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https://www.readbyqxmd.com/read/28820031/elimination-of-mycobacterium-chimaera-in-a-heater-cooler-device-used-during-on-pump-cardiothoracic-surgery
#1
Conny Nielsen, Conni L Winther, Philip K Thomsen, Jan J Andreasen
Since 2014, several infections with non-tuberculous mycobacteria (NTM) belonging to the species Mycobacterium ( M.) chimaera have been associated with the use of heater-cooler devices during on-pump cardiothoracic surgery both in European countries and the United States of America. Infections have been detected after surgery, with a delay of a few months and up to five years. Bacterial contamination of heater-cooler devices has also been described without any associated infections. In many centres, it has been a challenging task to eliminate NTM from the heater-cooler devices in order to reduce the risk to patients...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28820026/pilot-validation-of-an-individualised-pharmacokinetic-algorithm-for-protamine-dosing-after-systemic-heparinisation-for-cardiopulmonary-bypass
#2
Lachlan F Miles, Paolo Marchiori, Florian Falter
INTRODUCTION: This manuscript represents a pilot study assessing the feasibility of a single-compartment, individualised, pharmacokinetic algorithm for protamine dosing after cardiopulmonary bypass. METHODS: A pilot cohort study in a specialist NHS cardiothoracic hospital targeting patients undergoing elective cardiac surgery using cardiopulmonary bypass. Patients received protamine doses according to a pharmacokinetic algorithm (n = 30) or using an empirical, fixed-dose model (n = 30)...
September 2017: Perfusion
https://www.readbyqxmd.com/read/28815190/giant-left-atrial-myxoma-masquerading-as-cough-syncope-syndrome
#3
Jennifer N Bowman, Jennifer M Treece, Pradnya Brijmohan Bhattad, Melania Bochis, Kailash Bajaj
Left atrial myxomas are the most common type of benign primary cardiac tumor. Patients can present with generalized symptoms, such as fatigue, symptoms from obstruction of the myxoma, or even embolization of the myxoma causing distal thrombosis. We describe a case with several-month duration of syncopal episodes that occurred after coughing and with exertion. Computed tomography of the chest showed a 6.1 cm by 4.5 cm mass in the left atrium, later evaluated with an echocardiogram. Cardiothoracic surgery removed the mass, and it was determined to be an atrial myxoma...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28807988/high-flow-nasal-cannula-therapy-versus-intermittent-noninvasive-ventilation-in-obese-subjects-after-cardiothoracic-surgery
#4
François Stéphan, Laurence Bérard, Saida Rézaiguia-Delclaux, Priscilla Amaru
BACKGROUND: Obese patients are considered at risk of respiratory failure after cardiothoracic surgery. High-flow nasal cannula has demonstrated its non-inferiority after cardiothoracic surgery compared to noninvasive ventilation (NIV), which is the recommended treatment in obese patients. We hypothesized that NIV was superior to high-flow nasal cannula for preventing or resolving acute respiratory failure after cardiothoracic surgery in this population. METHODS: We performed a post hoc analysis of a randomized, controlled trial...
August 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28806174/left-ventricular-apex-venting-in-high-risk-redo-sternotomy-with-severe-aortic-insufficiency-a-case-report
#5
Brett J Wakefield, Alexander J Leone, Shiva Sale
Redo cardiac surgery in patients with severe aortic insufficiency can present unique challenges to the anesthesiologist. We report a case highlighting the challenge and importance of interdisciplinary planning between cardiothoracic surgeons and anesthesiologists prior to high-risk surgery. Failure to place an endoaortic balloon and percutaneous coronary sinus catheter due to anatomical abnormalities prompted the adoption of an alternate technique involving apical ventricular venting to assist sternal reentry...
August 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28803717/noninvasive-stroke-volume-variation-using-electrical-velocimetry-for-predicting-fluid-responsiveness-in-dogs-undergoing-cardiac-surgery
#6
Kazumasu Sasaki, Tatsushi Mutoh, Tomoko Mutoh, Yasuyuki Taki, Ryuta Kawashima
OBJECTIVE: To evaluate the ability of a noninvasive cardiac output monitoring system with electrical velocimetry (EV) for predicting fluid responsiveness in dogs undergoing cardiac surgery. STUDY DESIGN: Prospective experimental trial. ANIMALS: A total of 30 adult Beagle dogs. METHODS: Stroke volume (SV), stroke volume variation (SVV) and cardiac index were measured using the EV device in sevoflurane-anaesthetized, mechanically ventilated dogs undergoing thoracotomies for experimental creation of right ventricular failure...
