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https://www.readbyqxmd.com/read/28728718/cardiothoracic-critical-care
#1
REVIEW
Kevin W Lobdell, Douglas W Haden, Kshitij P Mistry
High-value CCC is rapidly evolving to meet the demands of increased patient acuity and to incorporate advances in technology. The high-performing CCC system and culture should aim to learn quickly and continuously improve. CCC demands a proactive, interactive, precise, an expert team, and continuity.
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28728717/team-based-care-the-changing-face-of-cardiothoracic-surgery
#2
REVIEW
Todd C Crawford, John V Conte, Juan A Sanchez
Cardiothoracic surgical care is a team sport. The increased complexity and sophistication of this field have resulted in the development of highly functioning multidisciplinary and interprofessional teams to optimize clinical outcomes. This article provides an overview of a team-based, patient-centric "systems" approach to the care of cardiothoracic surgery patients.
August 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28726359/earplugs-during-the-first-night-after-cardiothoracic-surgery-may-improve-a-fast-track-protocol
#3
Johannes Menger, Bernhard Urbanek, Keso Skhirtladze-Dworschak, Viktoria Wolf, Arabella Fischer, Harald Rinösl, Martin Dworschak
BACKGROUND: Sleep deprivation after major surgery is common and associated with worse outcome. Noise is one important reason for sleep fragmentation, which contributes to enhanced morbidity. The purpose of this work was to evaluate the impact of earplugs on patients' sleep quality during their first night after cardiothoracic surgery to eventually improve an existing fast-track concept. METHODS: Sixty-three patients undergoing cardiothoracic surgery eligible for a postoperative fast- track regimen on our cardiothoracic post anaesthesia care unit (C-PACU) were prospectively included...
July 20, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28718658/the-effect-of-nurse-to-patient-ratios-on-nurse-sensitive-patient-outcomes-in-acute-specialist-units-a-systematic-review-and-meta-analysis
#4
Andrea Driscoll, Maria J Grant, Diane Carroll, Sally Dalton, Christi Deaton, Ian Jones, Daniela Lehwaldt, Gabrielle McKee, Theresa Munyombwe, Felicity Astin
BACKGROUND: Nurses are pivotal in the provision of high quality care in acute hospitals. However, the optimal dosing of the number of nurses caring for patients remains elusive. In light of this, an updated review of the evidence on the effect of nurse staffing levels on patient outcomes is required. AIM: To undertake a systematic review and meta-analysis examining the association between nurse staffing levels and nurse-sensitive patient outcomes in acute specialist units...
July 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28714229/implementing-a-protocol-to-optimize-blood-use-in-a-cardiac-surgery-service-results-of-a-pre-post-analysis-and-the-impact-of-high-volume-blood-users
#5
Juan B Grau, Jacqueline H Fortier, Cyrus Kuschner, Giovanni Ferrari, Mariano E Brizzio, Alex Zapolanski, Richard E Shaw
BACKGROUND: Blood transfusions are a common and costly intervention for cardiac surgery patients. Evidence suggests that a more restrictive transfusion strategy may reduce costs and transfusion-related complications without increasing perioperative morbidity and mortality. STUDY DESIGN AND METHODS: A transfusion-limiting protocol was developed and implemented in a cardiovascular surgery unit. Over a 5-year period, data were collected on patient characteristics, procedures, utilization of blood products, morbidity, and mortality, and these were compared before and after the protocol was implemented...
July 16, 2017: Transfusion
https://www.readbyqxmd.com/read/28713211/early-extubation-in-pediatric-heart-surgery-across-a-spectrum-of-case-complexity-impact-on-hospital-length-of-stay-and-chest-tube-days
#6
Staci Beamer, Sunita Ferns, Lloyd Edwards, Greer Gunther, Jennifer Nelson
Early extubation is increasingly common in congenital heart surgery, but there are limited outcomes data across the spectrum of case complexity. We performed a retrospective review of 201 pediatric operations using cardiopulmonary bypass between 2012 and 2014. Patients extubated in the operating room or immediately on arrival to the ICU were compared to those extubated by traditional protocols. In-hospital mortality, major complications, need for re-intubation, hospital length of stay, and chest-tube days were compared between groups and by Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery Congenital Heart Surgery (STAT) mortality category...
