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Post cardiac surgery care

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https://www.readbyqxmd.com/read/30319401/dexamethasone-preconditioning-in-cardiac-procedures-reduces-decreased-antithrombin-activity-and-is-associated-to-beneficial-outcomes-role-of-endothelium
#1
Vicente Muedra, Lucrecia Moreno, Vicente Rodilla, Cristina Arce, Fermi Montó, Águeda Blázquez, Paloma Pérez, Pilar D'Ocón
Introduction: Decreased antithrombin (AT) activity in patients scheduled for cardiovascular surgery under cardiopulmonary bypass (CPB) is related to increased postoperative complications and hospitalization time. Indirect evidence suggests that glucocorticoids mitigate this decreased AT activity. To better understand the beneficial effects of AT we have analyzed: (i) the clinical relevance of acute dexamethasone (DX) administration before cardiac surgery on AT activity, (ii) the modulation by DX of AT expression in human endothelial cells (hECs), (iii) the activity of AT on migration and angiogenesis of hECs, or on angiogenesis of rat aorta...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/30319093/long-term-health-related-quality-of-life-and-survival-after-cardiac-surgery-a-prospective-study
#2
Kari Hanne Gjeilo, Roar Stenseth, Alexander Wahba, Stian Lydersen, Pål Klepstad
OBJECTIVES: Health-related quality of life (HRQOL) is an important end point after cardiac surgery, particularly in patients of older age. However, prospective long-term studies describing the trajectory of HRQOL after cardiac surgery are still scarce. Therefore, the aim was to assess survival, functional status, and trajectory of HRQOL 10 years after cardiac surgery. METHODS: In a prospective population-based study, 534 patients (23% aged 75 years or older, 67% male) were consecutively included before surgery...
June 7, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/30318663/weight-improvement-with-the-use-of-protein-and-energy-enriched-nutritional-formula-in-infants-with-a-prolonged-picu-stay
#3
R D Eveleens, D K Dungen, S C A T Verbruggen, J M Hulst, K F M Joosten
BACKGROUND: Reaching an optimal nutritional intake is challenging in critically ill infants. One possible way to minimise nutritional deficits is the use of protein and energy-enriched (PE)-formulas. We aimed to describe weight achievement and gastrointestinal symptoms in infants admitted to the paediatric intensive care unit (PICU) while receiving PE-formula for a prolonged period. METHODS: Records from infants admitted to a multidisciplinary PICU and using PE-formula were analysed retrospectively...
October 14, 2018: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/30311890/analysis-of-nosocomial-infections-in-post-cardiac-surgery-extracorporeal-membrane-oxygenation-support-therapy
#4
Binfei Li, Geqin Sun, Zhou Cheng, Chuangchuang Mei, Xiaozu Liao, Jianwei Li, Yong Yuan
OBJECTIVES: This study aims to analyze the nosocomial infection factors in post-cardiac surgery extracorporeal membrane oxygenation (ECMO) supportive treatment (pCS-ECMO). METHODS: The clinical data of the pCS-ECMO patients who obtained nosocomial infections (NI) were collected and analyzed retrospectively. Among the 74 pCS-ECMO patients, 30 occurred with NI, accounting for 40.5%; a total of 38 pathogens were isolated, including 22 strains of Gram-negative bacteria (57...
September 17, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/30311073/a-comparison-of-propofol-to-bis-post-operative-intensive-care-sedation-by-means-of-target-controlled-infusion-bayesian-based-and-predictive-control-methods-an-observational-open-label-pilot-study
#5
M Neckebroek, C M Ionescu, K van Amsterdam, T De Smet, P De Baets, J Decruyenaere, R De Keyser, M M R F Struys
PURPOSE: We evaluated the feasibility and robustness of three methods for propofol-to-bispectral index (BIS) post-operative intensive care sedation, a manually-adapted target controlled infusion protocol (HUMAN), a computer-controlled predictive control strategy (EPSAC) and a computer-controlled Bayesian rule-based optimized control strategy (BAYES). METHODS: Thirty-six patients undergoing short lasting sedation following cardiac surgery were included to receive propofol to maintain a BIS between 40 and 60...
