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cardiopulmonary bypass and cardiac surgery

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https://www.readbyqxmd.com/read/28098429/natural-history-of-nonimmune-mediated-thrombocytopenia-and-acute-kidney-injury-in-pediatric-open-heart-surgery
#1
Shannon Tew, Manuel L Fontes, Nathaniel H Greene, Miklos D Kertai, George Ofori-Amanfo, Robert D B Jaquiss, Andrew J Lodge, Warwick A Ames, Hercilia Mayumi Homi, Kelly A Machovec, Edmund H Jooste
OBJECTIVE: Thrombocytopenia and acute kidney injury (AKI) are common following pediatric cardiac surgery with cardiopulmonary bypass (CPB). However, the relationship between postoperative nadir platelet counts and AKI has not been investigated in the pediatric population. Our objective was to investigate this relationship and examine independent predictors of AKI. DESIGN: After IRB approval, we performed a retrospective review of the institution's medical records and database...
January 18, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28096823/comparison-of-del-nido-cardioplegia-and-st-thomas-hospital-solution-two-types-of-cardioplegia-in-adult-cardiac-surgery
#2
Prashant Mishra, Ranjit B Jadhav, Chandan Kumar Ray Mohapatra, Jayant Khandekar, Chaitanya Raut, Ganesh Kumar Ammannaya, Harsh S Seth, Jaskaran Singh, Vaibhav Shah
INTRODUCTION: St. Thomas' cardioplegic solution No. 2 (ST), although most widely used in adult cardiac surgery, needs to be given at short intervals, causing additional myocardial injury. AIM: To determine whether del Nido (DN) cardioplegia, with longer periods of arrest, provides equivalent myocardial protection as compared to ST. MATERIAL AND METHODS: The study population comprised 100 patients who underwent elective coronary artery bypass grafting (CABG) or double valve replacement (DVR) surgery between January 2015 and January 2016...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28095748/myocardial-inactivation-of-thyroid-hormones-in-patients-with-aortic-stenosis
#3
Bruno Paolino, Pablo Maria Pomerantzeff, Luiz Alberto O Dallan, Fabio Antonio Gaiotto, Nailliw Zanini Preite, Ana Claudia Latronico, Jose Carlos Nicolau, Antonio Carlos Bianco, Roberto Giraldez
OBJECTIVE: To study myocardial thyroid hormone metabolism in patients with aortic valve stenosis (AS) undergoing aortic valve replacement and in patients with coronary artery disease (CAD) undergoing coronary artery bypass grafting surgery. CONTEXT: The human heart expresses the type 2 deiodinase (D2) that activates T4 to T3. At the same time, the inactivating type 3 deiodinase (D3) has been found in a rat model of right ventricular hypertrophy. It is not known whether the human myocardium metabolizes thyroid hormone...
January 17, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28092320/does-a-platelet-transfusion-independently-affect-bleeding-and-adverse-outcomes-in-cardiac-surgery
#4
Fabienne M A van Hout, Esther K Hogervorst, Peter M J Rosseel, Johanna G van der Bom, Mohamed Bentala, Eveline L A van Dorp, Nan van Geloven, Anneke Brand, Nardo J M van der Meer, Leo M G van de Watering
BACKGROUND: Conflicting results have been reported concerning the effect of platelet transfusion on several outcomes. The aim of this study was to assess the independent effect of a single early intraoperative platelet transfusion on bleeding and adverse outcomes in cardiac surgery patients. METHODS: For this observational study, 23,860 cardiac surgery patients were analyzed. Patients who received one early (shortly after cardiopulmonary bypass while still in the operating room) platelet transfusion, and no other transfusions, were defined as the intervention group...
January 16, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28089142/bedside-monitoring-of-cerebral-energy-state-during-cardiac-surgery-a-novel-approach-utilizing-intravenous-microdialysis
#5
Simon Mölström, Troels H Nielsen, Claus Andersen, Carl H Nordström, Palle Toft
OBJECTIVES: This study investigated whether the lactate-to-pyruvate (LP) ratio obtained by microdialysis (MD) of the cerebral venous outflow reflected a derangement of global cerebral energy state during cardiopulmonary bypass (CPB). DESIGN: Interventional, prospective, randomized study. SETTING: Single-center, university teaching hospital. PARTICIPANTS: The study included 10 patients undergoing primary, elective coronary artery bypass grafting...
