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https://www.readbyqxmd.com/read/29679768/comparison-of-proaqt-pulsioflex%C3%A2-and-oesophageal-doppler-for-intraoperative-haemodynamic-monitoring-during-intermediate-risk-abdominal-surgery
#1
Grégoire Weil, Cyrus Motamed, Alexandre Eghiaian, Xavier Monnet, Stéphanie Suria
OBJECTIVE: To compare cardiac index (CI) between Proaqt/PulsioFlex® and esophageal Doppler (OD) and the ability of the PulsioFlex® to track CI changes induced by fluid challenge and secondly to assess the impact of the time interval between two auto-calibrations of PulsioFlex® on the accuracy of the measured CI. METHODS: In a single hospital, 49 intermediate-risk oncologic abdominal surgery patients were included in an observational study. We measured the cardiac Index (CI) provided by OD and by the Proaqt/PulsioFlex® before and after internal calibration, which were performed randomly at specific intervals after the initial one (30, 60, 90 and 120min)...
April 18, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29678987/protocol-for-a-phase-iii-non-inferiority-randomised-comparison-of-a-new-fibrinogen-concentrate-versus-cryoprecipitate-for-treating-acquired-hypofibrinogenaemia-in-bleeding-cardiac-surgical-patients-the-fibres-trial
#2
Keyvan Karkouti, Jeannie Callum, Vivek Rao, Nancy Heddle, Michael E Farkouh, Mark A Crowther, Damon C Scales
INTRODUCTION: Coagulopathic bleeding is a serious complication of cardiac surgery to which an important contributor is acquired hypofibrinogenaemia (plasma fibrinogen <1.5-2.0 g/L). The standard intervention for acquired hypofibrinogenaemia is cryoprecipitate, but purified fibrinogen concentrates are also available. There is little comparative data between the two therapies and randomised trials are needed. METHODS AND ANALYSIS: FIBrinogen REplenishment in Surgery (FIBRES) is a multicentre, randomised (1:1), active-control, single-blinded, phase III trial in adult cardiac surgical patients experiencing clinically significant bleeding related to acquired hypofibrinogenaemia...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678977/minimizing-icu-neurological-dysfunction-with-dexmedetomidine-induced-sleep-mindds-protocol-for-a-randomised-double-blind-parallel-arm-placebo-controlled-trial
#3
Kenneth T Shelton, Jason Qu, Federico Bilotta, Emery N Brown, Gaston Cudemus, David A D'Alessandro, Hao Deng, Alan DiBiasio, Jacob A Gitlin, Eunice Y Hahm, Lauren E Hobbs, Timothy T Houle, Reine Ibala, Marco Loggia, Kara J Pavone, Shahzad Shaefi, George Tolis, M Brandon Westover, Oluwaseun Akeju
INTRODUCTION: Delirium, which is prevalent in postcardiac surgical patients, is an acute brain dysfunction characterised by disturbances in attention, awareness and cognition not explained by a pre-existing neurocognitive disorder. The pathophysiology of delirium remains poorly understood. However, basic science and clinical studies suggest that sleep disturbance may be a modifiable risk factor for the development of delirium. Dexmedetomidine is a α-2A adrenergic receptor agonist medication that patterns the activity of various arousal nuclei similar to sleep...
April 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29678896/outcomes-for-patients-with-rheumatic-heart-disease-after-cardiac-surgery-followed-at-rural-district-hospitals-in-rwanda
#4
Emmanuel K Rusingiza, Ziad El-Khatib, Bethany Hedt-Gauthier, Gedeon Ngoga, Symaque Dusabeyezu, Neo Tapela, Cadet Mutumbira, Francis Mutabazi, Emmanuel Harelimana, Joseph Mucumbitsi, Gene F Kwan, Gene Bukhman
BACKGROUND: In sub-Saharan Africa, continued clinical follow-up, after cardiac surgery, is only available at urban referral centres. We implemented a decentralised, integrated care model to provide longitudinal care for patients with advanced rheumatic heart disease (RHD) at district hospitals in rural Rwanda before and after heart surgery. METHODS: We collected data from charts at non-communicable disease (NCD) clinics at three rural district hospitals in Rwanda to describe the outcomes of 54 patients with RHD who received cardiac valve surgery during 2007-2015...