January 11, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28795891/experience-using-closed-incision-negative-pressure-wound-therapy-in-sternotomy-patients
#7
B Philip, P McCluskey, J Hinchion
OBJECTIVE: Postoperative delayed wound healing, surgical site infections (SSIs), and other wound complications are associated with increased morbidity and health-care costs. In cardiothoracic surgery, wound complications can have life-threatening consequences. In recent years, negative pressure wound therapy (NPWT) has been applied over closed surgical incisions to help reduce tension and protect from external contamination. We report our initial experiences using a closed incision negative pressure therapy (ciNPT) over clean, closed sternotomy incisions at an Irish tertiary referral centre...
August 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28790151/frcs-first-pass-variance-deanery-and-specialty-contrariety
#8
Chris Brown, Tarig Abdelrahman, John Pollitt, Mark Holt, Wyn G Lewis
BACKGROUND: FRCS exit examination success may be interpreted as a surrogate marker for UK Deanery-related training quality. The aim of this study was to evaluate relative FRCS examination pass rates related to Deanery and Surgical Specialty. METHODS: Joint Committee on Surgical Training-published examination first attempt pass rates were scrutinised for type I higher surgical trainees and outcomes compared related to Deanery and Surgical Specialty. RESULTS: Of 9363 FRCS first attempts, 3974 were successful (42...
August 8, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28781089/what-does-nyerorcoverchallenge-mean-for-men-in-cardiothoracic-surgery
#9
EDITORIAL
Susan C Pitt
No abstract text is available yet for this article.
July 19, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28775110/bilateral-pneumothoraces-following-acupuncture
#10
Palmi Oskarsson, Craig Andrew Walker, Simon Leigh-Smith
A 50-year-old woman was brought to the emergency department with shortness of breath and chest tightness following acupuncture to her upper back for a chronically painful left shoulder. She had symptoms of respiratory distress and chest X-ray revealed bilateral pneumothoraces. Symptoms resolved after insertion of bilateral Seldinger chest drains. She was admitted to the Cardiothoracic Surgery ward, chest drains were removed on the second and third days and the patient was discharged from hospital after 3 days...
August 3, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28762458/removal-of-cardiothoracic-war-related-shrapnel-using-video-assisted-thoracoscopic-surgery
#11
Mohammed Khalifa, Fikri M Abu-Zidan, Navidul Khan, Edward Black
This is the first report in the literature to describe removing war-related cardiothoracic shrapnel using video-assisted thoracoscopic surgery (VATS). War blast caused penetrating thoracic and extremity injuries in 30-year-old man. He was referred to our hospital after stabilization. Magnetic resonance imaging was required to evaluate brachial plexus injury. Large, penetrating shrapnel fragment in the right posterior chest wall, retained shrapnel in apex of the right lung, and another fragment in the pericardium were removed using VATS in staged approach...
July 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28760467/resident-autonomy-in-the-operating-room-expectations-versus-reality
#12
Shari L Meyerson, Joel M Sternbach, Joseph B Zwischenberger, Edward M Bender
BACKGROUND: There is concern about graduating thoracic trainees' independent operative skills due to limited autonomy in training. This study compared faculty and trainee expected levels of autonomy with intraoperative measurements of autonomy for common cardiothoracic operations. METHODS: Participants underwent frame-of-reference training on the 4-point Zwisch scale of operative autonomy (show and tell → active help → passive help → supervision only) and evaluated autonomy in actual cases using the Zwisch Me!! mobile application...
July 28, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28759818/histological-topography-of-the-atrioventricular-node-and-its-extensions-in-relation-to-the-cardiothoracic-surgical-landmarks-in-normal-human-hearts
#13
Arpandeep Randhawa, Tulika Gupta, Anjali Aggarwal, Daisy Sahni, Rana Sandip Singh
BACKGROUND: Atrioventricular (AV) nodal injury which results in cardiac conduction disorders is one of the potential complications of heart valve surgeries and radiofrequency catheter ablations. Understanding the topography of the AV conduction system in relation to the tricuspid and mitral valves will help in reducing these complications. METHODS: A tissue block of 3cmx4cm, which contain the AV node, bundle of His and the AV nodal extensions, was excised at the AV septal junction in 20 apparently normal human hearts...
