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Clinical Practice Guidelines for Cardiopulmonary Bypass

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https://www.readbyqxmd.com/read/26543248/the-society-of-thoracic-surgeons-the-society-of-cardiovascular-anesthesiologists-and-the-american-society-of-extracorporeal-technology-clinical-practice-guidelines-for-cardiopulmonary-bypass-temperature-management-during-cardiopulmonary-bypass
#1
Richard Engelman, Robert A Baker, Donald S Likosky, Alina Grigore, Timothy A Dickinson, Linda Shore-Lesserson, John W Hammon
To improve our understanding of the evidence-based literature supporting temperature management during adult cardiopulmonary bypass, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiology and the American Society of ExtraCorporeal Technology tasked the authors to conduct a review of the peer-reviewed literature, including 1) optimal site for temperature monitoring, 2) avoidance of hyperthermia, 3) peak cooling temperature gradient and cooling rate, and 4) peak warming temperature gradient and rewarming rate...
September 2015: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/26279227/the-society-of-thoracic-surgeons-the-society-of-cardiovascular-anesthesiologists-and-the-american-society-of-extracorporeal-technology-clinical-practice-guidelines-for-cardiopulmonary-bypass-temperature-management-during-cardiopulmonary-bypass
#2
REVIEW
Richard Engelman, Robert A Baker, Donald S Likosky, Alina Grigore, Timothy A Dickinson, Linda Shore-Lesserson, John W Hammon
UNLABELLED: In order to improve our understanding of the evidence-based literature supporting temperature management during adult cardiopulmonary bypass, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiology and the American Society of ExtraCorporeal Technology tasked the authors to conduct a review of the peer-reviewed literature, including: 1) optimal site for temperature monitoring, 2) avoidance of hyperthermia, 3) peak cooling temperature gradient and cooling rate, and 4) peak warming temperature gradient and rewarming rate...
August 2015: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/26234862/the-society-of-thoracic-surgeons-the-society-of-cardiovascular-anesthesiologists-and-the-american-society-of-extracorporeal-technology-clinical-practice-guidelines-for-cardiopulmonary-bypass-temperature-management-during-cardiopulmonary-bypass
#3
Richard Engelman, Robert A Baker, Donald S Likosky, Alina Grigore, Timothy A Dickinson, Linda Shore-Lesserson, John W Hammon
In order to improve our understanding of the evidence-based literature supporting temperature management during adult cardiopulmonary bypass, The Society of Thoracic Surgeons, the Society of Cardiovascular Anesthesiology and the American Society of ExtraCorporeal Technology tasked the authors to conduct a review of the peer-reviewed literature, including: 1) optimal site for temperature monitoring, 2) avoidance of hyperthermia, 3) peak cooling temperature gradient and cooling rate, and 4) peak warming temperature gradient and rewarming rate...
August 2015: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/25790208/anesthetic-management-during-cardiopulmonary-bypass-a-systematic-review
#4
REVIEW
Aaron E Barry, Mark A Chaney, Martin J London
Cardiopulmonary bypass (CPB) required for cardiac surgery presents unique challenges to the cardiac anesthesiologist responsible for providing the 3 most basic facets of any anesthetic: amnesia, analgesia, and muscle relaxation. Unique pathophysiologic changes during CPB result in pharmacokinetic alterations that impact the serum and tissue concentrations of IV and volatile anesthetics. Similarly, CPB causes pharmacodynamic alterations that impact anesthetic efficacy. The clinical significance of these alterations represents a "moving target" as practice evolves and the technology of CPB circuitry advances...
April 2015: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/25383671/platelet-transfusion-a-clinical-practice-guideline-from-the-aabb
#5
Richard M Kaufman, Benjamin Djulbegovic, Terry Gernsheimer, Steven Kleinman, Alan T Tinmouth, Kelley E Capocelli, Mark D Cipolle, Claudia S Cohn, Mark K Fung, Brenda J Grossman, Paul D Mintz, Barbara A O'Malley, Deborah A Sesok-Pizzini, Aryeh Shander, Gary E Stack, Kathryn E Webert, Robert Weinstein, Babu G Welch, Glenn J Whitman, Edward C Wong, Aaron A R Tobian
BACKGROUND: The AABB (formerly, the American Association of Blood Banks) developed this guideline on appropriate use of platelet transfusion in adult patients. METHODS: These guidelines are based on a systematic review of randomized, clinical trials and observational studies (1900 to September 2014) that reported clinical outcomes on patients receiving prophylactic or therapeutic platelet transfusions. An expert panel reviewed the data and developed recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework...