October 11, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/30308071/case-conferences-for-infective-endocarditis-a-quality-improvement-initiative
#6
Charlie Tan, Mark S Hansen, Gideon Cohen, Karl Boyle, Alvin Yang, Asgar Rishu, Ruxandra Pinto, Neill K J Adhikari, Nick Daneman
BACKGROUND: A multidisciplinary approach has been recommended for the management of patients with infective endocarditis. We evaluated the impact of multidisciplinary case conferences on morbidity, mortality, and quality of care for these patients. METHODS: We conducted a quasi-experimental study of consecutive patients admitted for infective endocarditis before (2013/10/1-2015/10/12, n = 97) and after (2015/10/13-2017/11/30, n = 80) implementation of case conferences to discuss medical and surgical management...
2018: PloS One
https://www.readbyqxmd.com/read/30288600/respiratory-testing-and-hospital-outcomes-in-asymtomatic-infants-undergoing-heart-surgery
#7
Claudia Delgado-Corcoran, Anne J Blaschke, Zhining Ou, Angela P Presson, Phillip T Burch, Charles G Pribble, Shaji C Menon
Respiratory viral infections in infants undergoing congenital heart surgery lead to prolonged intubation time, hospital (HLOS) and cardiac intensive care unit length of stay (CICU LOS). The objective of this study was to evaluate the prevalence of respiratory viruses using molecular testing in otherwise healthy infants presenting for low complexity heart surgery, and to evaluate the impact of a positive viral screen and study questionnaire on post-surgical HLOS, CICU LOS, intubation time, respiratory complications, and oxygen therapy at home discharge...
October 4, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/30266700/optimizing-patient-access-during-an-emergency-while-using-intraoperative-computed-tomography
#8
Maria A Bustillo, Cynthia A Lien, Patricia Fogarty Mack, David J Kopman, Seyed A Safavynia, Lori Rubin, David Stein, Roger Hartl, Philip E Stieg, R Nick Hernandez, Peter A Goldstein
BACKGROUND: As minimally invasive spine surgery evolves, spine surgeons increasingly rely on advanced intraoperative computed tomography (iCT). iCT provides rapid acquisition of high-resolution images, reduces radiation exposure, improves surgical accuracy, and decreases operative time. However, all iCT systems currently available pose a patient safety risk as their physical space requirements limit patient access in the event of an emergency, particularly when patients are in the prone position...
September 25, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30261372/fixation-to-pelvis-in-pediatric-spine-deformity-an-analysis-of-30-day-outcomes
#9
Azeem Tariq Malik, Jeffery Kim, Elizabeth Yu, Safdar N Khan
OBJECTIVE: To assess the impact of fixation to pelvis on 30-day outcomes following posterior spinal fusions in pediatric spine deformities. METHODS: The 2012-2016 American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) Pediatric database was queried using Current Procedural Terminology codes for patients undergoing posterior spinal fusions (22800, 22802 and 22804). Patients undergoing concurrent anterior fusion/combined fusion and anterior-only fusions were removed from the study...
September 24, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30254739/a-retrospective-study-on-atrial-fibrillation-after-coronary-artery-bypass-grafting-surgery-at-the-national-heart-institute-kuala-lumpur
#10
Ahmad Farouk Musa, Chou Zhao Quan, Low Zheng Xin, Trived Soni, Jeswant Dillon, Yuen Kah Hay, Rusli Bin Nordin
Background: Atrial fibrillation (AF) is common after cardiac surgery and has been associated with poor outcome and increased resource utilization. The main objective of this study is to determine the incidence of POAF in Malaysia and identify the predictors of developing POAF. The secondary outcome of this study would be to investigate the difference in mortality and morbidity rates and the duration of intensive care unit (ICU), high dependency unit (HDU) and hospital stay between the two. Methods: This is a retrospective single-center, cross sectional study conducted at the National Heart Institute, Malaysia...
