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cardiopulmonary bypass and cardiac surgery

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https://www.readbyqxmd.com/read/28942979/differences-and-similarities-in-risk-factors-for-postoperative-acute-kidney-injury-between-younger-and-older-adults-undergoing-cardiac-surgery
#1
Nadim Saydy, Amine Mazine, Louis-Mathieu Stevens, Hughes Jeamart, Philippe Demers, Pierre Pagé, Yoan Lamarche, Ismail El-Hamamsy
OBJECTIVES: Acute kidney injury is a frequent complication after cardiac surgery. The purpose of this study was to assess the risk factors for acute kidney injury in patients ≤60 years of age undergoing cardiac surgery and to compare these risk factors with those identified in patients ≥65 years of age. METHODS: From 2010 to 2012, 1253 patients ≤60 years (mean age 52 ± 9 years) and 2488 patients ≥65 years (mean age 74 ± 6 years) underwent cardiac surgery...
August 26, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28940923/blood-conservation-in-cardiac-surgery
#2
REVIEW
G Blaudszun, A Butchart, A A Klein
This article aims at reviewing the currently available evidence about blood conservation strategies in cardiac surgery. Pre-operative anaemia and perioperative allogeneic blood transfusions are associated with worse outcomes after surgery. In addition, transfusions are a scarce and costly resource. As cardiac surgery accounts for a significant proportion of all blood products transfused, efforts should be made to decrease the risk of perioperative transfusion. Pre-operative strategies focus on the detection and treatment of anaemia...
September 21, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28940368/cerebral-oximetry-and-postoperative-delirium-after-cardiac-surgery-a-randomised-controlled-trial
#3
L Lei, R Katznelson, L Fedorko, J Carroll, H Poonawala, M Machina, R Styra, V Rao, G Djaiani
Postoperative delirium is associated with increased morbidity and mortality. We hypothesised that restoration of regional cerebral oxygen desaturation would reduce the incidence of postoperative delirium in elderly patients after cardiac surgery. After institutional ethics review board approval and informed consent, a double-blinded, prospective, randomised, controlled trial was conducted in patients ≥ 60 years of age undergoing cardiac surgery with cardiopulmonary bypass. In the intervention group, an algorithm was commenced if regional cerebral oxygen saturation decreased below 75% of baseline value for 1 min or longer...
September 22, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28937313/shed-blood-separation-and-cell-saver-an-integral-part-of-miecc-shed-blood-separation-and-its-influence-on-the-perioperative-inflammatory-response-during-coronary-revascularization-with-minimal-invasive-extracorporeal-circulation-systems-a-randomized-controlled
#4
Adrian Bauer, Harald Hausmann, Jan Schaarschmidt, Martin Scharpenberg, Dirk Troitzsch, Peter Johansen, Hans Nygaard, Thomas Eberle, J Michael Hasenkam
OBJECTIVE: The postoperative systemic inflammatory response after cardiopulmonary bypass (CPB) is still an undesirable side-effect after cardiac surgery. It is most likely caused by blood contact with foreign surfaces and by the surgical trauma itself. However, the recirculation of activated shed mediastinal blood is another main cause of blood cell activation and cytokine release. Minimal invasive extracorporeal circulation (MiECC) comprises a completely closed circuit, coated surfaces and the separation of suction blood...
September 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28931787/heparin-induces-the-mobilization-of-heart-derived-multipotent-mesoangioblasts-during-cardiac-surgery-with-cardiopulmonary-bypass-or-cardiac-catheterization
#5
Yoshihiro Hata, Masayoshi Iwasaki, Keisuke Fujitaka, Haengnam Park, Daisuke Sato, Chiharu Enoki, Naoki Minato, Keita Horitani, Miyuki Nakano, Hiroshi Kishimoto, Kensaku Wada, Masamichi Koyanagi, Yasushi Adachi, Yoshihiro Yamamoto, Andreas M Zeiher, Stefanie Dimmeler, Ichiro Shiojima
BACKGROUND: We previously identified circulating mesoangioblasts (cMABs), a subset of mesenchymal stem cells that express cardiac mesodermal markers, in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). We also found that hepatocyte growth factor (HGF) is upregulated during cardiac surgery with CPB in humans, and induces MAB-like cell mobilization in rodents. These results strongly suggest that heparin induced MAB mobilization via HGF upregulation. Here, we tested this hypothesis in patients undergoing cardiac surgery or cardiac catheterization...
