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https://www.readbyqxmd.com/read/28926643/skin-perfusion-pressure-as-an-indicator-of-tissue-perfusion-in-valvular-heart-surgery-preliminary-results-from-a-prospective-observational-study
#1
Young Song, Sarah Soh, Jae-Kwang Shim, Kyoung-Un Park, Young-Lan Kwak
Hemodynamic management aims to provide adequate tissue perfusion, which is often altered during cardiac surgery with cardiopulmonary bypass (CPB). We evaluated whether skin perfusion pressure (SPP) can be used for monitoring of adequacy of tissue perfusion in patients undergoing valvular heart surgery. Seventy-two patients undergoing valve replacement were enrolled. SPP and serum lactate level were assessed after anaesthesia induction (baseline), during CPB, after CPB-off, end of surgery, arrival at intensive care unit, and postoperative 6 h...
2017: PloS One
https://www.readbyqxmd.com/read/28925783/laparoscopic-assisted-resection-for-advanced-colorectal-cancer-in-solid-organ-transplant-recipients
#2
Ze-Nan Xia, Rui Hou, Wei Zhu, Ru Yao, Zhao Lu, Hui-Zhong Qiu, Guo-Le Lin
AIM: To evaluate the feasibility, short- and long-term outcomes, and safety of laparoscopic resection for advanced colorectal cancer (CRC) in solid organ transplant recipients. METHODS: Between September 2001 and April 2016, five patients who underwent laparoscopic-assisted resection for CRC after solid organ transplantation were included in this study. Their clinical data were retrospectively analyzed with regard to patient demographics, immunosuppressive therapy, tumor characteristics, surgical outcomes, and follow-up data...
September 19, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28889833/acute-kidney-injury-following-first-stage-palliation-in-hypoplastic-left-heart-syndrome-hybrid-versus-norwood-palliation
#3
Richard U Garcia, Girija Natarajan, Henry L Walters, Ralph E Delius, Sanjeev Aggarwal
OBJECTIVE: The aim of this study was to evaluate the prevalence of acute kidney injury after first-stage surgical palliation in patients with a single ventricle and to explore associated risk factors and outcomes. Design and patients This single-centre retrospective study included neonates who underwent either Norwood or Hybrid procedure from 2008 to 2015 for a single ventricle. Postoperative acute kidney injury was defined using the paediatric risk, injury, failure, loss, end-stage renal disease (pRIFLE), criteria within 72 hours of the procedure...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28882917/effects-of-cerebral-near-infrared-spectroscopy-on-the-outcome-of-patients-undergoing-cardiac-surgery-a-systematic-review-of-randomised-trials
#4
Giuseppe Filiberto Serraino, Gavin J Murphy
OBJECTIVES: Goal-directed optimisation of cerebral oxygenation using near-infrared spectroscopy (NIRS) during cardiopulmonary bypass is widely used. We tested the hypotheses that the use of NIRS cerebral oximetry results in reductions in cerebral injury (neurocognitive function, serum biomarkers), injury to other organs including the heart and brain, transfusion rates, mortality and resource use. DESIGN: Systematic review and meta-analysis. SETTING: Tertiary cardiac surgery centres in North America, Europe and Asia...
September 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28880966/the-prolyl-4-hydroxylase-inhibitor-gsk360a-decreases-post-stroke-brain-injury-and-sensory-motor-and-cognitive-behavioral-deficits
#5
Jin Zhou, Jie Li, Daniel M Rosenbaum, Jian Zhuang, Carrie Poon, Pu Qin, Katrina Rivera, John Lepore, Robert N Willette, Erding Hu, Frank C Barone
There is interest in pharmacologic preconditioning for end-organ protection by targeting the HIF system. This can be accomplished by inhibition of prolyl 4-hydroxylase (PHD). GSK360A is an orally active PHD inhibitor that has been previously shown to protect the failing heart. We hypothesized that PHD inhibition can also protect the brain from injuries and resulting behavioral deficits that can occur as a result of surgery. Thus, our goal was to investigate the effect of pre-stroke surgery brain protection using a verified GSK360A PHD inhibition paradigm on post-stroke surgery outcomes...
