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Protocols in cardiac surgery

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https://www.readbyqxmd.com/read/28631210/carcinoid-heart-disease-a%C3%A2-guide-for-screening-and-timing-of-surgical-intervention
#1
REVIEW
E A Hart, T A Meijs, R C A Meijer, K M Dreijerink, M E Tesselaar, C A de Groot, G D Valk, S A J Chamuleau
The cardiac manifestations of a neuroendocrine tumour are referred to as carcinoid heart disease (CaHD) and are associated with a poor prognosis. Surgical intervention is the only proven therapeutic option and may prolong survival and quality of life. No consensus has been reached internationally with regard to screening for CaHD and the optimal timing for surgery. Although limited evidence is available on this matter, a trend towards early surgery and subsequent reduced mortality has been observed. In this review we provide an overview of the current understanding and propose a protocol to guide cardiologists in the screening for CaHD and the timing of referral to a specialised surgical centre...
June 19, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28630035/the-effects-of-preoperative-volume-replacement-in-diabetic-patients-undergoing-coronary-artery-bypass-grafting-surgery-protocol-for-a-randomized-controlled-trial-verdict-trial
#2
Madeleine Clout, Tracy Harris, Chris Rogers, Lucy Culliford, Jodi Taylor, Gianni Angelini, Pradeep Narayan, Barnaby Reeves, James Hillier, Kate Ashton, Kunal Sarkar, Raimondo Ascione
BACKGROUND: Diabetes mellitus is a major risk factor for prolonged hospital stays, renal failure, and mortality in patients having coronary artery bypass grafting (CABG). Complications pose a serious threat to patients and prolong intensive care and hospital stays. Low glomerular filtration rate (GFR) due to existing renal impairment or volume depletion may exacerbate acute renal impairment/failure in these patients. Preoperative volume replacement therapy (VRT) is reported to increase the GFR and we hypothesize that VRT will reduce renal impairment and related complications in diabetic patients...
June 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28629445/effects-of-perioperative-statin-use-on-cardiovascular-complications-in-patients-submitted-to-non-cardiac-surgery-protocol-for-a-systematic-review-meta-analysis-and-trial-sequential-analysis
#3
Erica Aranha Suzumura, Rodrigo Antonini Ribeiro, Leticia Kawano-Dourado, Pedro Gabriel de Barros E Silva, Claudia Oliveira, Mabel Fernandes Figueiró, Alexandre Biasi Cavalcanti, Renato D Lopes, Otavio Berwanger
BACKGROUND: Preliminary evidence suggests statins may reduce major perioperative vascular events. However, evidence is limited to observational studies, underpowered trials, and non-comprehensive systematic reviews. This review aims to assess the effects of perioperative statin use on cardiovascular complications in patients submitted to non-cardiac surgery. METHODS: We will search MEDLINE/PubMed, EMBASE, LILACS, CENTRAL, Web of Science, and CINAHL for randomized controlled trials assessing the effects of perioperative statin use in adults undergoing non-cardiac surgery and reporting cardiovascular complications...
June 19, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28629228/use-of-provider-debriefing-to-improve-fast-track-extubation-rates-following-cardiac-surgery-at-an-academic-medical-center
#4
Jordan E Goldhammer, Jillian M Dashiell, Scott Davis, Marc C Torjman, Hitoshi Hirose
When used in appropriate patient populations, fast-track extubation (FTE) anesthetic techniques and intensive care unit (ICU) protocols safely reduce intubation times, ICU length of stay, and resource utilization. The authors hypothesized that perioperative provider debriefing on success or failure of FTE would improve FTE success. This retrospective observational study included consecutive patients undergoing elective coronary artery bypass graft (CABG), valve, or combined CABG/valve surgery between February 2015 and May 2016 (N = 313)...