June 30, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28758560/facing-the-ever-changing-challenges-of-caring-for-cardiothoracic-and-transplant-surgery-patients
#14
Miklos D Kertai, Mark M Twite, Nathaen Weitzel
No abstract text is available yet for this article.
September 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28742701/postoperative-delirium-as-a-target-for-surgical-quality-improvement
#15
Julia R Berian, Lynn Zhou, Marcia M Russell, Melissa A Hornor, Mark E Cohen, Emily Finlayson, Clifford Y Ko, Ronnie A Rosenthal, Thomas N Robinson
OBJECTIVE: To explore hospital-level variation in postoperative delirium using a multi-institutional data source. BACKGROUND: Postoperative delirium is closely related to serious morbidity, disability, and death in older adults. Yet, surgeons and hospitals rarely measure delirium rates, which limits quality improvement efforts. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) Geriatric Surgery Pilot (2014 to 2015) collects geriatric-specific variables, including postoperative delirium using a standardized definition...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28741057/the-role-of-angiography-in-the-congruence-of-cardiovascular-measurements-between-autopsy-and-postmortem-imaging
#16
Renaud Troxler, Costin Minoiu, Paul Vaucher, Katarzyna Michaud, Francesco Doenz, Kewin Ducrot, Silke Grabherr
INTRODUCTION: Postmortem CT angiography is the method of choice for the postmortem imaging investigations of the cardiovascular (CV) system. However, autopsy still remains the gold standard for CV measurement. Nevertheless, there are not any studies on CV measurements on the multi-phase postmortem angiography (MPMCTA) which includes comparisons with autopsy. Therefore, the aim of this study is to compare CV measurements between the native CT scan and the three phases of the MPMCTA to find out which of these modalities correlate the best with autopsy measurements...
July 24, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28728718/cardiothoracic-critical-care
#17
REVIEW
Kevin W Lobdell, Douglas W Haden, Kshitij P Mistry
High-value CCC is rapidly evolving to meet the demands of increased patient acuity and to incorporate advances in technology. The high-performing CCC system and culture should aim to learn quickly and continuously improve. CCC demands a proactive, interactive, precise, an expert team, and continuity.
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28728717/team-based-care-the-changing-face-of-cardiothoracic-surgery
#18
REVIEW
Todd C Crawford, John V Conte, Juan A Sanchez
Cardiothoracic surgical care is a team sport. The increased complexity and sophistication of this field have resulted in the development of highly functioning multidisciplinary and interprofessional teams to optimize clinical outcomes. This article provides an overview of a team-based, patient-centric "systems" approach to the care of cardiothoracic surgery patients.
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28726359/earplugs-during-the-first-night-after-cardiothoracic-surgery-may-improve-a-fast-track-protocol
#19
Johannes Menger, Bernhard Urbanek, Keso Skhirtladze-Dworschak, Viktoria Wolf, Arabella Fischer, Harald Rinösl, Martin Dworschak
BACKGROUND: Sleep deprivation after major surgery is common and associated with worse outcome. Noise is one important reason for sleep fragmentation, which contributes to enhanced morbidity. The purpose of this work was to evaluate the impact of earplugs on patients' sleep quality during their first night after cardiothoracic surgery to eventually improve an existing fast-track concept. METHODS: Sixty-three patients undergoing cardiothoracic surgery eligible for a postoperative fast- track regimen on our cardiothoracic post anaesthesia care unit (C-PACU) were prospectively included...
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28718658/the-effect-of-nurse-to-patient-ratios-on-nurse-sensitive-patient-outcomes-in-acute-specialist-units-a-systematic-review-and-meta-analysis
#20
Andrea Driscoll, Maria J Grant, Diane Carroll, Sally Dalton, Christi Deaton, Ian Jones, Daniela Lehwaldt, Gabrielle McKee, Theresa Munyombwe, Felicity Astin
BACKGROUND: Nurses are pivotal in the provision of high quality care in acute hospitals. However, the optimal dosing of the number of nurses caring for patients remains elusive. In light of this, an updated review of the evidence on the effect of nurse staffing levels on patient outcomes is required. AIM: To undertake a systematic review and meta-analysis examining the association between nurse staffing levels and nurse-sensitive patient outcomes in acute specialist units...
July 1, 2017: European Journal of Cardiovascular Nursing
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