2017: PloS One
https://www.readbyqxmd.com/read/28878768/natural-igm-and-tlr-agonists-switch-murine-splenic-pan-b-to-regulatory-cells-that-suppress-ischemia-induced-innate-inflammation-via-regulating-nkt-1-cells
#6
Peter I Lobo, Kailo H Schlegel, Amandeep Bajwa, Liping Huang, Mark D Okusa
Natural IgM anti-leukocyte autoantibodies (IgM-ALAs) inhibit inflammation by several mechanisms. Here, we show that pan-B cells and bone marrow-derived dendritic cells (BMDCs) are switched to regulatory cells when pretreated ex vivo with IgM. B cells are also switched to regulatory cells when pretreated ex vivo with CpG but not with LPS. Pre-emptive infusion of such ex vivo induced regulatory cells protects C57BL/6 mice from ischemia-induced acute kidney injury (AKI) via regulation of in vivo NKT-1 cells, which normally amplify the innate inflammatory response to DAMPS released after reperfusion of the ischemic kidney...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28869251/cardiac-surgery-associated-acute-kidney-injury-risk-factors-pathophysiology-and-treatment
#7
REVIEW
Ying Wang, Rinaldo Bellomo
Cardiac surgery-associated acute kidney injury (CSA-AKI) is the most common clinically important complication in adult patients undergoing open heart surgery, and is associated with increased mortality and morbidity. In patients in intensive care units, CSA-AKI is the second most common type of AKI after septic AKI. In this Review, we explore the definition of CSA-AKI, discuss its epidemiology and identify its risk factors. We discuss current theories of the pathophysiology of CSA-AKI and describe its clinical course...
September 4, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28861722/preoperative-assessment-for-ambulatory-surgery
#8
REVIEW
Amit Prabhakar, Erik Helander, Nikki Chopra, Aaron J Kaye, Richard D Urman, Alan David Kaye
PURPOSE OF REVIEW: Ambulatory surgery has grown in recent decades in volume and represents a significant number of anesthetics delivered throughout the USA. Preoperative anesthetic assessment in the ambulatory setting has become important because patients with numerous complex comorbidities are now commonplace in this arena. Disease states involving the lungs, the heart, the kidneys, and subpopulations including those who are obese and the elderly commonly receive anesthetics in an ambulatory setting...
August 31, 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28859893/predictors-of-long-term-survival-after-renal-cancer-surgery
#9
Joseph Zabell, Sevag Demirjian, Brian R Lane, Ithaar H Derweesh, Sudhir Isharwal, Chalairat Suk-Ouichai, Jitao Wu, Diego Aguilar Palacios, Steven C Campbell
PURPOSE: Renal cancer surgery (RCS) can adversely impact long-term function and survival. We evaluate predictors of chronic kidney disease (CKD) at 5-years and non-renal cancer mortality (NRCM) 10-years after RCS. MATERIALS AND METHODS: We analyzed 4,283 patients undergoing RCS (1997-2008). Radical nephrectomy (RN) and partial nephrectomy (PN) were performed in 46%/54% of patients, respectively. Cumulative probability ordinal modeling was used to predict CKD status 5-years after surgery and multivariable logistic regression for predicting NRCM at 10-years...
August 28, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28858859/independent-risk-factors-and-2-year-outcomes-of-acute-kidney-injury-after-surgery-for-congenital-heart-disease
#10
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...
September 1, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28834125/analysis-of-survival-for-patients-with-chronic-kidney-disease-primarily-related-to-renal-cancer-surgery
#11
Jitao Wu, Chalairat Suk-Ouichai, Wen Dong, Elvis Caraballo Antonio, Ithaar H Derweesh, Brian R Lane, Sevag Demirjian, Jianbo Li, Steven C Campbell
OBJECTIVES: To evaluate predictors of long-term survival for patients with chronic kidney disease primarily due to surgery (CKD-S). Patients with CKD-S have generally good survival that approximates patients who do not have CKD even after renal cancer surgery (RCS), yet there may be heterogeneity within this cohort. PATIENTS AND METHODS: From 1997-2008, 4,246 patients underwent RCS at our center. Median follow-up was 9.4 years (IQR=7.3-11.0). New baseline GFR was defined as highest GFR between nadir and 6 weeks after surgery...
