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https://www.readbyqxmd.com/read/28537973/identifying-variability-in-mental-models-within-and-between-disciplines-caring-for-the-cardiac-surgical-patient
#1
Evans K H Brown, Kathleen A Harder, Ioanna Apostolidou, Joyce A Wahr, Douglas C Shook, R Saeid Farivar, Tjorvi E Perry, Mojca R Konia
BACKGROUND: The cardiac operating room is a complex environment requiring efficient and effective communication between multiple disciplines. The objectives of this study were to identify and rank critical time points during the perioperative care of cardiac surgical patients, and to assess variability in responses, as a correlate of a shared mental model, regarding the importance of these time points between and within disciplines. METHODS: Using Delphi technique methodology, panelists from 3 institutions were tasked with developing a list of critical time points, which were subsequently assigned to pause point (PP) categories...
May 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28535202/clinical-implications-of-hypothermic-ventricular-fibrillation-versus-beating-heart-technique-during-cardiopulmonary-bypass-for-pulmonary-valve-replacement-in-patients-with-repaired-tetralogy-of-fallot
#2
Ji-Hyun Lee, Ji-Eun Lee, Jungho Shin, In-Kyung Song, Hee-Soo Kim, Chong-Sung Kim, Woong-Han Kim, Jin-Tae Kim
OBJECTIVES: This study aimed to compare the effects of hypothermic ventricular fibrillation and beating-heart techniques during cardiopulmonary bypass (CPB) on postoperative outcomes after simple pulmonary valve replacement in patients with repaired tetralogy of Fallot (TOF). METHODS: We retrospectively reviewed the data of 47 patients with repaired tetralogy of Fallot at a single institution, who received pulmonary valve replacement under the ventricular fibrillation or beating-heart technique without cardioplegic cardiac arrest during CPB between January 2005 and April 2015...
May 23, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28530132/development-of-a-high-fidelity-pressurized-porcine-beating-heart-simulator-for-cardiac-surgery-training
#3
Igo B Ribeiro, Janet M C Ngu, Gurinder Gill, Fraser D Rubens
BACKGROUND: Development of a high-fidelity cardiac surgery simulator (CSS) requires integration of a heart model with a mock cardiopulmonary bypass (CPB) circuit that can provide feedback to mimic the pathophysiology of cardiac surgery. However, the cost of commercially available simulators precludes regular use. We describe steps in the construction of a high-fidelity CSS that integrates a pulsatile paracorporeal ventricular-assist device (Pulse-VAD) and a commercially available CPB simulator...
May 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28525670/hemoadsorption-treatment-of-patients-with-acute-infective-endocarditis-during-surgery-with-cardiopulmonary-bypass-a-case-series
#4
Karl Träger, Christian Skrabal, Guenther Fischer, Thomas Datzmann, Janpeter Schroeder, Daniel Fritzler, Jan Hartmann, Andreas Liebold, Helmut Reinelt
INTRODUCTION: Infective endocarditis is a serious disease condition. Depending on the causative microorganism and clinical symptoms, cardiac surgery and valve replacement may be needed, posing additional risks to patients who may simultaneously suffer from septic shock. The combination of surgery bacterial spreadout and artificial cardiopulmonary bypass (CPB) surfaces results in a release of key inflammatory mediators leading to an overshooting systemic hyperinflammatory state frequently associated with compromised hemodynamic and organ function...
May 19, 2017: International Journal of Artificial Organs
https://www.readbyqxmd.com/read/28523396/clostridium-perfringens-beta-toxin-dna-prime-protein-boost-elicits-enhanced-protective-immune-response-in-mice
#5
Amit Kumar Solanki, Bharati Bhatia, Himani Kaushik, Sachin K Deshmukh, Aparna Dixit, Lalit C Garg
Clostridium perfringens beta toxin (CPB) is the primary pathogenic factor responsible for necrotic enteritis in sheep, cattle and humans. Owing to rapid progression of the disease, vaccination is the only possible recourse to avoid high mortality in animal farms and huge economic losses. The present study reports evaluation of a cpb gene-based DNA vaccine encoding the beta toxin of C. perfringens with homologous as well as heterologous booster strategy. Immunization strategy employing heterologous booster with heat-inactivated rCPB mounted stronger immune response when compared to that generated by homologous booster...
