, including coronary and non-coronary open-heart surgery patients does not increase perioperative morbidity and mortality. The objective of this observational study was to determine the success and failure profile of fast track extubation (FTE) practice in adult open-heart surgical patients. Methods: The study was conducted at cardiac operating room and Cardiac Intensive Care Unit (CICU) of a tertiary care hospital for a period of nine months, i...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28789610/management-of-refractory-bleeding-post-cardiopulmonary-bypass-in-an-acute-heparin-induced-thrombocytopenia-type-ii-renal-failure-patient-who-underwent-urgent-cardiac-surgery-with-bivalirudin-angiox-%C3%A2-anticoagulation
#19
Kimberly Hassen, Maria R Maccaroni, Haytham Sabry, Smitangshu Mukherjee, Shankari Serumadar, Inderpaul Birdi
Acute heparin-induced thrombocytopenia (HIT) patients present a myriad of anticoagulation management challenges, in clinical settings where unfractionated heparin (UFH) is the traditional drug of choice. UFH use in cardiac surgery is a known entity that has been subject to rigorous research. Research has, thus, led to its unparalleled use and the development of well-established protocols for cardiac surgery. In comparison to UFH, bivalirudin use for acute HIT patients requiring urgent cardiac surgery with cardiopulmonary bypass (CPB) is still in its infancy...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28782157/initial-clinical-experiences-with-novel-diagonal-ecls-system-in-pediatric-cardiac-patients
#20
Yildiz Okan, Haydin Sertac, Ozturk Erkut, Kasar Taner, Onan I Selen, Altin H Firat, Cine Nihat, Ayyildiz Pelin, Erkan Halime, Guzeltas Alper
Extracorporeal life support (ECLS) provides mechanical support following cardiac surgery when respiratory or cardiac failure occurs. The aim of this study was to analyze the safety and feasibility of the Medos Deltastream diagonal pump (DP3) ECLS system in pediatric cardiac patients. We described the technical considerations and risk factors related to the survival outcomes in 102 pediatric cardiac patients who received ECLS support between March 2011 and April 2016. We switched from the DP2 system, which was used for the initial 25 patients, to the DP3 system after November 2012...
August 2017: Artificial Organs
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