2018: F1000Research
https://www.readbyqxmd.com/read/30250733/relationship-between-endotoxin-core-staphylococcal-and-varicella-antibody-levels-and-outcome-following-aortic-valve-replacement-surgery-a-prospective-observational-study
#11
Andrew Smith, Sarka Moravcova, Thomas A Treibel, Patricia Colque-Navarro, Roland Mollby, James C Moon, Colin Hamilton-Davies
Background: Morbidity and mortality following cardiac valve surgery is high. Immunity is an important contributor to outcome. This study examines the relationship of staphylococcal and endotoxin antibody levels to outcome following cardiac surgery. Methods: Using enzyme-linked immunosorbent assays (ELISA), we measured pre-operative levels of antibodies to endotoxin core (EndoCAb); 3 common staphylococcal epitopes and varicella on saved serum of 60 adult patients scheduled to undergo elective primary surgical aortic valve replacement (AVR)...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/30250346/bloodless-heart-surgery-for-an-11-kg-infant-of-the-jehovah-s-witness-faith-undergoing-second-repair-for-complete-atrioventricular-canal
#12
Gary Plancher, Bharat Datt, Moui Nguyen, Hamish Munro, William M DeCampli, Kamal Pourmoghadam
Bloodless pediatric cardiac surgery is the intent of most surgical centers especially in the Jehovah's Witness population where it is a desire not to administer blood products because of religious belief. It is a tremendous feat, considering that most pediatric cardiovascular prime volumes are more than 20% of the patient's estimated blood volume (EBV). We report on our bloodless strategy for a 2-year old Jehovah's Witness with trisomy 21 and complete atrioventricular canal repair, who underwent atrial septal defect and ventricular septal defect patch closure, pulmonary artery debanding, and pulmonary arterioplasty...
September 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/30249533/promising-utilization-areas-of-therapeutic-plasmapheresis-in-cardiovascular-surgery-practice
#13
Mustafa Serkan Durdu, Mehmet Cakici, Fatih Gumus, Gunseli Cubukcuoglu Deniz, Sinem Civriz Bozdag, Evren Ozcinar, Nur Dikmen Yaman, Osman Ilhan, Kemalettin Ucanok
OBJECTIVE: Apheresis is performed for treatment of numerous diseases by removing auto-antibodies, antigen-antibody complexes, allo-antibodies, paraproteins, non-Ig proteins, toxins, exogenous poisons. In current study, we present our experience of using therapeutic plasma exchange (TPE) in patients with different types of clinical scenarios. METHODS: Between January 2013 and May 2016, we retrospectively presented the results of 64 patients in whom postoperative TPE was performed in ICU setting after cardiac surgery...
September 18, 2018: Transfusion and Apheresis Science
https://www.readbyqxmd.com/read/30249405/no-difference-in-total-episode-of-care-cost-between-staged-and-simultaneous-bilateral-total-joint-arthroplasty
#14
Jessica L H Phillips, Alexander J Rondon, Zylyftar Gorica, Yale A Fillingham, Matthew S Austin, P Maxwell Courtney
BACKGROUND: Due to concerns about higher complication rates, surgeons debate whether to perform simultaneous bilateral total joint arthroplasty (BTJA), particularly in the higher-risk Medicare population. Advances in pain management and rehabilitation protocols have called into question older studies that found an overall cost benefit for simultaneous procedures. The purpose of this study was to compare 90-day episode-of-care costs between staged and simultaneous BTJA among Medicare beneficiaries...
September 1, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/30217621/coronary-artery-bypass-graft-surgery-complications-a-review-for-emergency-clinicians
#15
REVIEW
Tim Montrief, Alex Koyfman, Brit Long
INTRODUCTION: Coronary artery bypass graft (CABG) surgery remains a high-risk procedure, and many patients require emergency department (ED) management for complications after surgery. OBJECTIVE: This narrative review provides an evidence-based summary of the current data for the emergency medicine evaluation and management of post-CABG surgery complications. DISCUSSION: While there has been a recent decline in all cardiac revascularization procedures, there remains over 200,000 CABG surgeries performed in the United States annually, with up to 14% of these patients presenting to the ED within 30 days of discharge with post-operative complications...
