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https://www.readbyqxmd.com/read/28543041/the-added-value-of-cardiac-index-and-pulse-pressure-variation-monitoring-to-mean-arterial-pressure-guided-volume-therapy-in-moderate-risk-abdominal-surgery-coguide-a-pragmatic-multicentre-randomised-controlled-trial
#1
J Stens, J-P Hering, C W P van der Hoeven, A Boom, H S Traast, L E Garmers, S A Loer, C Boer
There is disagreement regarding the benefits of goal-directed therapy in moderate-risk abdominal surgery. Therefore, we tested the hypothesis that the addition of non-invasive cardiac index and pulse pressure variation monitoring to mean arterial pressure-based goal-directed therapy would reduce the incidence of postoperative complications in patients having moderate-risk abdominal surgery. In this pragmatic multicentre randomised controlled trial, we randomly allocated 244 patients by envelope drawing in a 1:1 fashion, stratified per centre...
May 25, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28542316/antithrombotic-therapy-of-patients-with-atrial-fibrillation-discharged-after-major-non-cardiac-surgery-1-year-follow-up-sub-analysis-of-prague-14-study
#2
Martina Ondrakova, Zuzana Motovska, Petr Waldauf, Jiri Knot, Lukas Havluj, Lukas Bittner, Radek Bartoska, Robert Gűrlich, Martin Krbec, Valer Dzupa, Robert Grill, Petr Widimsky
BACKGROUND: The study investigated the discharge antithrombotic medication in patients with atrial fibrillation (AF) after major non-cardiac surgery and the impact on one-year outcomes. METHODS: A subgroup of 366 patients (mean age 75.9±10.5 years, women 42.3%, acute surgery 42.9%) undergoing major non-cardiac surgery and having any form of AF (30.6% of the total population enrolled in the PRAGUE-14 study) was followed for 1 year. RESULTS: Antithrombotics (interrupted due to surgery) were resumed until discharge in 51...
2017: PloS One
https://www.readbyqxmd.com/read/28539128/impaired-cardiac-output-during-exercise-in-adults-operated-for-ventricular-septal-defect-in-childhood-a-hitherto-unrecognised-pathophysiological-response
#3
Benjamin Asschenfeldt, Johan Heiberg, Steffen Ringgaard, Marie Maagaard, Andrew Redington, Vibeke E Hjortdal
BACKGROUND: Recent studies have demonstrated that surgical ventricular septal defect closure in childhood is associated with reduced functional capacity and disruption of the right ventricular force-frequency relationship during exercise. To further describe long-term cardiac function, we performed a non-invasive assessment of cardiac index during exercise in adults having undergone surgery for ventricular septal defect in early childhood. METHODS: A total of 20 patients (surgical age 2...
May 25, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28537454/transfusion-requirements-in-elective-cardiopulmonary-bypass-surgery-patients-predictive-value-of-multiplate-and-thromboelastography-teg-platelet-mapping-assay
#4
Praleene Sivapalan, Anne Caroline Bäck, Sisse Rye Ostrowski, Hanne Berg Ravn, Pär Ingemar Johansson
Managing haemostasis in patients undergoing cardiopulmonary bypass (CPB) surgery remains a challenge. There is no established laboratory test to predict transfusion requirements in cardiac surgery. We investigated whether preoperative Thromboelastography (TEG) with Platelet Mapping Assay (PMA) or Multiple Electrode Aggrometry (MEA) could predict transfusion requirements in patients undergoing elective coronary artery bypass grafting (CABG) or combined CABG with aortic or mitral valve replacement. We prospectively investigated 199 patients undergoing elective CABG or combined procedures...
May 24, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28537000/advances-in-clinical-cardiology-2016-a-summary-of-the-key-clinical-trials
#5
REVIEW
Alastair Gray, Conor McQuillan, Ian B A Menown
INTRODUCTION: The findings of many new cardiology clinical trials over the last year have been published or presented at major international meetings. This paper aims to describe and place in context a summary of the key clinical trials in cardiology presented between January and December 2016. METHODS: The authors reviewed clinical trials presented at major cardiology conferences during 2016 including the American College of Cardiology (ACC), European Association for Percutaneous Cardiovascular Interventions (EuroPCR), European Society of Cardiology (ESC), European Association for the Study of Diabetes (EASD), Transcatheter Cardiovascular Therapeutics (TCT), and the American Heart Association (AHA)...
May 23, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28536917/comparison-of-early-outcomes-of-surgical-ablation-procedures-for-atrial-fibrillation-concomitant-to-non-mitral-cardiac-surgery-a-japan-adult-cardiovascular-surgery-database-study
#6
Hideaki Takai, Hiroaki Miyata, Noboru Motomura, Kenichi Sasaki, Takashi Kunihara, Shinichi Takamoto
OBJECTIVE: Although the benefit of surgical ablation for atrial fibrillation (AF) performed concomitant to mitral valve surgery is established, whether that performed concomitant to non-mitral cardiac surgery is beneficial remains unclear. In non-mitral, non-left-atriotomy cardiac surgery, the optimal surgical approach for AF remains to be established. Therefore, using the Japan Adult Cardiovascular Surgery Database (JACVSD), we compared 2 surgical ablation procedures [the maze procedure and pulmonary vein isolation (PVI)] performed concomitant to non-mitral cardiac surgery...