June 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28616283/the-use-of-thrombolytics-in-the-management-of-complex-pleural-fluid-collections
#5
Jessica Heimes, Hannah Copeland, Aditya Lulla, Marjulin Duldulao, Khaled Bahjri, Salman Zaheer, Jason M Wallen
BACKGROUND: To determine the efficacy of thrombolytics for the management of complex pleural fluid collections. METHODS: We reviewed patients that received alteplase for persistent loculated pleural fluid collections after simple tube drainage between July 01, 2007 and November 01, 2012. Our alteplase protocol is 6 mg of alteplase in 50 mL of normal saline injected into the pleural chest tube. The chest tube is clamped for four hours and then opened. Normally this is repeated daily for 2 to 3 days (d)...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28595379/does-the-prophylactic-and-therapeutic-use-of-beta-blockers-in-preoperative-patients-with-tetralogy-of-fallot-significantly-prevent-and-treat-the-occurrence-of-cyanotic-spells
#6
Eliana Fanous, Gábor Mogyorósy
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Does the use of beta-blockers significantly prevent and treat the occurrence of cyanotic spells in preoperative infants with tetralogy of Fallot?' Altogether, 80 papers were found using the reported search, of which 6 represented the best evidence to answer the clinical question. The author, journal, date, country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
June 7, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28592276/different-strategies-for-mechanical-ventilation-during-cardiopulmonary-bypass-cpbvent-2014-study-protocol-for-a-randomized-controlled-trial
#7
Elena Bignami, Marcello Guarnieri, Francesco Saglietti, Enivarco Massimo Maglioni, Sabino Scolletta, Stefano Romagnoli, Stefano De Paulis, Gianluca Paternoster, Cinzia Trumello, Roberta Meroni, Antonio Scognamiglio, Alessandro Maria Budillon, Vincenzo Pota, Alberto Zangrillo, Ottavio Alfieri
BACKGROUND: There is no consensus on which lung-protective strategies should be used in cardiac surgery patients. Sparse and small randomized clinical and animal trials suggest that maintaining mechanical ventilation during cardiopulmonary bypass is protective on the lungs. Unfortunately, such evidence is weak as it comes from surrogate and minor clinical endpoints mainly limited to elective coronary surgery. According to the available data in the academic literature, an unquestionable standardized strategy of lung protection during cardiopulmonary bypass cannot be recommended...
June 7, 2017: Trials
https://www.readbyqxmd.com/read/28575392/should-limb-revascularization-take-priority-over-dissection-repair-in-type-a-aortic-dissection-presenting-as-isolated-acute-limb-ischaemia
#8
Ryan Preece, Vivek Srivastava, Enoch Akowuah, Simon Kendall
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was should limb revascularization take priority over dissection repair in acute type A aortic dissection (ATAAD) presenting as isolated acute limb ischaemia? Altogether 133 papers were found using the reported search, of which 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
June 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28569337/the-assessment-of-the-complexity-of-care-through-the-clinical-nursing-information-system-in-clinical-practice-a-study-protocol
#9
C Bravetti, A Cocchieri, F D'Agostino, R Alvaro, M Zega
BACKGROUND: The costs of nursing staff amounts to approximately 50% of the total budget of the health workforce and accounts for 20% to 30% of the total costs incurred by the health care companies. The goal of the study, by analyzing the complexity of care, is to provide a quantification of the assistance delivered, through the assessment of the technical aspects of the welfare activities according to the variable of time. Data from these activities flow into the clinical nursing information system Professional Assessment Instrument - PAI - which is used at the health facility involved in this study...
July 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/28558846/perioperative-antibiotics-in-pediatric-cardiac-surgery-protocol-for-a-systematic-review
#10
Vijay Anand, Angela Bates, Robin Featherstone, Srinivas Murthy
BACKGROUND: Post-operative infections in pediatric cardiac surgery are an ongoing clinical challenge, with rates between 1 and 20%. Perioperative antibiotics remain the standard for prevention of surgical-site infections, but the type of antibiotic and duration of administration remain poorly defined. Current levels of practice variation through informal surveys are very high. Rates of antibiotic-resistant organisms are increasing steadily around the world. METHODS/DESIGN: We will identify all controlled observational studies and randomized controlled trials examining prophylactic antibiotic use in pediatric cardiac surgery...
May 30, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28553041/a-single-center-experience-of-kidney-transplantation-from-donation-after-circulatory-death-challenges-and-scope-in-india
#11
S Singh, S Kumar, S Dasgupta, D B Kenwar, M Rathi, A Sharma, H S Kohli, V Jha, K L Gupta, M Minz
Donation after circulatory death (DCD) has never been attempted in India because of legal constraints and lack of guidelines for the withdrawal of life support in end-of-life situations. The present report describes the initial experience of transplantation of organs from DCD donors in a tertiary care center in India. Between 2011 and 2015, five donors had kidneys retrieved after cardiac arrest. These patients were declared dead after waiting for 5 min with no electrocardiographic signal on monitor following cardiopulmonary resuscitation (CPR), which was restarted in three patients till organ retrieval...
