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https://www.readbyqxmd.com/read/29330638/predictors-of-severe-postoperative-hyperglycemia-after-cardiac-surgery-in-infants-a-single-center-retrospective-observational-study
#1
Natsuhiro Yamamoto, Tomoya Irie, Shunsuke Takaki, Osamu Yamaguchi, Takahisa Goto
PURPOSE: Hyperglycemia is a common issue in infants after cardiac surgery for congenital heart disease. Poor glycemic control is suspected to be associated with adverse postoperative outcomes. This study was performed to investigate clinical factors contributing to hyperglycemia in the perioperative period in infats. METHODS: A total of 69 infants (aged 1-12 months) who were admitted to Yokohama City University Hospital Intensive Care Unit (ICU) after surgical repair of congenital heart diseases with cardiopulmonary bypass (CPB) were retrospectively analysed...
January 12, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29314058/impact-of-using-scatter-mimicking-beams-instead-of-standard-beams-to-measure-penetration-when-assessing-the-protective-value-of-radiation-protective-garments
#2
A Kyle Jones, Alexander S Pasciak, Louis K Wagner
PURPOSE: Use standardized methods to determine how assessment of protective value of radiation-protective garments changes under conditions employing standard beam qualities, scatter-mimicking primary beams, and a modified Hp (10) measurement. METHODS: The shielding properties of radiation-protective garments depend on the spectrum of beam energies striking the garment and the attenuation properties of materials used to construct the garment, including X-ray fluorescence produced by these materials...
January 3, 2018: Medical Physics
https://www.readbyqxmd.com/read/29312714/off-vs-on-pump-coronary-artery-bypass-graft-surgery-on-hospital-outcomes-in-134-117-octogenarians
#3
Umberto Benedetto, Gianni D Angelini, Massimo Caputo, Dmitriy N Feldman, Luke K Kim, Christopher Lau, Antonino Di Franco, Leonard N Girardi, Mario Gaudino
Background: In octogenarian patients there is a potential for more tangible clinical benefits from off-pump coronary artery bypass (OPCAB) compared to conventional coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) (COCAB). We aimed to investigate whether, compared to COCAB, OPCAB is associated with better operative outcomes in octogenarians by analyzing the Nationwide Inpatient Sample (NIS) databases 2003-2011. Methods: Of the 134,117 discharge records from 797 hospitals analyzed of patients aged ≥80 years undergoing first time isolated CABG from 2003 to 2011, 70...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29310555/mechanical-circulatory-support-for-the-failing-fontan-conversion-to-assisted-single-ventricle-circulation-preliminary-observations
#4
Syed M Peer, Kristopher B Deatrick, Thomas J Johnson, Jonathan W Haft, Francis D Pagani, Richard G Ohye, Edward L Bove, Alvaro Rojas-Peña, Ming-Sing Si
BACKGROUND: Mechanical circulatory support (MCS) of a failing Fontan circulation remains challenging. We hypothesized that MCS can be provided by converting the Fontan circulation into a mechanically assisted single ventricle parallel circulation (MASVC). METHODS: A porcine model of functionally univentricular circulation was created under cardiopulmonary bypass (CPB) by performing an atrial septectomy, tricuspid valvectomy, and interrupting antegrade pulmonary blood flow...
January 2018: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29310468/lidocaine-dose-response-effect-on-postoperative-cognitive-deficit-meta-analysis-and-meta-regression
#5
Mohammad Reza Habibi, Valiollah Habibi, Ali Habibi, Aria Soleimani
The true influence of the perioperative intravenous lidocaine on the development of postoperative cognitive deficit (POCD) in coronary artery bypass grafting (CABG) remains controversial. The principal aim is to undertake a meta-regression to determine whether moderator variables mediate the relationship between lidocaine and POCD. Areas covered: We searched the Web of Science, PubMed database, Scopus and the Cochrane Library database (up to June 2017) and systematically reviewed a list of retrieved articles...