April 20, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29678618/concomitant-surgical-atrial-fibrillation-ablation-is-safe-and-efficacious-in-patients-undergoing-double-valve-replacement-a-cohort-study
#5
Guang Tong, Hao Yu, Xuan Zhou, Ben Zhang, Shenghui Bi, Lin Luo, Tao Yan, Xianyue Wang, Hua Lu, Tao Ma, Xiaowu Wang, Zhongchan Sun, Weida Zhang
BACKGROUND: Current European Society of Cardiology Guidelines recommend concomitant atrial fibrillation (AF) ablation for all symptomatic patients undergoing other cardiac surgeries, but the safety and potential benefits of concomitant atrial fibrillation (AF) ablation at the time of double valve replacement (DVR: aortic and mitral valve replacement) remains unexamined. MATERIALS AND METHODS: We conducted a retrospective review of 238 patients with AF who underwent DVR with or without concomitant surgical ablation (Ablation group, n=113; Non-ablation group, n=125) at a single institute from April 2006 to September 2011...
April 17, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29677083/east-multicenter-trial-on-targeted-temperature-management-for-hanging-induced-cardiac-arrest
#6
Cindy H Hsu, Bryce E Haac, Mack Drake, Andrew C Bernard, Alberto Aiolfi, Kenji Inaba, Holly E Hinson, Chinar Agarwal, Joseph Galante, Emily M Tibbits, Nicholas J Johnson, David Carlbom, Mina F Mirhoseini, Mayur B Patel, Karen R OʼBosky, Christian Chan, Pascal O Udekwu, Megan Farrell, Jeffrey L Wild, Katelyn A Young, Daniel C Cullinane, Deborah J Gojmerac, Alexandra Weissman, Clifton Callaway, Sarah M Perman, Mariana Guerrero, Imoigele P Aisiku, Raghu R Seethala, Ivan N Co, Debbie Y Madhok, Bryan Darger, Dennis Y Kim, Lara Spence, Thomas M Scalea, Deborah M Stein
BACKGROUND: We sought to determine the outcome of suicidal hanging and the impact of targeted temperature management (TTM) on hanging-induced cardiac arrest (CA) through an Eastern Association for the Surgery of Trauma (EAST) multicenter retrospective study. METHODS: We analyzed hanging patient data and TTM variables from January 1992 to December 2015. Cerebral performance category (CPC) score of 1 or 2 was considered good neurologic outcome, while CPC of 3 or 4 was considered poor outcome...
April 19, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29675833/risks-of-restrictive-red-blood-cell-transfusion-strategies-in-patients-with-cardiovascular-disease-cvd-a-meta-analysis
#7
I Cortés-Puch, B M Wiley, J Sun, H G Klein, J Welsh, R L Danner, P Q Eichacker, C Natanson
AIM: To evaluate the risks of restrictive red blood cell transfusion strategies (haemoglobin 7-8 g dL-1 ) in patients with and without known cardiovascular disease (CVD). BACKGROUND: Recent guidelines recommend restrictive strategies for CVD patients hospitalised for non-CVD indications, patients without known CVD and patients hospitalised for CVD corrective procedures. METHODS/MATERIALS: Database searches were conducted through December 2017 for randomised clinical trials that enrolled patients with and without known CVD, hospitalised either for CVD-corrective procedures or non-cardiac indications, comparing effects of liberal with restrictive strategies on major adverse coronary events (MACE) and death...
April 19, 2018: Transfusion Medicine
https://www.readbyqxmd.com/read/29672403/association-of-hospital-network-participation-with-surgical-outcomes-and-medicare-expenditures
#8
Kyle H Sheetz, Andrew M Ryan, Andrew M Ibrahim, Justin B Dimick
OBJECTIVE: The aim of this study was to evaluate whether hospital network participation is associated with improvement in surgical outcomes and spending compared to control hospitals not participating in a network. SUMMARY BACKGROUND DATE: Hospitals face significant financial and organizational pressures to integrate into networks. It remains unclear whether these business arrangements impact clinical quality or healthcare expenditures. METHODS: We conducted a longitudinal, quasi-experimental study of 1,981,095 national Medicare beneficiaries (2007-2014) undergoing general, vascular, cardiac, or orthopedic surgery at a network (n = 1868) or non-network (n = 2734) hospital...
April 18, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29671149/biological-scoring-system-for-early-prediction-of-acute-bowel-ischemia-after-cardiac-surgery-the-palm-score
#9
Elie Zogheib, Cyril Cosse, Charles Sabbagh, Simon Marx, Thierry Caus, Marc Henry, Joseph Nader, Mathurin Fumery, Michael Bernasinski, Patricia Besserve, Faouzi Trojette, Cedric Renard, Pierre Duhaut, Said Kamel, Jean-Marc Regimbeau, Hervé Dupont
BACKGROUND: Bowel ischemia is a life-threatening emergency defined as an inadequate vascular perfusion leading to bowel inflammation resulting from impaired colonic/small bowel blood supply. Main issue for physicians regarding bowel ischemia diagnosis lies in the absence of informative and specific clinical or biological signs leading to delayed management, resulting in a poorer prognosis, especially after cardiac surgery. The aim of the present series was to propose a simple scoring system based on biological data for the diagnosis of bowel ischemia...