February 3, 2015: Annals of Internal Medicine
https://www.readbyqxmd.com/read/24869619/does-regional-variation-impact-decision-making-in-the-management-and-palliation-of-pancreatic-head-adenocarcinoma-results-from-an-international-survey
#6
Valerie Hurdle, Jean-Francois Ouellet, Elijah Dixon, Thomas J Howard, Keith D Lillemoe, Charles M Vollmer, Francis R Sutherland, Chad G Ball
BACKGROUND: Management and palliation of pancreatic head adenocarcinoma is challenging. End-of-life decision-making is a variable process involving multiple factors. METHODS: We conducted a qualitative, physician-based, 40-question international survey characterizing the impact of medical, religious, social, training and system factors on care. RESULTS: A total of 258 international clinicians completed the survey. Respondents were typically fellowship-trained (78%), with a mean of 16 years' experience in a university-affiliated (93%) hepato-pancreato-biliary group (96%) practice...
June 2014: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/24440007/the-year-in-cardiothoracic-and-vascular-anesthesia-selected-highlights-from-2013
#7
REVIEW
Harish Ramakrishna, Benjamin A Kohl, Jacob T Gutsche, Jens Fassl, Prakash A Patel, Hynek Riha, Kamrouz Ghadimi, William J Vernick, Michael Andritsos, George Silvay, John G T Augoustides
This article reviewed selected research highlights of 2013 that pertain to the specialty of cardiothoracic and vascular anesthesia. The first major theme is the commemoration of the sixtieth anniversary of the first successful cardiac surgical procedure with cardiopulmonary bypass conducted by Dr Gibbon. This major milestone revolutionized the practice of cardiovascular surgery and invigorated a paradigm of mechanical platforms for contemporary perioperative cardiovascular practice. Dr Kolff was also a leading contributor in this area because of his important contributions to the refinement of cardiopulmonary bypass and mechanical ventricular assistance...
February 2014: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/24303597/report-from-amsect-s-international-consortium-for-evidence-based-perfusion-american-society-of-extracorporeal-technology-standards-and-guidelines-for-perfusion-practice-2013
#8
Robert A Baker, Shahna L Bronson, Timothy A Dickinson, David C Fitzgerald, Donald S Likosky, Nicholas B Mellas, Kenneth G Shann
UNLABELLED: One of the roles of a professional society is to develop standards and guidelines of practice as an instrument to guide safe and effective patient care. The American Society of Extracorporeal Technology (AmSECT) first published its Essentials for Perfusion Practice, Clinical Function: Conduct of Extracorporeal Circulation in 1993. The International Consortium for Evidence-Based Perfusion (ICEBP), a committee within AmSECT, was tasked with updating this document in 2010. The aim of this report is to describe the method of development and content of AmSECT's new professional standards and guidelines...
September 2013: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/24176099/the-impact-of-continuous-haemofiltration-with-high-volume-fluid-exchange-during-cardiopulmonary-bypass-surgery-on-the-recovery-of-patients-with-impaired-renal-function-a-pilot-randomised-trial
#9
RANDOMIZED CONTROLLED TRIAL
B Matata, N Mediratta, M Morgan, S Shirley, N Scawn, I Kemp, R Stables, A Haycox, R Houten, S Richards, C McLeod, S Lane, A Sharma, K Wilson
BACKGROUND: There is widespread variability in clinical practice within cardiac surgery units worldwide on the use of haemofiltration. The clinical impact and safety of this modality is, however, unknown. OBJECTIVES: The primary pilot trial objectives were as follows: to assess the feasibility of randomising 60 patients with impaired kidney function undergoing on-pump coronary artery bypass graft (CABG) surgery within 6 months; to assess the suitability and reliability of our chosen outcome measures; to explore issues that may impact on recruitment into a definitive trial; and to undertake an exploratory economic evaluation...