January 9, 2018: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/29305679/decreased-coronary-arteriolar-response-to-kca-channel-opener-after-cardioplegic-arrest-in-diabetic-patients
#6
Yuhong Liu, Victoria Cole, Isabella Lawandy, Afshin Ehsan, Frank W Sellke, Jun Feng
We have recently found that diabetes is associated with the inactivation of the calcium-activated potassium channels (KCa) in endothelial cells, which may contribute to endothelial dysfunction in diabetic patients at baseline. In the current study, we further investigated the effects of diabetes on coronary arteriolar responses to the small (SK) and intermediate (IK) KCa opener NS309 in diabetic and non-diabetic patients and correlated that data with the changes in the SK/IK protein expression/distribution in the setting of cardioplegic ischemia and reperfusion (CP) and cardiopulmonary bypass (CPB)...
January 5, 2018: Molecular and Cellular Biochemistry
https://www.readbyqxmd.com/read/29304830/emergence-of-g12-and-g9-rotavirus-genotypes-in-the-central-african-republic-january-2014-to-february-2016
#7
Ulrich Aymard Ekomi Moure, Virginie Banga-Mingo, Jean Chrysostom Gody, Jason M Mwenda, Jean Fandema, Diane Waku-Kouomou, Casimir Manengu, Thomas D'Aquin Koyazegbe, Mathew D Esona, Michael D Bowen, Ionela Gouandijka-Vasilache
OBJECTIVES: Rotavirus gastroenteritis is a major cause of death among children under 5 years globally. A rotavirus gastroenteritis surveillance program started in October 2011 in the Central African Republic (CAR) with the Surveillance Epidémiologique en Afrique Centrale (SURVAC) project. We present here genotyping results showing the emergence of G9 and G12 genotypes in Central African Republic. RESULTS: Among 222 children hospitalized with acute gastroenteritis who had a stool sample collected at the sentinel site, Complexe Pédiatrique de Bangui (CPB), Bangui, Central African Republic, 100 (45%) were positive for rotavirus between January 2014 and February 2016...
January 5, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29302123/bloodless-repair-for-a-3-6-kilogram-transposition-of-the-great-arteries-with-jehovah-s-witness-faith
#8
Jeffery L Burnside, Todd M Ratliff, Ashley B Hodge, Daniel Gomez, Mark Galantowicz, Aymen Naguib
Achieving pediatric cardiac surgery using cardiopulmonary bypass (CPB) without allogeneic blood transfusion is challenging. There are many clinical and economic factors that point to the importance of avoiding blood transfusions. In some instances, honoring patients or parents beliefs may be the reason for avoiding blood transfusions. For example, patients or parents of the Jehovah's Witness faith refuse blood transfusion based on their religious beliefs. Over the last decade, our institution has seen a steady increase in our pediatric Jehovah's Witness patient population...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302121/use-of-a-modified-cardiopulmonary-bypass-circuit-for-suction-embolectomy-with-the-angiovac-device
#9
Cara M Michelson, Cornelius M Dyke, Douglas J Wick, Rory Guenther, Dylan Dangerfield, Matthew E Wiisanen
The AngioVac suction cannula and circuit were designed for the percutaneous removal of soft thrombus and emboli in procedures requiring extracorporeal circulatory support. We describe a modification of the AngioVac suction catheter and cardiopulmonary bypass (CPB) circuit to effectively remove thrombus while maintaining the ability to rapidly initiate full CPBs during a medical crisis. This article will discuss the design concepts of the modified circuit as well as procedural protocols and considerations. The design modifications of incorporating an oxygenator, reservoir, and bridge allow for an increased flexibility that allows adaption to veno-venous extracorporeal membrane oxygenation or full CPB support when required for oxygenation or hemodynamic support...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302118/blood-and-blood-product-conservation-results-of-strategies-to-improve-clinical-outcomes-in-open-heart-surgery-patients-at-a-tertiary-hospital
#10
Junaid H Khan, Emily A Green, Jimmin Chang, Alexandria M Ayala, Marilyn S Barkin, Emily E Reinys, Jeffrey Stanton, Russell D Stanten