September 21, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28930238/a-thrombomodulin-gene-polymorphism-c1418t-is-associated-with-early-outcomes-in-patients-undergoing-coronary-artery-bypass-graft-surgery-with-a-conventional-cardiopulmonary-bypass-during-hospitalization
#6
Ching-Chou Pai, Yi-Wen Lin, Yi-Ting Tsai, Shih-Hurng Loh, Chih-Yuan Lin, Chin-Sheng Lin, Yi-Chang Lin, Hung-Yen Ke, Feng-Yen Lin, Chien-Sung Tsai
Background: Thrombomodulin (TM) is a type of cell membrane-bound anticoagulant protein cofactor in the thrombin-mediated activation of protein C. Previous evidence has shown an association between TM polymorphisms and systemic inflammation. Conventional cardiopulmonary bypass (CPB), beating-heart CPB, and off-pump techniques have been widely used in cardiac surgery. However, these techniques may also cause systemic inflammatory responses in the patients. Whether TM polymorphisms are associated with systemic inflammation after cardiac surgery is still unclear...
April 23, 2017: Medicines (Basel, Switzerland)
https://www.readbyqxmd.com/read/28927471/a-vascular-endothelial-growth-factor-a-genetic-variant-is-associated-with-improved-ventricular-function-and-transplant-free-survival-after-surgery-for-non-syndromic-chd
#7
Constantine D Mavroudis, Daniel Seung Kim, Nancy Burnham, Alexandra H Morss, Jerry H Kim, Amber A Burt, David R Crosslin, Donna M McDonald-McGinn, Elaine H Zackai, Meryl S Cohen, Susan C Nicolson, Thomas L Spray, Ian B Stanaway, Deborah A Nickerson, Mark W Russell, Hakon Hakonarson, Gail P Jarvik, J William Gaynor
BACKGROUND: We have previously shown that the minor alleles of vascular endothelial growth factor A (VEGFA) single-nucleotide polymorphism rs833069 and superoxide dismutase 2 (SOD2) single-nucleotide polymorphism rs2758331 are both associated with improved transplant-free survival after surgery for CHD in infants, but the underlying mechanisms are unknown. We hypothesised that one or both of these minor alleles are associated with better systemic ventricular function, resulting in improved survival...
September 20, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28926643/skin-perfusion-pressure-as-an-indicator-of-tissue-perfusion-in-valvular-heart-surgery-preliminary-results-from-a-prospective-observational-study
#8
Young Song, Sarah Soh, Jae-Kwang Shim, Kyoung-Un Park, Young-Lan Kwak
Hemodynamic management aims to provide adequate tissue perfusion, which is often altered during cardiac surgery with cardiopulmonary bypass (CPB). We evaluated whether skin perfusion pressure (SPP) can be used for monitoring of adequacy of tissue perfusion in patients undergoing valvular heart surgery. Seventy-two patients undergoing valve replacement were enrolled. SPP and serum lactate level were assessed after anaesthesia induction (baseline), during CPB, after CPB-off, end of surgery, arrival at intensive care unit, and postoperative 6 h...
2017: PloS One
https://www.readbyqxmd.com/read/28922985/delayed-development-of-malignant-hyperthermia-following-cardiopulmonary-bypass
#9
Stephen Hall Sams, Stephen Revilla, David Lawrence Stahl
Malignant hyperthermia (MH) is a rare but potentially life-threatening disorder encountered during general anesthesia. The use of cardiopulmonary bypass during cardiac surgery can obscure many of the cardinal signs and symptoms of MH. The development of postoperative MH following cardiac surgery is rare, but anesthesiologists and intensivists must maintain a high index of suspicion in order to make a prompt diagnosis. Initiation and tailored maintenance of MH therapy must also consider the complex physiologic changes of patients in the immediate post-cardiac surgery period...