June 2017: Progress in Pediatric Cardiology
https://www.readbyqxmd.com/read/28712521/subclinical-kidney-injury-in-children-receiving-nonsteroidal-anti-inflammatory-drugs-after-cardiac-surgery
#7
Edward Nehus, Ahmad Kaddourah, Michael Bennett, Olivia Pyles, Prasad Devarajan
OBJECTIVE: To investigate the association of nonsteroidal anti-inflammatory drug (NSAID) administration with urinary neutrophil gelatinase-associated lipocalin (NGAL) levels in children following cardiopulmonary bypass (CPB) who did not develop acute kidney injury (AKI). STUDY DESIGN: In this prospective observational study, urinary NGAL levels were investigated in 210 children who underwent cardiothoracic surgery requiring CPB. Children with clinical AKI (defined as an increase in serum creatinine ≥50% from baseline within 72 hours of CPB) were excluded from the analysis...
July 13, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28711585/global-outbreak-of-severe-mycobacterium-chimaera-disease-after-cardiac-surgery-a-molecular-epidemiological-study
#8
Jakko van Ingen, Thomas A Kohl, Katharina Kranzer, Barbara Hasse, Peter M Keller, Anna Katarzyna Szafrańska, Doris Hillemann, Meera Chand, Peter Werner Schreiber, Rami Sommerstein, Christoph Berger, Michele Genoni, Christian Rüegg, Nicolas Troillet, Andreas F Widmer, Sören L Becker, Mathias Herrmann, Tim Eckmanns, Sebastian Haller, Christiane Höller, Sylvia B Debast, Maurice J Wolfhagen, Joost Hopman, Jan Kluytmans, Merel Langelaar, Daan W Notermans, Jaap Ten Oever, Peter van den Barselaar, Alexander B A Vonk, Margreet C Vos, Nada Ahmed, Timothy Brown, Derrick Crook, Theresa Lamagni, Nick Phin, E Grace Smith, Maria Zambon, Annerose Serr, Tim Götting, Winfried Ebner, Alexander Thürmer, Christian Utpatel, Cathrin Spröer, Boyke Bunk, Ulrich Nübel, Guido V Bloemberg, Erik C Böttger, Stefan Niemann, Dirk Wagner, Hugo Sax
BACKGROUND: Since 2013, over 100 cases of Mycobacterium chimaera prosthetic valve endocarditis and disseminated disease were notified in Europe and the USA, linked to contaminated heater-cooler units (HCUs) used during cardiac surgery. We did a molecular epidemiological investigation to establish the source of these patients' disease. METHODS: We included 24 M chimaera isolates from 21 cardiac surgery-related patients in Switzerland, Germany, the Netherlands, and the UK, 218 M chimaera isolates from various types of HCUs in hospitals, from LivaNova (formerly Sorin; London, UK) and Maquet (Rastatt, Germany) brand HCU production sites, and unrelated environmental sources and patients, as well as eight Mycobacterium intracellulare isolates...
July 12, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28705484/is-it-all-about-the-money-not-all-surgical-subspecialization-leads-to-higher-lifetime-revenue-when-compared-to-general-surgery
#9
Maria Baimas-George, Brian Fleischer, Douglas Slakey, Emad Kandil, James R Korndorffer, Christopher DuCoin
OBJECTIVE: It is believed that spending additional years gaining expertise in surgical subspecialization leads to higher lifetime revenue. Literature shows that more surgeons are pursuing fellowship training and dedicated research years; however, there are no data looking at the aggregate economic impact when training time is accounted for. It is hypothesized that there will be a discrepancy in lifetime income when delay to practice is considered. DESIGN: Data were collected from the Medical Group Management Association's 2015 report of average annual salaries...