August 21, 2017: BJU International
https://www.readbyqxmd.com/read/28831235/benign-heart-murmurs-as-a-predictor-for-complications-following-total-joint-arthroplasty
#12
James M Friedman, Ricardo Couso, Michael Kitchens, Venus Vakhshori, Cody D Hillin, Chia H Wu, Joshua Steere, Jaimo Ahn, Eric Hume
BACKGROUND: There is scant literature examining the predictive role of heart murmurs in the absence of suspected structural heart disease on complications of non-cardiac surgery. We hypothesize the detection of heart murmurs in the absence of structural heart disease will help identify patients at risk for complications following total joint arthroplasty (TJA) surgery. METHOD: This was a prospective cohort of patients undergoing TJA over a twenty-month period. The study was performed at a single academic institution with four subspecialty surgeons...
December 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28826704/application-of-a-three-dimensional-printed-product-to-fill-the-space-after-organ-removal-a-case-report
#13
Jui-Yu Weng, Che-Chuaa Wang, Pei-Jar Chen, Sher-Wei Lim, Jinn-Rung Kuo
BACKGROUND: Maintaining body integrity, especially in Asian societies, is an independent predictor of organ donation. CASE DESCRIPTION: Herein, we report the case of an 18-year-old man who suffered traumatic brain injury with brain death caused by a car accident. According to the family's wishes, we used a three-dimentional (3D) printer to create a simulated heart, kidneys, and liver to fill the spaces after the patient's organs were removed. This is the first case report to introduce this new clinical application of 3D printed products during transplantation surgery...
August 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28790271/-chronic-kidney-disease-tips-and-pitfall-of-perioperative-management
#14
Satsuki Fukushima, Tomoyuki Fujita, Junjiro Kobayashi
Chronic kidney disease(CKD) is an important risk factor of open heart surgery. In addition, worsening of kidney function after the surgery leads to poor prognosis long-term. It is therefore crucial to protect the kidney function by intensive perioperative management in open heart surgery. In the patients having stage 3-4 CKD, mean arterial pressure needs to be higher than 70 mmHg and cardiac index needs to be greater than 2.4 intraoperatively and postoperatively. Continuous right heart monitoring by Swan-Ganz catheter is useful for this purpose...
July 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28782492/impact-of-pre-existing-kidney-dysfuntion-on-outcomes-following-transcatheter-aortic-valve-replacement
#15
Ikechukwu A Ifedili, Oluwaseyi Bolorunduro, Tamunoinemi Bob-Manuel, Mark R Heckle, Ellis Christian, Saibal Kar, Uzoma N Ibebuogu
BACKGROUND: Pre-existing chronic kidney disease (CKD) portends adverse outcomes following heart valve surgery. However, only limited and conflicting evidence is available on the impact of CKD on outcomes following transcatheter aortic valve replacement (TAVR). The objective of this review was to evaluate the effect of pre-existing CKD on TAVR outcomes. METHODS: We performed a systematic electronic search using the PRISMA statement to identify all randomized controlled trials and observational studies investigating the effect of pre-existing CKD on outcomes following TAVR...
August 4, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28777704/noninvasive-identification-of-renal-hypoxia-in-experimental-myocardial-infarctions-of-different-sizes-by-using-bold-mr-imaging-in-a-mouse-model
#16
Di Chang, Yuan-Cheng Wang, Ting-Ting Xu, Xin-Gui Peng, Yu Cai, Lin Wang, Ying-Ying Bai, Shenghong Ju
Purpose To test the feasibility of using blood oxygen level-dependent (BOLD) magnetic resonance (MR) imaging to measure alterations in renal oxygenation in a mouse model with experimental myocardial infarctions (MIs) of different sizes. Materials and Methods The study was approved by the local animal ethics committee. One hundred eighty-nine male C57BL/6 J mice were randomly subjected to MI surgery (with different locations of left anterior descending coronary artery occlusion) or sham surgery, defined as the exposure of the heart but no ligation...