Blood product usage is a quality outcome for patients undergoing cardiac surgery. To address an increase in blood product usage since the discontinuation of aprotinin, blood conservation strategies were initiated at a tertiary hospital in Oakland, CA. Improving transfusion rates for open heart surgery patients requiring Cardiopulmonary bypass (CPB) involved multiple departments in coordination. Specific changes to conserve blood product usage included advanced CPB technology upgrades, and precise individualized heparin dose response titration assay for heparin and protamine management...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302117/an-in-vitro-study-comparing-the-gme-handling-of-two-contemporary-oxygenators
#11
Carl J Gisnarian, Angela Hedman, Kenneth G Shann
Gaseous microemboli (GME) are a potential complication of cardiopulmonary bypass (CPB). Though it is difficult to prove that GME is the only major cause of neurological deficits, it may increase the chance of post-operative cognitive dysfunction if not removed. The objectives of this research were to compare LivaNova-Sorin Inspire (Inspire) oxygenator with a Medtronic arterial filter to the Medtronic Fusion (Fusion) oxygenator with and without a Medtronic arterial filter based on each system's ability to handle GME...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302114/the-influence-of-intraoperative-autotransfusion-on-postoperative-hematocrit-after-cardiac-surgery-a-cross-sectional-study
#12
Andrew J Stasko, Alfred H Stammers, Linda B Mongero, Eric A Tesdahl, Samuel Weinstein
Utilization of intraoperative autotransfusion (IAT) during cardiac surgery with cardiopulmonary bypass (CPB) has been shown to reduce allogeneic red blood cell transfusion. Previous research has emphasized the benefits of using IAT in the intraoperative period. The present study was designed to evaluate the effects of using IAT on overall hematocrit (Hct) drift between initiation of CPB and the immediate postoperative period. We reviewed 3,225 adult cardiac procedures occurring between February 2016 and January 2017 at 84 hospitals throughout the United States...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302113/does-the-type-of-cardioplegic-technique-influence-hemodilution-and-transfusion-requirements-in-adult-patients-undergoing-cardiac-surgery
#13
Alfred H Stammers, Eric A Tesdahl, Linda B Mongero, Andrew J Stasko, Samuel Weinstein
During cardiac surgery, myocardial protection is performed using diverse cardioplegic (CP) solutions with and without the presence of blood. New CP formulations extend ischemic intervals but use high-volume, crystalloid-based solutions. The present study evaluated four commonly used CP solutions and their effect on hemodilution during cardiopulmonary bypass (CPB). Records from 16,670 adult patients undergoing cardiac surgery with CPB between February 2016 and January 2017 were reviewed. Patients were classified into one of four groups according to CP type: 4-1 blood to crystalloid (4:1), microplegia (MP), del Nido (DN) and histidine-tryptophan-ketoglutarate (HTK)...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29302112/low-oxygen-delivery-as-a-predictor-of-acute-kidney-injury-during-cardiopulmonary-bypass
#14
Richard F Newland, Robert A Baker
Low indexed oxygen delivery (DO2i) during cardiopulmonary bypass (CPB) has been associated with an increase in the likelihood of acute kidney injury (AKI), with critical thresholds for oxygen delivery reported to be 260-270 mL/min/m2. This study aims to explore whether a relationship exists for oxygen delivery during CPB, in which the integral of amount and time below a critical threshold, is associated with the incidence of postoperative AKI. The area under the curve (AUC) with DO2i during CPB above or below 270 mL/min/m2 was calculated as a metric of oxygen delivery in 210 patients undergoing CPB...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29301459/the-effect-of-ultrafiltration-on-end-cardiopulmonary-bypass-hematocrit-during-cardiac-surgery
#15
Linda Mongero, Alfred Stammers, Eric Tesdahl, Andrew Stasko, Samuel Weinstein
OBJECTIVE: Ultrafiltration (UF) during cardiopulmonary bypass (CPB) is a well-accepted method for hemoconcentration to reduce excess fluid and increase hematocrit, platelet count and plasma constituents. The efficacy of this technique may confer specific benefit to certain patients presenting with acquired cardiac defects. The purpose of this study was to retrospectively evaluate the effect of UF on end-CPB hematocrit by cardiac surgical procedure type. METHODS: A review of 73,506 cardiac procedures from a national registry (SCOPE) was conducted between April 2012 and October 2016 at 197 institutions...