July 10, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28705074/factors-associated-with-severity-of-sleep-apnoea-syndrome-in-patients-with-chronic-kidney-disease
#10
Akihito Tanaka, Daijo Inaguma, Eri Ito, Naoki Kamegai, Akiko Kato, Minami Mizutani, Hiroya Shimogushi, Hibiki Shinjo, Yasuhiro Otsuka, Asami Takeda
Background In patients with chronic kidney disease (CKD), prevalence of sleep apnoea syndrome (SAS) is reported to be markedly high. However, the factors associated with severity of SAS in such patients rarely have been reported. Methods This was a cross-sectional study of 100 stable non-dialysis patients with CKD who attended a CKD educational programme from April 2014 to August 2015. Diagnosis of SAS and its severity were assessed using a type-3 portable monitor. Results Eighty-six men and 14 women with a mean age of 71...
July 14, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28696880/performance-of-pediatric-risk-of-mortality-score-among-critically-ill-children-with-heart-disease
#11
Rebecca A Russell, Mallikarjuna Rettiganti, Nancy Brundage, Howard E Jeffries, Punkaj Gupta
OBJECTIVE: To evaluate the performance of the Pediatric Risk of Mortality 3 (PRISM-3) score in critically ill children with heart disease. METHODS: Patients <18 years of age admitted with cardiac diagnoses (cardiac medical and cardiac surgical) to one of the participating pediatric intensive care units in the Virtual Pediatric Systems, LLC, database were included. Performance of PRISM-3 was evaluated with discrimination and calibration measures among both cardiac surgical and cardiac medical patients...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28695972/the-incidence-of-postoperative-pneumonia-in-various-surgical-subspecialties-a-dual-database-analysis
#12
Morad Chughtai, Chukwuweike U Gwam, Anton Khlopas, Jared M Newman, Gannon L Curtis, Pedro A Torres, Rafay Khan, Michael A Mont
INTRODUCTION: Pneumonia is the third most common postoperative complication. However, its epidemiology varies widely and is often difficult to assess. For a better understanding, we utilized two national databases to determine the incidence of postoperative pneumonia after various surgical procedures. Specifically, we used the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) and the Nationwide Inpatient Sample (NIS) to determine the incidence and yearly trends of postoperative pneumonia following orthopaedic, urologic, otorhinolaryngologic, cardiothoracic, neurosurgery, and general surgeries...
July 11, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28688940/thoracostomy-tube-removal-implementation-of-a-multidisciplinary-procedural-pain-management-guideline
#13
Lisa M Ring, Anne Watson
OBJECTIVE: Thoracostomy tubes are placed following cardiothoracic surgery for the repair or palliation of congenital heart defects. The aim of this project was to develop and implement a clinical practice guideline for the provision of optimal analgesia during removal of thoracostomy tubes in pediatric postoperative cardiothoracic surgery patients. METHODS: Methods used include a nonexperimental design utilizing chart audits to determine baseline documentation as well as procedure note evaluation to determine both baseline documentation and compliance with the new guideline...
July 6, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28686356/relaxing-responses-to-hydrogen-peroxide-and-nitric-oxide-in-human-pericardial-resistance-arteries-stimulated-with-endothelin-1
#14
Thomas M Leurgans, Maria Bloksgaard, Akhmadjon Irmukhamedov, Lars P Riber, Jo G R De Mey
In human pericardial resistance arteries, effects of the endothelium-dependent vasodilator bradykinin are mediated by NO during contraction induced by K(+) or the TxA2 analogue U46619 and by H2 O2 during contraction by endothelin-1 (ET-1), respectively. We tested the hypotheses that ET-1 reduces relaxing effects of NO and increases those of H2 O2 in resistance artery smooth muscle of patients with cardiovascular disease. Arterial segments, dissected from the parietal pericardium of 39 cardiothoracic surgery patients, were studied by myography during amplitude-matched contractions induced by K(+) , the TXA2 analogue U46619 or ET-1...