October 2013: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/24151752/prevention-and-management-of-potential-adverse-events-during-transapical-aortic-valve-replacement
#10
REVIEW
Ludwig K von Segesser, Gino Gerosa, Michael A Borger, Enrico Ferrari
BACKGROUND AND AIM OF THE STUDY: Transapical transcatheter aortic valve replacement (TAVR) is a new minimally invasive technique with a known risk of unexpected intra-procedural complications. Nevertheless, the clinical results are good and the limited amount of procedural adverse events confirms the usefulness of a synergistic surgical/anesthesiological management in case of unexpected emergencies. METHODS: A review was made of the authors' four-year database and other available literature to identify major and minor intra-procedural complications occurring during transapical TAVR procedures...
May 2013: Journal of Heart Valve Disease
https://www.readbyqxmd.com/read/24025294/nice-thromboprophylaxis-guidelines-are-not-associated-with-increased-pericardial-effusion-after-surgery-of-the-proximal-thoracic-aorta
#11
I A Rahman, A Hussain, A Davies, A J Bryan
INTRODUCTION: In 2010 the National Institute for Health and Clinical Excellence (NICE) released guidelines on venous thromboembolism. Strategy focused on risk assessment, antiembolic stockings, sequential compression devices, subcutaneous high dose enoxaparin (40 mg), early mobilisation and hydration. The 40 mg enoxaparin dose over the previous 20 mg regimen was worrisome, and its effect on pericardial effusion rates and mortality in proximal aortic surgery was investigated. METHODS: Proximal aortic reconstructions performed between December 2008 and April 2011 were identified from prospectively collected data in a tertiary centre database...
September 2013: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/23930380/has-the-new-usp-assay-for-heparin-affected-dosage-for-patients-undergoing-cardiopulmonary-bypass
#12
Daniel A Anderson, David W Holt
In October 2009, the U.S. Pharmacopoeia (USP) changed the monograph for heparin to bring USP units in line with international units for heparin. The result was a 10% decrease in potency as measured by in vitro laboratory tests. This decrease led to questions regarding dosing guidelines. There existed a need for an in vivo study to determine the practical changes that may need to be implemented in regard to heparin administration for cardiopulmonary bypass in the clinical setting. A retrospective study was conducted to determine the heparin dose administered and the corresponding effect on patients undergoing coronary artery bypass grafting surgery using cardiopulmonary bypass...
June 2013: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/23690340/clinical-decision-support-for-perioperative-information-management-systems
#13
REVIEW
Jonathan P Wanderer, Jesse M Ehrenfeld
Clinical decision support (CDS) systems are being used to optimize the increasingly complex care that our health care system delivers. These systems have become increasingly important in the delivery of perioperative care for patients undergoing cardiac, thoracic, and vascular procedures. The adoption of perioperative information management systems (PIMS) has allowed these technologies to enter the operating room and support the clinical work flow of anesthesiologists and operational processes. Constructing effective CDS systems necessitates an understanding of operative work flow and technical considerations as well as achieving integration with existing information systems...
December 2013: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/23123988/drug-devices-technologies-and-techniques-for-blood-management-in-minimally-invasive-and-conventional-cardiothoracic-surgery-a-consensus-statement-from-the-international-society-for-minimally-invasive-cardiothoracic-surgery-ismics-2011
#14
Alan H Menkis, Janet Martin, Davy C H Cheng, David C Fitzgerald, John J Freedman, Changqing Gao, Andreas Koster, G Scott Mackenzie, Gavin J Murphy, Bruce Spiess, Niv Ad
OBJECTIVE: The objectives of this consensus conference were to evaluate the evidence for the efficacy and safety of perioperative drugs, technologies, and techniques in reducing allogeneic blood transfusion for adults undergoing cardiac surgery and to develop evidence-based recommendations for comprehensive perioperative blood management in cardiac surgery, with emphasis on minimally invasive cardiac surgery. METHODS: The consensus panel short-listed the potential topics for review from a comprehensive list of potential drugs, devices, technologies, and techniques...