November 2, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28081351/the-effect-of-methylprednisolone-treatment-on-fibrinolysis-thecoagulation-system-and-blood-loss-in-cardiac-surgery
#6
Leila Ebrahimi, Maryam Kheirandish, Mahnoosh Foroughi
BACKGROUND/AIM: The purpose of this study was to examine steroid pretreatment in order to decrease postoperative coagulopathy disorders and bleeding. MATERIALS AND METHODS: In this randomized double-blinded study, the efficacy of low versus high doses of methylprednisolone on the coagulation system and postoperative bleeding was compared in patients who were undergoing cardiac surgery with cardiopulmonary bypass (CPB). The platelet response to agonists, D-dimer concentration, tissue plasminogen activator (tPA), plasminogen activator inhibitor (PAI-1) antigens, and platelet receptors CD42b, CD62P, and CD41a were evaluated...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28077532/modern-hydroxyethyl-starch-and-acute-kidney-injury-after-cardiac-surgery-a-prospective-multicentre-cohort
#7
M Vives, R Callejas, P Duque, G Echarri, D N Wijeysundera, A Hernandez, A Sabate, M Bes-Rastrollo, P Monedero
BACKGROUND: Recent trials have shown hydroxyethyl starch (HES) solutions increase the risk of acute kidney injury (AKI) in critically ill patients. It is uncertain whether these adverse effects also affect surgical patients. We sought to determine the renal safety of modern tetrastarch (6% HES 130/0.4) use in cardiac surgical patients. METHODS: In this multicentre prospective cohort study, 1058 consecutive patients who underwent cardiac surgery from 15th September 2012 to 15th December 2012 were recruited in 23 Spanish hospitals...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077530/impact-of-balanced-tetrastarch-raw-material-on-perioperative-blood-loss-a-randomized-double-blind-controlled-trial
#8
A Joosten, R Tircoveanu, S Arend, P Wauthy, P Gottignies, P Van der Linden
BACKGROUND: As 6% hydroxyethyl starch (HES) 130/0.40 or 130/0.42 can originate from different vegetable sources, they might have different clinical effects. The purpose of this prospective, randomized, double-blind controlled trial was to compare two balanced tetrastarch solutions, one maize-derived and one potato-derived, on perioperative blood loss in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). METHODS: We randomly assigned 118 patients undergoing elective cardiac surgery into two groups, to receive either a maize- or a potato-derived HES solution...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28077517/two-phase-hospital-associated-outbreak-of-mycobacterium-abscessus-investigation-and-mitigation
#9
Arthur W Baker, Sarah S Lewis, Barbara D Alexander, Luke F Chen, Richard J Wallace, Barbara A Brown-Elliott, Pamela J Isaacs, Lisa C Pickett, Chetan B Patel, Peter K Smith, John M Reynolds, Jill Engel, Cameron R Wolfe, Carmelo A Milano, Jacob N Schroder, Robert D Davis, Matthew G Hartwig, Jason E Stout, Nancy Strittholt, Eileen K Maziarz, Jennifer Horan Saullo, Kevin C Hazen, Richard J Walczak, Ravikiran Vasireddy, Sruthi Vasireddy, Celeste M McKnight, Deverick J Anderson, Daniel J Sexton
BACKGROUND: Nontuberculous mycobacteria (NTM) commonly colonize municipal water and cause healthcare-associated outbreaks. We investigated a biphasic outbreak of Mycobacterium abscessus at a tertiary care hospital. METHODS: Case patients had recent hospital exposure and laboratory-confirmed colonization or infection with M. abscessus from January 2013 through December 2015. We conducted a multidisciplinary epidemiologic, field, and laboratory investigation. RESULTS: The incidence rate of M...
January 11, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28075500/very-short-short-term-benefit-of-inpatient-outpatient-cardiac-rehabilitation-programs-after-coronary-artery-bypass-grafting-surgery
#10
Dejan Spiroski, Mojsije Andjić, Olivera Ilić Stojanović, Milica Lazović, Ana Djordjević Dikić, Miodrag Ostojić, Branko Beleslin, Snežana Kostić, Marija Zdravković, Dragan Lović
BACKGROUND: Exercise-based rehabilitation is an important part of treatment patients following coronary artery bypass graft (CABG) surgery. HYPOTHESIS: To evaluate effect of very short/short-term exercise training on cardiopulmonary exercise testing (CPET) parameters. METHODS: We studied 54 consecutive patients with myocardial infarction (MI) treated with CABG surgery referred for rehabilitation. The study population consisted of 50 men and 4 women (age 57...