May 18, 2017: Applied Microbiology and Biotechnology
https://www.readbyqxmd.com/read/28523169/risk-factors-for-continuous-renal-replacement-therapy-after-surgical-repair-of-type-a-aortic-dissection
#6
Hai-Bo Wu, Wei-Guo Ma, Hong-Lei Zhao, Jun Zheng, Jian-Rong Li, Ou Liu, Li-Zhong Sun
BACKGROUND: To identify the risk factors for continuous renal replacement therapy (CRRT) following surgical repair of type A aortic dissection (TAAD) using the total arch replacement and frozen elephant trunk (TAR + FET) technique. METHODS: The study included 330 patients with TAAD repaired using TAR + FET between January 2014 and April 2015. Mean age was 47.1±10.2 years (range, 18-73 years) and 242 were male (73.3%). Univariate and multivariate analyses were used to identify the risk factors for CRRT...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28515851/blood-conservation-pediatric-cardiac-surgery-in-all-ages-and-complexity-levels
#7
Mohsen Karimi, Jill M Sullivan, Carrie Linthicum, Anil Mathew
AIM: To demonstrate the feasibility of blood conservation methods and practice across all ages and risk categories in congenital cardiac surgery. METHODS: We retrospectively analyzed a collected database of 356 patients who underwent cardiac surgery using cardiopulmonary bypass (CPB) from 2010-2015. The patients were grouped into blood conservation (n = 138) and non-conservation (n = 218) groups and sub-grouped based on their ages and procedural complexity scores...
April 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28510741/early-or-late-fresh-frozen-plasma-administration-in-newborns-and-small-infants-undergoing-cardiac-surgery-the-appear-randomized-trial
#8
P Bianchi, M Cotza, C Beccaris, S Silvetti, G Isgrò, G Pomè, A Giamberti, M Ranucci
Background: In newborns and small infants undergoing cardiac surgery with cardiopulmonary bypass (CPB) and blood priming, it is unclear whether there is reduced blood loss if fresh frozen plasma (FFP) is added to the CPB priming volume. This single-centre, randomized trial tested the hypothesis that the administration of FFP after CPB (late FFP group) is superior to FFP priming (early FFP group) in terms of postoperative bleeding and overall red blood cell (RBC) transfusion. Methods: Seventy-three infants weighing <10 kg were randomly allocated to receive FFP to supplement RBCs in the CPB priming solution ( n =36) or immediately after CPB ( n =37)...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28510738/pharmacokinetic-pharmacodynamic-model-for-unfractionated-heparin-dosing-during-cardiopulmonary-bypass
#9
X Delavenne, E Ollier, S Chollet, F Sandri, J Lanoiselée, S Hodin, A Montmartin, J-F Fuzellier, P Mismetti, L Gergelé
Background: High-dose heparin is used during cardiopulmonary bypass (CPB) to prevent thrombosis in the circuits used for extracorporeal circulation. The aim of this study was, initially, to develop a population pharmacokinetic/pharmacodynamic (PK/PD) model to assess the variability of PK/PD parameters and their correlation with the results of the routine haemostatic test activated clotting time (ACT) and thereafter to develop a Bayesian estimator enabling an individualized dosing strategy...
May 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28507572/transient-dilutional-acidosis-but-no-lactic-acidosis-upon-cardiopulmonary-bypass-in-patients-undergoing-coronary-artery-bypass-grafting
#10
Johanna Katharina Teloh, Daniel-Sebastian Dohle, Serhat Sönmez, Konstantinos Tsagakis, Rabea Verhaegh, Miriam Petersen, Heinz Jakob, Herbert de Groot
INTRODUCTION: Dilutional acidosis may result from the introduction of a large fluid volume into the patients' systemic circulation, resulting in a considerable dilution of endogenous bicarbonate in the presence of a constant carbon dioxide partial pressure. Its significance or even existence, however, has been strongly questioned. Blood gas samples of patients operated on with standard cardiopulmonary bypass (CPB) were analyzed in order to provide further evidence for the existence of dilutional acidosis...