April 18, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29671041/oropharyngeal-and-nasopharyngeal-decontamination-with-chlorhexidine-gluconate-in-lung-cancer-surgery-a-randomized-clinical-trial
#10
Xavier Benoit D'Journo, Pierre-Emmanuel Falcoz, Marco Alifano, Jean-Philippe Le Rochais, Thomas D'Annoville, Gilbert Massard, Jean Francois Regnard, Philippe Icard, Charles Marty-Ane, Delphine Trousse, Christophe Doddoli, Bastien Orsini, Sophie Edouard, Matthieu Million, Nathalie Lesavre, Anderson Loundou, Karine Baumstarck, Florence Peyron, Stephane Honoré, Stéphanie Dizier, Aude Charvet, Marc Leone, Didier Raoult, Laurent Papazian, Pascal Alexandre Thomas
PURPOSE: Respiratory complications are the leading causes of morbidity and mortality after lung cancer surgery. We hypothesized that oropharyngeal and nasopharyngeal decontamination with chlorhexidine gluconate (CHG) would be an effective method to reduce these complications as reported in cardiac surgery. METHODS: In this multicenter parallel-group randomized double-blind placebo-controlled trial, we enrolled consecutive adults scheduled for anatomical pulmonary resection for lung cancer...
April 18, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29670747/percutaneous-management-of-ostial-stenosis-of-the-left-internal-mammary-artery-graft
#11
Tanuka Datta, Mohammed Gibreal, Ramesh Mazhari, Allen J Solomon
A 61-year-old man, who had undergone coronary artery bypass surgery 10 years earlier, presented with a non-ST segment elevation myocardial infarction. He was treated with medical therapy and taken to the Cardiac Catheterization Laboratory. A left heart catheterization demonstrated an ostial stenosis in the left internal mammary artery graft, which was felt to be the culprit lesion. This was successfully repaired with a drug eluting stent. This case is presented as an unusual location for a de novo coronary stenosis...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29670189/preoperative-red-cell-distribution-width-and-30-day-mortality-in-older-patients-undergoing-non-cardiac-surgery-a-retrospective-cohort-observational-study
#12
H R Abdullah, Y E Sim, Y T Sim, A L Ang, Y H Chan, T Richards, B C Ong
Increased red cell distribution width (RDW) is associated with poorer outcomes in various patient populations. We investigated the association between preoperative RDW and anaemia on 30-day postoperative mortality among elderly patients undergoing non-cardiac surgery. Medical records of 24,579 patients aged 65 and older who underwent surgery under anaesthesia between 1 January 2012 and 31 October 2016 were retrospectively analysed. Patients who died within 30 days had higher median RDW (15.0%) than those who were alive (13...
April 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29667097/an-elevated-respiratory-quotient-predicts-complications-after-cardiac-surgery-under-extracorporeal-circulation-an-observational-pilot-study
#13
J Piot, A Hébrard, M Durand, J F Payen, P Albaladejo
Following cardiac surgery, hyperlactatemia due to anaerobic metabolism is associated with an increase in both morbidity and mortality. We previously found that an elevated respiratory quotient (RQ) predicts anaerobic metabolism. In the present study we aimed to demonstrate that it is also associated with poor outcome following cardiac surgery. This single institution, prospective, observational study includes all those patients that were consecutively admitted to the intensive care unit (ICU) after cardiac surgery with cardiopulmonary bypass, that had also been monitored using pulmonary artery catheter...
April 17, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29667078/impact-of-different-coarctation-therapies-on-aortic-stiffness-phase-contrast-mri-study
#14
Michal Schäfer, Gareth J Morgan, Max B Mitchell, Michael Ross, Alex J Barker, Kendall S Hunter, Brian Fonseca, Michael DiMaria, Daniel Vargas, D Dunbar Ivy, Neil Wilson, Lorna P Browne
Coarctation of the aorta has been associated with increased thoracic aortic stiffness in adolescents and young adults. However, the effects of different therapeutic strategies on aortic stiffness in a young population is unknown. This study aimed to non-invasively assess aortic stiffness between different repair or intervention strategies in patients with coarctation of the aorta. Forty-nine coarctation patients who underwent either surgery (n = 26), balloon angioplasty (n = 14), or stent implantation (n = 12), and 26 age- and size-matched normotensive healthy controls underwent evaluation of thoracic aortic stiffness and flow hemodynamics via phase-contrast cardiac magnetic resonance...