January 11, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28074820/airway-management-of-the-cardiac-surgical-patients-current-perspective
#11
REVIEW
Arindam Choudhury, Nishkarsh Gupta, Rohan Magoon, Poonam Malhotra Kapoor
The difficult airway (DA) is a common problem encountered in patients undergoing cardiac surgery. However, the challenge is not only just establishment of airway but also maintaining a definitive airway for the safe conduct of cardiopulmonary bypass from initiation to weaning after surgical correction or palliation, de-airing of cardiac chambers. This review describes the management of the DA in a cardiac theater environment. The primary aims are recognition of DA both anatomical and physiological, necessary preparations for (and management of) difficult intubation and extubation...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074792/remifentanil-prevents-increases-of-blood-glucose-and-lactate-levels-during-cardiopulmonary-bypass-in-pediatric-cardiac-surgery
#12
Tomohiro Chaki, Yuko Nawa, Keishi Tamashiro, Eri Mizuno, Naoyuki Hirata, Michiaki Yamakage
INTRODUCTION: Cardiopulmonary bypass (CPB) can cause stress response that increases levels of cytokine and catecholamine in plasma, resulting in hyperglycemia. In adults, it has been demonstrated that remifentanil infusion during CPB could prevent increases of cytokine, catecholamine, and blood glucose levels, but such effects of remifentanil in children have not been elucidated. AIM: In this study, we investigated the preventive effects of remifentanil on blood glucose and lactate levels during CPB in children...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074790/incidence-and-progression-of-cardiac-surgery-associated-acute-kidney-injury-and-its-relationship-with-bypass-and-cross-clamp-time
#13
Habib Md Reazaul Karim, Mohd Yunus, Manuj Kumar Saikia, Jyoti Prasad Kalita, Mrinal Mandal
INTRODUCTION: Cardiac surgery-associated kidney injury (CSA-AKI) is common but relatively less is known about its progression. The present study is aimed at evaluating the incidence and course of CSA-AKI and its relationship with the different durations of cardiopulmonary bypass (CPB) and cross clamp times. MATERIALS AND METHODS: Occurrences of CSA-AKI are evaluated as per the Akin Kidney Injury Network (AKIN) criteria over the course of 5 postoperative day (POD) in 100 patients...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28072936/haptoglobin-and-free-haemoglobin-during-cardiac-surgery-is-there-a-link-to-acute-kidney-injury
#14
A J Wetz, E M Richardt, H Schotola, M Bauer, A Bräuer
Acute kidney injury (AKI) is frequently observed after cardiac surgery (CS) with cardiopulmonary bypass (CPB). Multiple mechanisms underlie this phenomenon, including CPB-dependent haemolysis. Haemoglobin is released during haemolysis, and free haemoglobin (frHb) causes tubular cell injury after exceeding the binding capacity of haptoglobin (Hp). The objective of this study was to investigate the influence of perioperative changes in frHb and Hp levels on the incidence of CS-associated (CSA) AKI. After receiving local ethics committee approval and obtaining informed consent from our patients, we analysed the data pertaining to 154 patients undergoing CPB surgery...
January 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28072699/prevention-preferable-to-treatment-3-case-reports-of-patients-experiencing-right-sided-heart-failure-after-ebstein-anomaly-correction
#15
Ming Luo, Jing Lin, Zhen Qin, Lei Du
RATIONALE: Ebstein anomaly is a common congenital heart disease that may induce severe tricuspid regurgitation and dilation of the "atrialized" portion of the right ventricle. Patients who undergo surgery to correct Ebstein anomaly are at high risk of postoperative right-sided heart failure, yet little is known about what pre-, peri-, or postoperative procedures may help reduce this risk. PATIENT CONCERNS: Here, we describe 3 cases of adults with Ebstein anomaly who underwent corrective surgery and in whom right-sided heart failure occurred with severe tricuspid regurgitation detected by transesophageal echocardiography...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28060903/a-comparison-of-a-machine-learning-model-with-euroscore-ii-in-predicting-mortality-after-elective-cardiac-surgery-a-decision-curve-analysis
#16
Jérôme Allyn, Nicolas Allou, Pascal Augustin, Ivan Philip, Olivier Martinet, Myriem Belghiti, Sophie Provenchere, Philippe Montravers, Cyril Ferdynus
BACKGROUND: The benefits of cardiac surgery are sometimes difficult to predict and the decision to operate on a given individual is complex. Machine Learning and Decision Curve Analysis (DCA) are recent methods developed to create and evaluate prediction models. METHODS AND FINDING: We conducted a retrospective cohort study using a prospective collected database from December 2005 to December 2012, from a cardiac surgical center at University Hospital. The different models of prediction of mortality in-hospital after elective cardiac surgery, including EuroSCORE II, a logistic regression model and a machine learning model, were compared by ROC and DCA...