April 1, 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28506542/coronary-sinus-isoflurane-concentration-in-cardiac-surgery
#11
Ka Ting Ng, R Peter Alston, George Just, Chris McKenzie
OBJECTIVE: Volatile anesthetic agents such as isoflurane may be associated with fewer adverse myocardial events compared with total intravenous anesthesia in cardiac surgery. The authors aimed to determine whether reasonable isoflurane concentrations at tissue level were being achieved to protect the myocardium using this agent. The isoflurane concentration in myocardium has never been measured. The primary aim was to sample coronary sinus (CS) blood and measure its isoflurane concentration...
March 9, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28496946/alpha-alumina-nanoparticle-conjugation-to-cysteine-peptidase-a-and-b-an-efficient-method-for-autophagy-induction
#12
Fatemeh Beyzay, Ahmad Zavaran Hosseini, Sara Soudi
BACKGROUND: Autophagy as a cellular pathway facilitates several immune responses against infection. It also eliminates invading pathogens through transferring content between the cytosol and the lysosomal vesicles and contributes to the cross-presentation of exogenous antigens to T lymphocytes via MHC class I pathway. Autophagy induction is one of the main targets for new drugs and future vaccine formulations. Nanoparticles are one of the candidates for autophagy induction. Cysteine Peptidase A (CPA) and Cysteine Peptidase B (CPB) are two members of papain family (Clan CA, family C1) enzyme that have been considered as a virulence factor of Leishmania (L...
April 2017: Avicenna Journal of Medical Biotechnology
https://www.readbyqxmd.com/read/28493083/protective-effects-of-acupuncture-in-cardiopulmonary-bypass-induced-lung-injury-in-rats
#13
Wen Ma, Zigang Li, Zhou Lu, Wenling Tan, Zhewen Zhang, Yajun Li, Zhongwei Yang, Jia Zhou, Huifang Tang, Huashun Cui
Acute lung injury caused by cardiopulmonary bypass (CPB) increases the mortality after cardiac surgery. Our previous clinical study suggested that electroacupuncture (EAc) has a protective effect during CPB, but the mechanism was unclear. So, we design this study to investigate the effects of EAc on CPB-induced lung injury and the underlying mechanism. Male Sprague Dawley rats were randomly divided into control, CPB, and CPB + EAc groups. A lung injury model was created by CPB surgery to serve as the CPB group, and EAc (2/100 Hz) was used before CPB in the CPB + EAc group...
May 10, 2017: Inflammation
https://www.readbyqxmd.com/read/28488229/chronic-prostatitis-and-its-detrimental-impact-on-sperm-parameters-a-systematic-review-and-meta-analysis
#14
R A Condorelli, G Ivan Russo, A E Calogero, G Morgia, S La Vignera
PURPOSE: Prostatitis is a very common urogenital disease of the male with prevalence ranging from 2.2 to 9.7% worldwide. Interestingly, some recent evidences have showed a significant association between chronic prostatitis (CP) and male infertility including a detrimental effect on sperm parameters, reduction of zinc concentration on semen sperm and production of anti-semen antibodies (ASAs). The aim of the current meta-analysis was to evaluate the association between CP and alteration of semen parameters...
May 9, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/28487062/mitochondrial-damps-are-released-during-cardiopulmonary-bypass-surgery-and-are-associated-with-postoperative-atrial-fibrillation
#15
Nicola Sandler, Elzbieta Kaczmarek, Kiyoshi Itagaki, Yi Zheng, Leo Otterbein, Kamal Khabbaz, David Liu, Venkatachalam Senthilnathan, Russell L Gruen, Carl J Hauser
BACKGROUND: Atrial fibrillation (AF) is the most frequent complication of surgery performed on cardiopulmonary bypass (CPB) and recent work associates CPB with postoperative inflammation. We have shown that all tissue injury releases mitochondrial damage associated molecular patterns (mtDAMPs) including mitochondrial DNA (mtDNA). This can act as a direct, early activator of neutrophils (PMN), eliciting a systemic inflammatory response syndrome (SIRS) while suppressing PMN function. Neutrophil Extracellular Traps (NETs) are crucial to host defence...