July 7, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28683753/two-stage-correction-of-type-iv-total-anomalous-pulmonary-venous-connection
#15
Hunbo Shim, Ji-Hyuk Yang, Tae-Gook Jun
BACKGROUND: The small size of the pulmonary veins in infants increases the risk of pulmonary vein obstruction (PVO) after surgical repair of type IV total anomalous pulmonary venous connection (TAPVC). Here, we described the outcomes of our strategy, which delayed total correction after initial partial correction. METHODS: We reviewed the data of patients who underwent total correction for type IV TAPVC. In total, 11 out of 103 patients with TAPVC had type IV TAPVC with biventricular physiology...
July 6, 2017: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/28681054/establishment-of-a-minimally-invasive-cardiac-surgery-programme-in-singapore
#16
Theo Kofidis, Guohao Chang, Chuen Neng Lee
In Singapore, although minimally invasive cardiac surgery is available, it is not widely practised. Local surgeons have pioneered technologies in Singapore following their launch in the West and introduced them, addressing various heart pathologies. However, the unique position and function of Singapore in the region, the structure and dynamics of cardiothoracic surgery practice in government centres and private practice, and the overall small volume of patients in the country may pose limitations, in spite of all possibilities, in thriving and sharing of such new technologies...
July 6, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28678115/a-theoretical-model-of-flow-disruptions-for-the-anesthesia-team-during-cardiovascular-surgery
#17
Albert Boquet, Tara Cohen, Fawaaz Diljohn, Jennifer Cabrera, Scott Reeves, Scott Shappell
OBJECTIVES: This investigation explores flow disruptions observed during cardiothoracic surgery and how they serve to disconnect anesthesia providers from their primary task. We can improve our understanding of this disengagement by exploring what we call the error space or the accumulated time required to resolve disruptions. METHODS: Trained human factors students observed 10 cardiac procedures for disruptions impacting the anesthesia team and recorded the time required to resolve these events...
July 3, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28677097/erratum-to-the-cardiothoracic-ratio-and-all-cause-and-cardiovascular-disease-mortality-in-patients-undergoing-maintenance-hemodialysis-results-of-the-mbd-5d-study
#18
Hiroaki Ogata, Junji Kumasawa, Shingo Fukuma, Masahide Mizobuchi, Eriko Kinugasa, Masafumi Fukagawa, Shunichi Fukuhara, Tadao Akizawa
No abstract text is available yet for this article.
July 4, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28673776/private-practice-radiologist-subspecialty-classification-using-medicare-claims
#19
Andrew B Rosenkrantz, Wenyi Wang, Sudheshna Bodapati, Danny R Hughes, Richard Duszak
PURPOSE: The aim of this study was to assess both existing Medicare provider code assignments and a new claims-based system for subspecialty classification of private practice radiologists. METHODS: Websites of the 100 largest US radiology private practices were used to identify 1,476 radiologists self-identified with a single subspecialty ([1] abdominal, [2] breast, [3] cardiothoracic, or [4] musculoskeletal imaging; [5] nuclear medicine; [6] interventional radiology; [7] neuroradiology)...
June 30, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28669788/the-effect-of-gender-on-resident-autonomy-in-the-operating-room
#20
Shari L Meyerson, Joel M Sternbach, Joseph B Zwischenberger, Edward M Bender
OBJECTIVE: Discrimination against women training in medicine and surgery has been subjectively described for decades. This study objectively documents gender differences in the degree of autonomy given to thoracic surgery trainees in the operating room. DESIGN: Thoracic surgery residents and faculty underwent frame of reference training on the use of the 4-point Zwisch scale to measure operative autonomy. Residents and faculty then submitted evaluations of their perception of autonomy granted for individual operations as well as operative difficulty on a real-time basis using the "Zwisch Me!!" mobile application...
June 29, 2017: Journal of Surgical Education
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