May 2017: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/28492786/the-brazilian-registry-of-adult-patient-undergoing-cardiovascular-surgery-the-bypass-project-results-of-the-first-1-722-patients
#12
Walter J Gomes, Rita Simone Moreira, Alexandre Cabral Zilli, Luiz Carlos Bettiati, Fernando Augusto Marinho Dos Santos Figueira, Stephanie Steremberg Pires D' Azevedo, Marcelo José Ferreira Soares, Marcio Pimentel Fernandes, Roberto Vito Ardito, Renata Andrea Barberio Bogdan, Valquíria Pelisser Campagnucci, Diana Nakasako, Renato Abdala Karam Kalil, Clarissa Garcia Rodrigues, Anilton Bezerra Rodrigues, Marcelo Matos Cascudo, Fernando Antibas Atik, Elson Borges Lima, Vinicius José da Silva Nina, Renato Albuquerque Heluy, Lisandro Gonçalves Azeredo, Odilon Silva Henrique, José Teles de Mendonça, Katharina Kelly de Oliveira Gama Silva, Marcelo Pandolfo, José Dantas de Lima, Renato Max Faria, Jonas Pereira Dos Santos, Rodrigo Pereira Paez, Guilherme Henrique Biachi Coelho, Sergio Nunes Pereira, Roberta Senger, Enio Buffolo, Guido Marco Caputi, José Amalth do Espírito Santo, Juliana Aparecida Borges de Oliveira, Otavio Berwanger, Alexandre Biasi Cavalcanti, Fabio B Jatene
Objective: To report the early results of the BYPASS project - the Brazilian registrY of adult Patient undergoing cArdiovaScular Surgery - a national, observational, prospective, and longitudinal follow-up registry, aiming to chart a profile of patients undergoing cardiovascular surgery in Brazil, assessing the data harvested from the initial 1,722 patients. Methods: Data collection involved institutions throughout the whole country, comprising 17 centers in 4 regions: Southeast (8), Northeast (5), South (3), and Center-West (1)...
March 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28483663/e-r-a-s-pathway-in-colorectal-surgery-in-elderly-our-experience-a%C3%A2-retrospective-cohort-study
#13
Basilio Pirrera, Andrea Lucchi, Carlo Gabbianelli, Vincenzo Alagna, Giacomo Martorelli, Pierluigi Berti, Ilaria Panzini, Elisabetta Fabbri, Gianluca Garulli
AIM: Numerous geriatric patients develop colorectal disease. Elderly patients are often considered high-risk surgical candidates. Enhanced recovery after surgery (E.R.A.S.) has been proven to be beneficial for patients. The aim of the study was to evaluate the results of an ERAS protocol in older patients that underwent colorectal surgery compared to younger patients. METHOD: In the period between January 2010 to December 2015 a total of 589 patients underwent elective colorectal surgical interventions treated within the E...
May 5, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28481635/heterotopic-implantation-of-decellularized-pulmonary-artery-homografts-in-a-rodent-model-technique-description-and-preliminary-report
#14
Arben Dedja, Massimo A Padalino, Mila Della Barbera, Cosimo Rasola, Paola Pesce, Anna Milan, Michela Pozzobon, David Sacerdoti, Gaetano Thiene, Giovanni Stellin
PURPOSE: Despite a substantial amount of literature on tissue-guided regeneration, decellularization process, repopulation time points and stem cell turnover, more in-depth study on the argument is required. Currently, there are plenty of reports involving large animals, as well as clinical studies facing cardiac repair with decellularized homografts, but no exhaustive rodent models are described. The purpose of this study was to develop such a model in rats; preliminary results are also herein reported...
May 8, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28458765/right-ventricular-perforation-from-a-floating-rib-following-deep-sternal-wound-infection-debridement-and-application-of-a-vacuum-assisted-closure-device-a-case-report-and-literature-review
#15
Amanda J Ross, Nada N Berry
Introduction: Deep sternal wound infection following major cardiac surgery is a deleterious complication with sequelae that can be life threatening. The use of vacuum-assisted closure therapy in management of sternal wounds with resultant right ventricular rupture has been documented in the cardiothoracic and to a lesser extent in the reconstructive literature. Methods/Case Report: We present a case of a 67-year-old male patient who suffered from right ventricular perforation from a floating rib following debridement of a deep sternal wound infection and placement of a vacuum-assisted closure device...