May 23, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28533990/anomalous-origin-of-right-coronary-artery-originating-from-the-pulmonary-trunk-arcapa-an-incidental-finding-in-a-patient-presenting-with-chest-pain
#7
Pragathi Balakrishna, Michael Illovsky, Youssef M Al-Saghir, Abdul M Minhas
Anomalous origin of the right coronary artery originating from the pulmonary trunk (ARCAPA) is a rare congenital coronary anomaly with an estimated prevalence of 0.002%. Most patients are asymptomatic and the anomaly is detected incidentally during evaluation for other problems. Occasionally, ARCAPA may lead to myocardial ischemia and/or sudden cardiac arrest. We present a case of a 55-year-old female with a history of hypertension who presented to the emergency department with intermittent chest discomfort for three days...
April 17, 2017: Curēus
https://www.readbyqxmd.com/read/28533194/mortality-in-cardiac-surgery-myriad-a-randomized-controlled-trial-of-volatile-anesthetics-rationale-and-design
#8
Giovanni Landoni, Vladimir Lomivorotov, Antonio Pisano, Caetano Nigro Neto, Umberto Benedetto, Giuseppe Biondi Zoccai, Marco Gemma, Samuele Frassoni, Felice Eugenio Agrò, Massimo Baiocchi, Filomena R Barbosa Gomes Galas, Andrei Bautin, Nikola Bradic, Cristiana Carollo, Giuseppe Crescenzi, Abeer Elnakera, Mohamed R El-Tahan, Evgeny Fominskiy, Ahmed G Farag, Gordana Gazivoda, Stefano Gianni, Evgeny Grigoryev, Fabio Guarracino, Sidik Hanafi, Weiqing Huang, Gudrun Kunst, Jan Kunstyr, Chong Lei, Rosalba Lembo, Zhi-Jian Li, Valery Likhvantsev, Andrey Lozovskiy, Jun Ma, Fabrizio Monaco, Paolo Navalesi, Bukamal Nazar, Vadim Pasyuga, Elena Porteri, Colin Royse, Laura Ruggeri, Hynek Ryha, Fernanda Santos Silva, Luca Severi, Vladimir Shmyrev, Nikolay Uvaliev, Cheng Bin Wang, Chew-Yin Wang, Dario Winterton, Chow-Yen Yong, Jingui Yu, Rinaldo Bellomo, Alberto Zangrillo
OBJECTIVE: There is initial evidence that the use of volatile anesthetics can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalization following coronary artery bypass graft (CABG) surgery. Nevertheless, small Randomized Controlled Trials have failed to demonstrate a survival advantage. Thus, whether volatile anesthetics improve the postoperative outcome of cardiac surgical patients remains uncertain...
May 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#9
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28528237/skin-deformation-during-shoulder-movements-and-upper-extremity-activities
#10
Weiqing Ge, Alison Sfara, Brittany Hians
BACKGROUND: The necessity of sternal precautions for patients following cardiac surgery with median sternotomy has been questioned by clinicians, researchers, and even patients. The primary purpose was to determine if sternal skin deformation during shoulder movements and upper extremity activities is compressive or distractive and if there are any significant differences between the skin deformation at different positions during shoulder movements and upper extremity activities. The secondary purpose was to determine if sternal skin deformation is correlated with scapular stabilizer muscle strength...
May 12, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28524032/-preoperative-risk-factors-analysis-of-pulmonary-hypertension-crisis-during-perioperative-period-for-caesarean-section-of-woman-with-severe-pulmonary-hypertension
#11
Chunlei Zhang, Yaguang Liu, Enming Qing, Jun Ma
OBJECTIVE: To analyze preoperative risk factors of perioperative pulmonary hypertension crisis (PHC) for pregnant woman with severe pulmonary artery hypertension (PAH), and approach its clinical value. METHODS: A retrospective analysis was conducted. The clinical data from 152 pregnant women with severe PAH underwent cesarean delivery admitted to Beijing Anzhen Hospital from January 1st 2008 to December 31st 2016 was collected. The patients were divided into two groups according to with perioperative PHC or not...
May 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28523031/myocardial-protection-with-glucose-insulin-potassium-infusion-during-adult-cardiac-surgery
#12
Suhail Ahmad, Rana Altaf Ahmad, Bilal Ahsan Qureshi, Mirza Ahmad Raza Baig
BACKGROUND & OBJECTIVE: Recent meta-analysis reports have called for more randomized trials to evaluate the effectiveness of GIK solution in patients of cardiac surgery. So this study was conducted to evaluate the effectiveness of Glucose-insulin-potassium (GIK) solutions in non-diabetic patients undergoing coronary artery bypass grafting. METHODS: A total number of one hundred and sixty (160) patients were randomized into two equal groups; GIK Group and non-GIK group...