March 24, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28481998/minimally-invasive-heart-valve-surgery-influence-on-coagulation-and-inflammatory-response%C3%A2
#16
Domenico Paparella, Crescenzia Rotunno, Pietro Guida, Mattia Travascia, Micaela De Palo, Andrea Paradiso, Alessandro Carrozzo, Ruggero Rociola
OBJECTIVES: Minimally invasive valve surgery (MIVS) is associated with improved clinical outcome but longer cardiopulmonary bypass (CPB) time. The aim of the present study is to compare inflammatory and coagulation parameters in patients undergoing minimally invasive or standard valve surgery. METHODS: A prospective non-randomized study was performed enrolling 79 patients undergoing mitral (20 right mini-thoracotomy and 18 standard sternotomy) and aortic valve (20 mini-sternotomy and 21 standard sternotomy) procedures...
May 6, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28481742/ultraprotective-ventilation-during-cpb-protects-the-alveolar-capillary-barrier-in-pulmonary-normotensive-congenital-heart-patients
#17
Ugur Gocen, Atakan Atalay
BACKGROUND: Alveolar-capillary membrane damage develops as a result of the inflammatory effect of cardiopulmonary bypass (CPB). In the presence of a healthy alveolar-capillary barrier, there is little or no surfactant in the blood. The aim of this study was to evaluate the protective effects of ultraprotective ventilation during CPB by measuring serum and bronchoalveolar lavage (BAL) surfactant protein B (SPB) values in congenital heart surgery. METHODS: This prospective study was designed for 46 patients with congenital heart defects...
May 1, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28469127/surgical-experience-of-primary-cardiac-tumor-single-institution-23-year-report
#18
Shuanglei Li, Changqing Gao
BACKGROUND Primary cardiac tumors are rare but have favorable surgical prognosis. Previous studies have been small series studies with limited surgical approaches. To date, few studies have examined the clinical features associated with different surgical procedures. MATERIAL AND METHODS In a search of the cardiovascular surgery database of our institution, we retrospectively identified 225 patients who had cardiac tumor resection from January 1993 to May 2016. The patients' clinical characteristics and operation information were reviewed, and the operation parameters, postoperative complications, and short-term prognosis among robotic, mini-thoracotomy, and conventional procedures in our center were compared...
May 3, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28465122/authentication-of-radial-versus-femoral-arterial-pressure-waveform-derived-cardiac-output-with-transesophageal-echocardiography-derived-cardiac-output-measurements-in-patients-undergoing-on-pump-coronary-bypass-surgery
#19
Madan Mohan Maddali, Niranjan Dilip Waje, Panchatcharam Murthi Sathiya
OBJECTIVE: The aim of this study was to ascertain if arterial waveform-derived cardiac output measurements from radial and femoral cannulation sites were reliable as compared with transesophageal echocardiography (TEE)-derived cardiac output (CO) values, and which of the CO measurements derived from radial and the femoral arterial pressure waveforms closely tracked simultaneously measured TEE-derived CO values. This study also aimed to ascertain if cardiopulmonary bypass (CPB) would impact the accuracy of arterial pressure-derived CO values from either of the 2 sites...
February 3, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28460544/pulmonary-vascular-resistance-index-during-coronary-artery-bypass-surgery-with-aprotinin
#20
Vesa Toikkanen, Timo Rinne, Jari Laurikka, Helena Porkkala, Matti Tarkka, Ari Mennander
Low pulmonary vascular resistance index (PVRI) reflects favorable redundant pulmonary circulation following coronary artery bypass grafting with cardiopulmonary bypass surgery (CPB). This randomized study investigated whether aprotinin given in different modalities impacts PVRI after coronary artery bypass grafting. A total of 40 patients undergoing coronary artery bypass grafting were randomized to four groups according to aprotinin dose: (1) high dose, (2) early low dose, (3) late low dose, and (4) without aprotinin...
May 2, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
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