2017: PloS One
https://www.readbyqxmd.com/read/28054177/factors-associated-with-a-low-initial-cerebral-oxygen-saturation-value-in-patients-undergoing-cardiac-surgery
#17
Kensuke Kobayashi, Tadashi Kitamura, Satoshi Kohira, Shinzo Torii, Tetsuya Horai, Mitsuhiro Hirata, Toshiaki Mishima, Koichi Sughimoto, Hirotoki Ohkubo, Yusuke Irisawa, Takuya Matsushiro, Hidenori Hayashi, Yurie Miyata, Yuta Tsuchida, Naoki Ohtomo, Kagami Miyaji
Regional cerebral oximetry using near-infrared spectroscopy device, an INVOS 5100 C (Medtronic, Minneapolis, MN, USA), during cardiac surgery aims to avoid perioperative neurological impairment, especially during cardiopulmonary bypass. However, it is not uncommon to encounter critically low initial cerebral regional oxygen saturation or a low value unresponsive to intervention. Therefore, it is important to identify factors associated with low saturation value other than true cerebral hypoxia. We investigated the relationship between preoperative regional cerebral oxygen saturation and clinical variables during cardiac surgery...
January 4, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28052313/thromboelastography-teg-or-rotational-thromboelastometry-rotem-to-monitor-haemostatic-treatment-in-bleeding-patients-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#18
REVIEW
A Wikkelsø, J Wetterslev, A M Møller, A Afshari
Coagulopathy and severe bleeding are associated with high mortality. We evaluated haemostatic treatment guided by the functional viscoelastic haemostatic assays, thromboelastography or rotational thromboelastometry in bleeding patients. We searched for randomised, controlled trials irrespective of publication status, publication date, blinding status, outcomes published or language from date of inception to 5 January 2016 in six bibliographic databases. We included 17 trials (1493 participants), most involving cardiac surgery...
January 4, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28048971/insulin-resistance-plays-a-potential-role-in-postoperative-cognitive-dysfunction-in-patients-following-cardiac-valve-surgery
#19
Ni Tang, Rongrong Jiang, Xiaobin Wang, Jian Wen, Li Liu, Jiali Wu, Chunxiang Zhang
Severe insulin resistance(IR) promotes the development of Alzheimer disease. IR and postoperative cognitive dysfunction (POCD) are a common complication during the cardiac perioperative period. The authors hypothesized that IR of individuals with cardiac valve surgery would have increased the risk of POCD. The purpose of the study was to analyze the association of IR and POCD after cardiac valve surgery. Total 131 patients who underwent valve replacement via cardiopulmonary bypass(CPB) were included. Cognitive function was assessed by a series of neuropsychological measurements at 1 day before and 7 days after the surgery...
December 31, 2016: Brain Research
https://www.readbyqxmd.com/read/28045013/extracorporeal-cardiopulmonary-resuscitation-for-refractory-cardiac-arrest-in-children-after-cardiac-surgery
#20
Ersin Erek, Selim Aydın, Dilek Suzan, Okan Yıldız, Fırat Altın, Barış Kırat, Ibrahim Halil Demir, Ender Ödemiş
OBJECTIVE: Extracorporeal membrane oxygenation (ECMO) is used to provide cardiorespiratory support during cardiopulmonary resuscitation (extracorporeal cardiopulmonary resuscitation; ECPR) unresponsive to conventional methods. In this study, the results of ECPR in a cardiac arrest setting after cardiac surgery in children were analyzed. METHODS: In this retrospective cohort study, between November 2010 and June 2014, 613 congenital heart operations were performed by the same surgical team...
March 3, 2016: Anatolian Journal of Cardiology
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