2017: Eplasty
https://www.readbyqxmd.com/read/28457372/lung-transplantation-from-donors-after-previous-cardiac-surgery-ideal-graft-in-marginal-donor
#16
A Palleschi, P Mendogni, D Tosi, M Montoli, R Carrinola, A V Mariolo, F Briganti, M Nosotti
Lung transplantation is a limited by donor pool shortage. Despite the efforts to extend the graft acceptability with recurrent donor criteria reformulations, previous cardiothoracic surgery is still considered a contraindication. A donor who underwent cardiac surgery could potentially provide an ideal lung but high intraoperative risks and intrinsic technical challenges are expected during the graft harvesting. The purpose of this study is to present our dedicated protocol and four clinical cases of successful lung procurements from donors who had a previous major cardiac surgery...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28446882/modified-low-dose-triiodo-l-thyronine-therapy-safely-improves-function-following-myocardial-ischemia-reperfusion-injury
#17
Viswanathan Rajagopalan, Youhua Zhang, Christine Pol, Clifford Costello, Samantha Seitter, Ann Lehto, Olga V Savinova, Yue-Feng Chen, A Martin Gerdes
Background: We have shown that thyroid hormones (THs) are cardioprotective and can be potentially used as safe therapeutic agents for diabetic cardiomyopathy and permanent infarction. However, no reliable, clinically translatable protocol exists for TH treatment of myocardial ischemia-reperfusion (IR) injury. We hypothesized that modified low-dose triiodo-L-thyronine (T3) therapy would confer safe therapeutic benefits against IR injury. Methods: Adult female rats underwent left coronary artery ligation for 60 min or sham surgeries...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28437372/heart-rate-modification-of-cardiac-output-following-cardiac-surgery-the-importance-of-cardiac-time-intervals
#18
Guido Tavazzi, Andy Kontogeorgis, Fabio Guarracino, Niels Bergsland, Ana Martinez-Naharro, John Pepper, Susanna Price
OBJECTIVES: Inadequate cardiac output is associated with a poor outcome following cardiac surgery and is generally modified by the use of positive inotropic agents, volume resuscitation, and pacing. Echocardiography-guided pacemaker optimization is used in the outpatient setting, using different variables including total isovolumic time and the Tei index. We sought to determine the acute impact of heart rate on cardiac electromechanics, cardiac output, and stroke volume in the perioperative setting...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437263/a-randomised-trial-to-evaluate-preoperative-oral-carbohydrate-administration-on-insulin-resistance-in-off-pump-coronary-artery-bypass-patients
#19
Bora Lee, Sarah Soh, Jae-Kwang Shim, Ha Y Kim, Hyelin Lee, Young-Lan Kwak
BACKGROUND: In fasting cardiac surgery patients, preoperative carbohydrate (CHO) drink intake attenuated insulin resistance and improved cardiac metabolism, although its beneficial effects were not evident after cardiac surgery possibly due to cardiopulmonary bypass-related extreme systemic inflammation. OBJECTIVE: We aimed to evaluate whether preoperative CHO intake affected insulin resistance and free-fatty acid (FFA) concentrations in off-pump coronary revascularisation...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28430754/biomarkers-for-early-acute-kidney-injury-diagnosis-and-severity-prediction-a-pilot-multicenter-canadian-study-of-children-admitted-to-the-icu
#20
Jennifer Palermo, Allison B Dart, Alanna De Mello, Prasad Devarajan, Ronald Gottesman, Gonzalo Garcia Guerra, Greg Hansen, Ari R Joffe, Cherry Mammen, Nick Majesic, Catherine Morgan, Peter Skippen, Michael Pizzi, Ana Palijan, Michael Zappitelli
OBJECTIVE: Acute kidney injury occurs early in PICU admission and increases risks for poor outcomes. We evaluated the feasibility of a multicenter acute kidney injury biomarker urine collection protocol and measured diagnostic characteristics of urine neutrophil gelatinase-associated lipocalin, interleukin-18, and liver fatty acid binding protein to predict acute kidney injury and prolonged acute kidney injury. DESIGN: Prospective observational pilot cohort study...
June 2017: Pediatric Critical Care Medicine
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