August 4, 2017: Radiology
https://www.readbyqxmd.com/read/28767907/retinal-changes-in-solid-organ-and-bone-marrow-transplantation-patients
#17
Fernando Korn Malerbi, Sergio Henrique Teixeira, Luis Gustavo Gondo Hirai, Nilson Hideo Matsudo, Adriano Biondi Monteiro Carneiro
Objective: To evaluate retinal changes in patients who underwent solid organ or bone marrow transplantation. Methods: A retrospective analysis of medical records of patients evaluated from February 2009 to December 2016. All patients included underwent funduscopy. Clinical and demographic data regarding transplantation and ophthalmological changes were collected. Results: A total of 126 patients were analyzed; of these, 108 underwent transplantation and 18 were in the waiting list...
April 2017: Einstein
https://www.readbyqxmd.com/read/28751850/anmco-sic-sici-gise-sicch-executive-summary-of-consensus-document-on-risk-stratification-in-elderly-patients-with-aortic-stenosis-before-surgery-or-transcatheter-aortic-valve-replacement
#18
Giovanni Pulignano, Michele Massimo Gulizia, Samuele Baldasseroni, Francesco Bedogni, Giovanni Cioffi, Ciro Indolfi, Francesco Romeo, Adriano Murrone, Francesco Musumeci, Alessandro Parolari, Leonardo Patanè, Paolo Giuseppe Pino, Annalisa Mongiardo, Carmen Spaccarotella, Roberto Di Bartolomeo, Giuseppe Musumeci
Aortic stenosis is one of the most frequent valvular diseases in developed countries, and its impact on public health resources and assistance is increasing. A substantial proportion of elderly people with severe aortic stenosis is not eligible to surgery because of the advanced age, frailty, and multiple co-morbidities. Transcatheter aortic valve implantation (TAVI) enables the treatment of very elderly patients at high or prohibitive surgical risk considered ineligible for surgery and with an acceptable life expectancy...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28743566/mortality-prediction-in-patients-with-acute-kidney-injury-requiring-renal-replacement-therapy-after-cardiac-surgery
#19
Inga Skarupskienė, Dalia Adukauskienė, Jurgita Kuzminskienė, Laima Rimkutė, Vilma Balčiuvienė, Edita Žiginskienė, Vytautas Kuzminskis, Agnė Adukauskaitė, Daiva Pentiokinienė, Inga Arūnė Bumblytė
BACKGROUND AND OBJECTIVE: Acute kidney injury (AKI) is a common and potentially serious postoperative complication after cardiac surgery, and it remains a cause of major morbidity and mortality. The aim of our study was to assess the prognostic illness severity score and to estimate the significant risk factors for poor outcome of patients with AKI requiring renal replacement therapy (RRT) after cardiac surgery. MATERIALS AND METHODS: We retrospectively analyzed data of adult (>18 years) patients (n=111) who underwent open heart surgery and had developed AKI with need for RRT...
July 14, 2017: Medicina
https://www.readbyqxmd.com/read/28740713/outcomes-of-minimally-invasive-double-valve-surgery
#20
Orlando Santana, Steve Xydas, Roy F Williams, Angelo LaPietra, Maurice Mawad, Frederick Hasty, Esteban Escolar, Christos G Mihos
BACKGROUND: Double valve surgery is associated with an increased peri-operative morbidity and mortality. A less invasive right thoracotomy approach may be a viable alternative to median sternotomy surgery in these higher-risk patients. METHODS: We retrospectively analyzed the baseline demographics, operative characteristics, and post-operative outcomes of patients who underwent minimally invasive double valve surgery between January 2009 and December 2011 at our institution...
June 2017: Journal of Thoracic Disease
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