April 17, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29664117/perioperative-hyperoxia-and-post-operative-cardiac-complications-in-adults-undergoing-non-cardiac-surgery-systematic-review-protocol
#15
REVIEW
C Petersen, J Wetterslev, C S Meyhoff
BACKGROUND: Oxygen therapy is used liberally for all patients undergoing anaesthesia. Recent studies have raised concerns that it may not be without complications when arterial oxygen concentrations reach supranormal concentrations (hyperoxia). Studies of oxygen therapy have raised concerns that the risk of myocardial injury and infarction is elevated in patients with hyperoxia due to vasoconstriction and formation of reactive oxygen species. Due to lack of symptoms or silent ischaemia, post-operative myocardial injury may be missed clinically...
April 17, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29662808/critical-illness-related-corticosteroid-insufficiency-in-patients-with-low-cardiac-output-syndrome-after-cardiac-surgery
#16
You Jung Ok, Ju Yong Lim, Sung-Ho Jung
Background: Low cardiac output syndrome (LCOS) after cardiac surgery usually requires inotropes. In this setting, critical illness-related corticosteroid insufficiency (CIRCI) may develop. We aimed to investigate the clinical features of CIRCI in the presence of LCOS and to assess the efficacy of steroid treatment. Methods: We reviewed 28 patients who underwent a rapid adrenocorticotropic hormone (ACTH) test due to the suspicion of CIRCI between February 2010 and September 2014...
April 2018: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29661388/degree-of-obesity-is-not-associated-with-more-than-one-intubation-attempt-a-large-centre-experience
#17
W Saasouh, K Laffey, A Turan, R Avitsian, A Zura, J You, N M Zimmerman, L Szarpak, D I Sessler, K Ruetzler
BACKGROUND: The role of obesity as a risk factor for difficult intubation remains controversial. We primarily assessed the association between body mass index (BMI) and difficult tracheal intubation. METHODS: We analysed electronic records of more than 67 000 adults having elective non-cardiac surgery requiring tracheal intubation at the Cleveland Clinic between 2011 and 2015. The association between BMI and difficult intubation, defined as more than one intubation attempt, was assessed using multivariable logistic regression adjusting for pre-specified confounders...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661385/different-methods-of-modelling-intraoperative-hypotension-and-their-association-with-postoperative-complications-in-patients-undergoing-non-cardiac-surgery
#18
L M Vernooij, W A van Klei, M Machina, W Pasma, W S Beattie, L M Peelen
BACKGROUND: Associations between intraoperative hypotension (IOH) and postoperative complications have been reported. We examined whether using different methods to model IOH affected the association with postoperative myocardial injury (POMI) and acute kidney injury (AKI). METHODS: This two-centre cohort study included 10 432 patients aged ≥50 yr undergoing non-cardiac surgery. Twelve different methods to statistically model IOH [representing presence, depth, duration, and area under the threshold (AUT)] were applied to examine the association with POMI and AKI using logistic regression analysis...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29659840/what-is-the-optimal-target-for-the-second-arterial-graft-in-patients-undergoing-coronary-bypass-surgery
#19
Dimos Karangelis, Amine Mazine, Apostolos Roubelakis, George Stavridis
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether the anterolateral or the inferior wall served as a better location for the 2nd arterial graft in a 3-system coronary artery bypass grafting procedure. In total, more than 1800 papers were found, of which 6 represented the best evidence to answer the clinical question. All papers demonstrated equivalent early postoperative mortality and morbidity. The 3 largest studies comparing bilateral internal thoracic arteries showed no difference in perioperative mortality and morbidity regardless of whether the 2nd internal thoracic artery was used to graft the left or right system...
April 5, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29658868/serum-levels-of-mir-155-mir-326-and-mir-133b-as-early-diagnostic-biomarkers-for-the-detection-of-human-acute-heart-allograft-rejection-in-comparison-with-serum-cardiac-troponin-t
#20
Aghil Esmaeili-Bandboni, Jamshid Bagheri, Ali Reza Bakhshandeh, Javad Mohammadnejad, Esmaeil Sadroddiny
BACKGROUND: Acute heart allograft rejection occurs as a result of antibody-mediated rejection that presents during the first month after transplantation. Finding a non-invasive biomarker is essential for diagnosis of heart allograft rejection. In this research, we intended to compare expression levels of several microRNAs across cardiac troponin T levels between rejected patients (who died before one month following transplantation), non-rejected patients (who survived for at least one month after transplantation), and non-transplanted patients (CABG surgery patients)...
March 12, 2018: Heart Surgery Forum
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