September 8, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30192561/activity-based-protein-profiling-of-intraoperative-serine-hydrolase-activities-during-cardiac-surgery
#16
Mario Navarrete, Julie Ho, Ravi C Dwivedi, Nora Choi, Peyman Ezzati, Victor Spicer, Rakesh C Arora, Claudio Rigatto, John A Wilkins
The processes involved in the initiation of acute kidney injury (AKI) following cardiopulmonary bypass (CPB) are thought to occur during the intraoperative period. Such a rapid development might indicate that some of the inductive events are not dependent on de novo protein synthesis, raising the possibility that changes in activities of pre-existing enzymes could contribute to the development of AKI. Activity-based protein profiling (ABPP) was used to compare the serine hydrolase enzyme activities present in the urines of CPB patients who subsequently developed AKI versus those who did not (non-AKI) during the intra- and immediate postoperative periods...
October 5, 2018: Journal of Proteome Research
https://www.readbyqxmd.com/read/30184204/sustainability-of-clinical-pathway-guided-care-in-cardiac-surgery-icu-patients-9-years-experience-in-over-7500-patients
#17
B M van der Kolk, M van den Boogaard, J G van der Hoeven, L Noyez, P Pickkers
Objective: To determine trends over time regarding inclusion of post-operative cardiac surgery intensive care unit (ICU) patients in a clinical pathway (CP), and the association with clinical outcome. Design: Retrospective cohort study. Setting: ICU of an academic hospital. Participants: All cardiac surgery patients operated between 2007 and 2015. Measures and Results: A total of 7553 patients were operated...
September 1, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/30183701/red-cell-distribution-width-at-hospital-discharge-and-out-of-hospital-outcomes-in-critically-ill-non-cardiac-vascular-surgery-patients
#18
Gerdine C I von Meijenfeldt, Maarten J van der Laan, Clark J A M Zeebregts, Kenneth B Christopher
OBJECTIVE: Red cell distribution width (RDW) is associated with mortality and bloodstream infection risk in the critically ill. In vascular surgery patients surviving critical care it is not known if RDW can predict subsequent risk of all-cause mortality following hospital discharge. We hypothesized that an increase in RDW at hospital discharge in vascular surgery patients who received critical care would be associated with increased mortality following hospital discharge. DESIGN, SETTING, AND PARTICIPANTS: We performed a two-center observational cohort study of critically ill non-cardiac vascular surgery patients surviving admission 18 years or older treated between November, 1997, and December 2012 in Boston, Massachusetts...
2018: PloS One
https://www.readbyqxmd.com/read/30172857/long-term-survival-following-arterial-vs-atrial-switch-in-d-transposition-of-the-great-arteries
#19
Alex Kiener, Michael Kelleman, Courtney McCracken, Lazaros Kochilas, James D St Louis, Matthew E Oster
BACKGROUND: The arterial switch operation (ASO) became the procedure of choice for dextro-transposition of the great arteries (d-TGA) almost 30 years ago, but the long-term results of this operation are unknown. We aimed to compare the long-term transplant-free survival of patients with d-TGA who underwent ASO vs. atrial switch in the Pediatric Cardiac Care Consortium (PCCC). METHODS: We performed a retrospective cohort study of d-TGA patients undergoing ASO or atrial switch in the US between 1982 and 1991...
August 30, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/30170649/applicability-of-the-cleveland-clinic-scoring-system-for-the-risk-prediction-of-acute-kidney-injury-after-cardiac-surgery-in-a-south-asian-cohort
#20
Shobhana Nayak Rao, Pradeep Shenoy M, Mundayat Gopalakrishnan, Amith Kiran B
BACKGROUND: Acute kidney injury (AKI) after cardiac surgery is a frequent post-operative complication associated with an increased risk of mortality, morbidity and hospital costs. Preoperative risk scores such as the Cleveland Clinic Scoring Tool (CCST) have been validated in Western population group to identify patients at higher risk of AKI and may facilitate preventive strategies. However, the scoring tool has not been validated systematically in a South Asian cohort. We aimed to evaluate the applicability of the CCST in prediction of AKI after open cardiac surgery in a South-Indian tertiary care center...
July 2018: Indian Heart Journal
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