July 2012: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/23123542/approach-to-hypophosphataemia-in-intensive-care-units-a-nationwide-survey
#15
D A Geerse, A J Bindels, M A Kuiper, A N Roos, P E Spronk, M J Schultz
BACKGROUND: Evidence-based guidelines for monitoring of serum phosphate levels and for the treatment of hypophosphataemia in critically ill patients are lacking. The aim of this survey was to evaluate current practice with respect to diagnosis and treatment of hypophosphataemia in critically ill patients among intensive care unit (ICU) physicians in the Netherlands. METHODS: A survey was conducted among all hospitals with an ICU in the Netherlands. Paediatric ICUs were excluded from participation...
November 2012: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/23006704/protecting-the-infant-brain-during-cardiac-surgery-a-systematic-review
#16
REVIEW
Jennifer C Hirsch, Marshall L Jacobs, Dean Andropoulos, Erle H Austin, Jeffrey P Jacobs, Daniel J Licht, Frank Pigula, James S Tweddell, J William Gaynor
Prevention of brain injury during congenital heart surgery has focused on intraoperative and perioperative neuroprotection and neuromonitoring. Many strategies have been adopted as "standard of care." However, the strength of evidence for these practices and the relationship to long-term outcomes are unknown. We performed a systematic review (January 1, 1990 to July 30, 2010) of neuromonitoring and neuroprotection strategies during cardiopulmonary bypass (CPB) in infants of age 1 year or less. Papers were graded individually and as thematic groups, assigning evidence-based medicine and American College of Cardiology/American Heart Association (ACC/AHA) level of evidence grades...
October 2012: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/22730861/developing-a-benchmarking-process-in-perfusion-a-report-of-the-perfusion-downunder-collaboration
#17
Robert A Baker, Richard F Newland, Carmel Fenton, Michael McDonald, Timothy W Willcox, Alan F Merry
Improving and understanding clinical practice is an appropriate goal for the perfusion community. The Perfusion Downunder Collaboration has established a multi-center perfusion focused database aimed at achieving these goals through the development of quantitative quality indicators for clinical improvement through benchmarking. Data were collected using the Perfusion Downunder Collaboration database from procedures performed in eight Australian and New Zealand cardiac centers between March 2007 and February 2011...
March 2012: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/22490369/surgical-ablation-for-atrial-fibrillation
#18
REVIEW
Nikolaos Fragakis, Ioannis Pantos, Jenan Younis, Marios Hadjipavlou, Demosthenes G Katritsis
This paper reviews the history of surgical procedures developed for eradication of atrial fibrillation (AF) during cardiac surgery for structural heart disease, and in patients with AF without other indication for cardiac surgery. Current evidence indicates that, despite their proven efficacy, the Cox-Maze procedure and its modifications require cardiopulmonary bypass and cannot be easily justified in the case of AF without other indication for cardiac surgery. In patients undergoing cardiac surgery for mitral valve disease, concomitant ablation techniques using modifications of the Maze and alternative energy sources appear to be safe and effective in treating AF, especially in non-rheumatic disease...
November 2012: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/22459238/cardiac-surgery-and-heparin-induced-thrombocytopaenia-hit-a-case-report-and-short-review
#19
REVIEW
W J McMeniman, R B Chard, J Norrie, J Posen
This patient presented for emergency cardiac surgery following two episodes of thrombocytopaenia, one before and one associated with exposure to unfractionated heparin in a seven-week period of intensive care management. Although the diagnosis of heparin induced thrombocytopaenia (HIT) was uncertain on clinical grounds when assessed by current criteria, the positive antibody status directed management in accordance with the internationally recognised guidelines published by the American College of Chest Physicians (ACCP) Evidence-based Clinical Practice Guidelines...
May 2012: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/22307394/optimal-intraoperative-anticoagulation-strategy-in-patients-undergoing-off-pump-coronary-artery-bypass
#20
REVIEW
Sonia Rasoli, Mohamed Zeinah, Thanos Athanasiou, Antonios Kourliouros
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was what the optimal intraoperative anticoagulation strategy should be in patients undergoing off-pump coronary artery bypass graft (CABG) surgery. A total of 157 papers were identified using the reported search, of which 8 were judged to represent the best evidence. The authors, journal, date, country of publication, study type, patient group studied, relevant outcomes and results were tabulated...
May 2012: Interactive Cardiovascular and Thoracic Surgery
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