September 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28920034/the-use-of-intraoperative-transesophageal-echocardiography-in-thoracic-aortic-dissection-due-to-chronic-cocaine-abuse
#10
Ali Dabbagh, Mohammad Kazem Arabnia, Mahnoosh Foroughi, Mehran Shahzamani, Hassan Rahmian
INTRODUCTION: Aortic dissection is a life threatening disease and is usually accompanied by a high rate of mortality and morbidity. Here we present a case report in which intraoperative tranesophageal echocardiography was used for intraoperative assessments of thoracic aortic dissection due to cocaine abuse. CASE PRESENTATION: A 45- year- old male was admitted to a university hospital due to severe chest pain. He was suffering from severe excruciating chest pain that had started after a psychological stress, leading to heavy cocaine abuse...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28913500/neuroendocrine-stress-response-implications-for-cardiac-surgery-associated-acute-kidney-injury
#11
REVIEW
J Mauricio Del Rio, Alina Nicoara, Madhav Swaminathan
Surgical stress causes biochemical and physiologic perturbations of every homeostatic axis. These alterations include volume/baroreceptor regulation, sympathetic activation, parasympathetic suppression, neuroendocrine activation, acute phase response protein synthesis and secretion, immune response modulation and long-term behavioral adaptation. The kidney is central to the stress response because of its main role in the maintenance of water, electrolyte balance and hence, intracellular and extracellular compartments, including the intravascular volume...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28912778/neuroprotective-effects-of-annexin-a1-tripeptide-after-deep-hypothermic-circulatory-arrest-in-rats
#12
Zhiquan Zhang, Qing Ma, Bijal Shah, G Burkhard Mackensen, Donald C Lo, Joseph P Mathew, Mihai V Podgoreanu, Niccolò Terrando
Resolution agonists, including lipid mediators and peptides such as annexin A1 (ANXA1), are providing novel approaches to treat inflammatory conditions. Surgical trauma exerts a significant burden on the immune system that can affect and impair multiple organs. Perioperative cerebral injury after cardiac surgery is associated with significant adverse neurological outcomes such as delirium and postoperative cognitive dysfunction. Using a clinically relevant rat model of cardiopulmonary bypass (CPB) with deep hypothermic circulatory arrest (DHCA), we tested the pro-resolving effects of a novel bioactive ANXA1 tripeptide (ANXA1sp) on neuroinflammation and cognition...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28901224/coronary-revascularization-in-children-at-a-mexican-cardiac-center-thirteen-year-outcomes
#13
Samuel E Ramírez-Marroquín, Alejandra Iturriaga-Hernández, Juan Calderón-Colmenero, Antonio Benita-Bordes, Jorge L Cervantes-Salazar
BACKGROUND: The indications for pediatric coronary revascularization are diverse. There are a large proportion of patients with sequelae of severe inflammatory diseases such as Kawasaki disease, and other less common causes. METHODS: Retrospective review of ten pediatric patients undergoing coronary artery bypass surgery from January 2004 to December 2016. RESULTS: Ten children and adolescents ranging in age from 2 to 17 (median, 6) years at operation were followed up for as long as 13 years with a median follow-up of 2 years...
September 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28893433/effects-of-remote-ischemic-preconditioning-in-patients-with-concentric-myocardial-hypertrophy-a-randomized-controlled-trial-with-molecular-insights
#14
Young Song, Jong Wook Song, Sak Lee, Ji-Hae Jun, Young-Lan Kwak, Jae-Kwang Shim
BACKGROUND: Efficacy of remote ischemic preconditioning (RIPC) for cardioprotection in cardiac surgery is controversial. We aimed to evaluate the clinical and molecular effects of RIPC on the concentrically hypertrophied myocardium. METHODS: Seventy-two aortic stenosis patients receiving aortic valve replacement (AVR) under sevoflurane anesthesia were randomly allocated to RIPC (3cycles of 5-min inflation [300mmHg] and deflation on the left arm) or control (deflated cuff placement) group...
September 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28891056/performance-of-the-minto-model-for-the-target-controlled-infusion-of-remifentanil-during-cardiopulmonary-bypass
#15
Y J Cho, W Y Jo, H Oh, C-H Koo, J Oh, J-Y Cho, K-S Yu, Y Jeon, T K Kim
We studied the predictive performance of the Minto pharmacokinetic model during cardiopulmonary bypass in patients undergoing cardiac surgery. Patients received remifentanil target-controlled infusion using the Minto model during total intravenous anaesthesia with propofol. From 56 patients, 275 arterial blood samples were drawn before, during and after bypass to determine the plasma concentration of remifentanil, and the predicted concentrations were recorded at each time. For pooled data, the median prediction error and median absolute prediction error were 21...