January 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29300861/asanguineous-priming-of-miniaturized-paediatric-cardiopulmonary-bypass-circuits-for-congenital-heart-surgery-independent-predictors-associated-with-transfusion-requirements-and-effects-on-postoperative-morbidity
#16
Wolfgang Boettcher, Matthias Redlin, Frank Dehmel, Katharina Graefe, Mi-Young Cho, Helmut Habazettl, Marian Kukucka
OBJECTIVES: In paediatric cardiac surgery, body weight-adjusted miniaturized cardiopulmonary bypass (CPB) circuits within a comprehensive blood-sparing approach can reduce transfusion requirements. Haemodilution resulting from mixing the patient's blood with a CPB crystalloid solution may be reduced to the extent that asanguineous priming becomes possible. Therefore, we adopted asanguineous priming in our clinical routine. Our goal was to report the effects of asanguineous priming on transfusion requirements, clinical features associated with transfusion and effects on in-hospital morbidity...
January 2, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29290079/buckberg-versus-calafiore-cardioplegia-in-patients-with-acute-coronary-syndromes
#17
Elmar W Kuhn, Oliver Liakopoulos, Ingo Slottosch, Antje Christin Deppe, Yeong-Hoon Choi, Navid Madershahian, Thorsten C W Wahlers
BACKGROUND:  Choice of cardioplegic solution plays a pivotal role in special subgroups of patients referred for on-pump cardiac surgery. This retrospective analysis aimed to assess the impact of intermittent warm (Calafiore, Cala) versus intermittent cold blood cardioplegia (Buckberg, Buck) in patients referred to coronary artery bypass graft (CABG) surgery due to acute coronary syndromes (ACS). METHODS:  From 2008 to 2015, all consecutive patients undergoing urgent on-pump CABG surgery due to ACS (n = 950) were retrospectively analyzed...
December 31, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29290078/is-300-seconds-act-safe-and-efficient-during-miecc-procedures
#18
Adrian Bauer, Harald Hausmann, Jan Schaarschmidt, Michal Szlapka, Martin Scharpenberg, Thomas Eberle, J Michael Hasenkam
INTRODUCTION:  The recommended minimum activated clotting time (ACT) level for cardiopulmonary bypass (CPB) of 480 seconds originated from investigations with bubble oxygenators and uncoated extracorporeal circulation (ECC) systems. Modern minimal invasive ECC (MiECC) systems are completely closed circuits containing a membrane oxygenator and a tip-to-tip surface coating. We hypothesized that surface coating and the "closed-loop" design allow the MiECC to safely run with lower ACT levels and that an ACT level of 300 seconds can be safely applied without thromboembolic complications...
December 31, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29285155/the-level-of-urinary-il-18-in-acute-kidney-injury-after-cardiopulmonary-bypass
#19
Changan Wang, Jinghua Zhang, Jianle Han, Qingyan Yang, Jinrui Liu, Bing Liang
This study investigated the diagnostic value of urinary interleukin-18 (uIL-18) in acute kidney injury (AKI) after cardiopulmonary bypass (CPB) in clinical practice. A total of 103 patients who underwent CPB were divided into the AKI group and non-AKI group according to the diagnostic criteria of AKI, and we collected the urine samples before and at 2, 4, 6, 8 and 12 h after CPB and the blood samples before and at 12, 24, 48 and 72 h after CPB for detection of the levels of uIL-18 and urinary neutrophil gelatinase-associated lipocalin (uNGAL) in urine samples and the levels of serum creatinine (Scr) in blood samples, respectively...
December 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29282039/plasma-levels-of-alarmin-hnps-1-3-associate-with-lung-dysfunction-after-cardiac-surgery-in-children
#20
XiWang Liu, QiXing Chen, YuJia Luo, YaoQin Hu, DengMing Lai, XiaoLe Zhang, XiangHong Zhang, JianGen Yu, XiangMing Fang, Qiang Shu
BACKGROUND: Early onset of lung injury is considerable common after cardiac surgery and is associated with increasing in morbidity and mortality, but current clinical predictors for the occurrence of this complication always have limited positive warning value. This study aimed to evaluate whether elevated plasma levels of human neutrophil peptides (HNPs) 1-3 herald impaired lung function in infants and young children after cardiac surgery necessitating cardiopulmonary bypass (CPB). METHODS: Consecutive children younger than 3 years old who underwent cardiac surgery were prospectively enrolled...
December 28, 2017: BMC Pulmonary Medicine
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