March 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28516472/nasal-decontamination-for-the-prevention-of-surgical-site-infection-in-staphylococcus-aureus-carriers
#13
REVIEW
Zhenmi Liu, Gill Norman, Zipporah Iheozor-Ejiofor, Jason Kf Wong, Emma J Crosbie, Peter Wilson
BACKGROUND: Surgical site infection rates in the month following surgery vary from 1% to 5%. Due to the large number of surgical procedures conducted annually, the costs of these surgical site infections (SSIs) can be considerable in financial and social terms. Nasal decontamination using antibiotics or antiseptics is performed to reduce the risk of SSIs by preventing organisms from the nasal cavity being transferred to the skin where a surgical incision will be made. Staphylococcus aureus (S aureus) colonises the nasal cavity and skin of carriers and can cause infection in open or unhealed surgical wounds...
May 18, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28515851/blood-conservation-pediatric-cardiac-surgery-in-all-ages-and-complexity-levels
#14
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/28515746/veno-arterial-extracorporeal-membrane-oxygenation-as-cardiogenic-shock-therapy-support-in-adult-patients-after-heart-surgery
#15
Robert Musiał, Krystyna Ochońska, Andrzej Proc, Jarosław Stoliński, Dariusz Plicner, Bogusław Kapelak, Rafał Drwiła
INTRODUCTION: The authors present their personal experience in qualifying and treating adult patients using veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) in postcardiotomy cardiogenic shock. AIM: The aim of this study was to analyze the results of VA ECMO in patients with postcardiotomy cardiogenic shock. An analysis of the risk factors of postoperative mortality was also performed. MATERIAL AND METHODS: We analyzed the perioperative results of survivors and non-survivors of treatment using VA ECMO...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28511778/elevated-cranial-ultrasound-resistive-indices-are-associated-with-improved-neurodevelopmental-outcomes-one-year-after-pediatric-cardiac-surgery-a-single-center-pilot-study
#16
Christopher L Jenks, Ana Hernandez, Peter L Stavinoha, Michael C Morris, Fenghua Tian, Hanli Liu, Parvesh Garg, Joseph M Forbess, Joshua Koch
OBJECTIVE: To determine if a non-invasive, repeatable test can be used to predict neurodevelopmental outcomes in patients with congenital heart disease. METHODS: This was a prospective study of pediatric patients less than two months of age undergoing congenital heart surgery at the Children's Health Children's Medical Center at Dallas. Multichannel near-infrared spectroscopy (NIRS) was utilized during the surgery, and ultrasound (US) resistive indices (RI) of the major cranial vessels were obtained prior to surgery, immediately post-operatively, and prior to discharge...
May 13, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28511069/ischaemic-preconditioning-current-knowledge-and-potential-future-applications-after-30-years-of-experience
#17
REVIEW
Karolina Stokfisz, Anna Ledakowicz-Polak, Maciej Zagorski, Marzenna Zielinska
Ischaemic preconditioning (IPC) phenomenon has been known for thirty years. During that time several studies showed that IPC provided by brief ischaemic and reperfusion episodes prior to longer ischaemia can bestow a protective effect to both preconditioned and also remote organs. IPC affecting remote organs is called remote ischaemic preconditioning. Initially, most IPC studies were focused on enhancing myocardial resistance to subsequent ischaemia and reperfusion injury. However, preconditioning was found to be a universal phenomenon and was observed in various organs and tissues including the heart, liver, brain, retina, kidney, skeletal muscles and intestine...
May 13, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28510738/pharmacokinetic-pharmacodynamic-model-for-unfractionated-heparin-dosing-during-cardiopulmonary-bypass
#18
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/28509399/association-of-renin-angiotensin-antagonists-with-adverse-perioperative-events-in-patients-undergoing-elective-orthopaedic-surgery-a-case-control-study
#19
Amith Zainudheen, Ian A Scott, Xenia Caney
BACKGROUND: Renin angiotensin antagonists (RAAs) may block protective vasopressor responses during surgery. Evidence linking RAAs with intraoperative hypotension and perioperative adverse events is conflicting. METHODS: Retrospective case-control study of 258 consecutive patients who underwent elective total knee or hip replacement between January 1(st) 2013 and August 31(st) 2016, and who were chronically prescribed a single blood pressure lowering agent up to the time of surgery...
May 16, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28506731/risk-of-heart-failure-in-obese-patients-with-and-without-bariatric-surgery-in-sweden-a-registry-based-study
#20
Christina E Persson, Lena Björck, Jesper Lagergren, Georgios Lappas, Kok Wai Giang, Annika Rosengren
BACKGROUND: Obesity is a known risk factor for heart failure. The prevalence of both conditions has increased in Sweden the last decades. Obesity surgery has been shown to improve cardiac function. We therefore investigated whether the risk of heart failure was lower in obese patients after bariatric surgery compared with obese patients without surgical intervention. METHODS AND RESULTS: From the Swedish National Patient Registry we created a cohort including 47,859 patients aged 18-74 years with a primary diagnosis of obesity from 2000 to 2011...
May 12, 2017: Journal of Cardiac Failure
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