October 2017: Anaesthesia
https://www.readbyqxmd.com/read/28890081/factors-associated-with-postoperative-atrial-fibrillation-and-other-adverse-events-after-cardiac-surgery
#16
Emmanuel Akintoye, Frank Sellke, Roberto Marchioli, Luigi Tavazzi, Dariush Mozaffarian
OBJECTIVE: The study objective was to evaluate the impact of various surgical characteristics and practices on the risk of postoperative atrial fibrillation and other adverse outcomes after cardiac surgery. METHODS: By using the prospectively collected data of patients who underwent cardiac surgery in 28 centers across the United States, Italy, and Argentina, the details of surgery characteristics were collected for each patient and the outcomes, including postoperative atrial fibrillation, major adverse cardiovascular events, and mortality...
August 16, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28889829/neutrophil-gelatinase-associated-lipocalin-reflects-inflammation-and-is-not-a-reliable-renal-biomarker-in-neonates-and-infants-after-cardiopulmonary-bypass-a-prospective-case-control-study
#17
Karl Reiter, Gunter Balling, Vittorio Bonelli, Jelena Pabst von Ohain, Siegmund Lorenz Braun, Peter Ewert, Bettina Ruf
Introduction Acute kidney injury is a frequent complication after cardiac surgery with cardiopulmonary bypass in infants. Neutrophil gelatinase-associated lipocalin has been suggested to be a promising early biomarker of impending acute kidney injury. On the other hand, neutrophil gelatinase-associated lipocalin has been shown to be elevated in systemic inflammatory diseases without renal impairment. In this secondary analysis of data from our previous study on acute kidney injury after infant cardiac surgery, our hypothesis was that neutrophil gelatinase-associated lipocalin may be associated with surgery-related inflammation...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28885216/microcirculation-measurements-barriers-for-use-in-clinical-routine
#18
Dietrich Henzler, Matthias Scheffler, Arne Westheider, Thomas Köhler
BACKGROUND: In patients with shock, inflammation and sepsis alterations in microcirculation are common problems. Although the pathophysiologic consequences are well understood, measurements of microcirculation have not entered clinical routine so far. OBJECTIVE: To characterize the requirements for clinical microcirculation measurement techniques and the barriers for implementation into routine practice. METHODS: Clinical review of reliability, reproducibility, validity, availability and usefulness of clinically available measurement techniques to be used in patients with sepsis or cardiac surgery with cardiopulmonary bypass...
September 4, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28883853/cardiac-surgery-related-cardio-renal-syndrome-assessed-by-conventional-and-novel-biomarkers-under-or-overestimated-diagnosis
#19
Jowita Biernawska, Joanna Bober, Katarzyna Kotfis, Anna Bogacka, Edyta Barnik, Maciej Żukowski
INTRODUCTION: Serum creatinine is a 'gold standard' criterion of recognizing and staging of acute kidney injury (AKI) despite it being a suboptimal, delayed indicator. The interpretation of increased values of biomarkers imposes great difficulty regarding cardiac surgery procedures performed with cardiopulmonary bypass and may lead to under- or overestimated diagnosis. The aim of this study was to evaluate the clinical utility of the sole serum creatinine or urine neutrophil gelatinase-associated lipocalin (NGAL) concentration used for identification of patients with AKI after cardiac surgery...
August 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/28883474/plasma-exosomal-mir-223-expression-regulates-inflammatory-responses-during-cardiac-surgery-with-cardiopulmonary-bypass
#20
Kin-Shing Poon, Kalaiselvi Palanisamy, Shih-Sheng Chang, Kuo-Ting Sun, Kuen-Bao Chen, Ping-Chun Li, Tso-Chou Lin, Chi-Yuan Li
Cardiopulmonary bypass (CPB) induces inflammatory responses, and effective endogenous homeostasis is important for preventing systemic inflammation. We assessed whether plasma exosomal microRNAs in patients undergoing cardiac surgery with CPB are involved in the regulation of inflammatory responses. Plasma samples were isolated from CPB patients (n = 21) at 5 specified time points: pre-surgery, pre-CPB and 2 hours (h), 4 h and 24 h after CPB began. Plasma TNF-α expression was increased after CPB began compared to that in the pre-surgery samples...
September 7, 2017: Scientific Reports
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