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Dexmedetomidine Extraction by the Extracorporeal Membrane Oxygenation Circuit: Results From an in Vitro Study
Dexmedetomidine is a sedative administered to minimize distress and decrease the risk of life threatening complications in children supported with extracorporeal membrane oxygenation. The extracorporeal membrane oxygenation circuit can extract drug and decrease drug exposure, placing the patient at risk of therapeutic failure.
Determinants of the Effect of Extracorporeal Carbon Dioxide Removal in the SUPERNOVA Trial: Implications for Trial Design
To describe the variability and determinants of the effect of extracorporeal CO2 removal (ECCO2R) on tidal volume (Vt), driving pressure (ΔP), and mechanical power (PowerRS) and to determine whether highly responsive patients can be identified for the purpose of predictive enrichment in ECCO2R trial design.
Peritoneal Dialysis Vs Diuretics in Children After Congenital Heart Surgery
This study conducted a comprehensive search in Medline, EMBASE, Scopus, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews from the databases’ inception through April 24, 2018. Independent reviewers selected studies and extracted data. A random effects meta-analysis was performed to pool the outcomes of interest across studies.
Neurological Complications After Cardiac Surgery Anesthetic Considerations Based on Outcome Evidence
Neurological complications after cardiac surgery remain prevalent. This review aims to discuss the modifiable and outcome-relevant risk factors based on an up-to-date literature review, with a focus on interventions that may improve outcomes.
Predicting Outcome After Out-of-Hospital Cardiac Arrest: Lactate, Need for Vasopressors, and Cytochrome c
Outcome prediction after out-of-hospital cardiac arrest (OHCA) is difficult. We hypothesized that lactate and need for vasopressors would predict outcome, and that addition of a mitochondrial biomarker would enhance performance of the tool.
Multiple Organ Dysfunction Syndrome
Multiple organ dysfunction syndrome (MODS) is one of the most common syndromes of critical illness and the leading cause of mortality among critically ill patients. Multiple organ dysfunction syndrome is the clinical consequence of a dysregulated inflammatory response, triggered by clinically diverse factors with the main pillar of management being invasive organ support.
Comparison of Machine Learning Methods With National Cardiovascular Data Registry Models for Prediction of Risk of Bleeding After Percutaneous Coronary Intervention
Can machine learning techniques, bolstered by better selection of variables, improve prediction of major bleeding after percutaneous coronary intervention (PCI)?
911: The Call that Wakes Us…
Editor’s Note: It seems hard to believe that it‚Äôs been 18 years since September 11, 2001. Just like everyone else I remember exactly where I was the moment I found out that our innocence was lost and that we were under attack. The 9/11 date infers an odd coincidence considering the national call-sign for any…
Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly
Aspirin is a well-established therapy for the secondary prevention of cardiovascular events. However, its role in the primary prevention of cardiovascular disease is unclear, especially in older persons, who have an increased risk.
Toward Precision Policy — The Case of Cardiovascular Care
The U.S. health care system is in the midst of a transition toward delivery of high-value rather than volume-based health care.
Comparison Of The Effect Of 80 vs 40 mg Atorvastatin In Patients With Isolated Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial
Atorvastatin can decrease cardiac injury after coronary artery bypass graft (CABG) surgery. We compared the effects of 80 and 40 mg of atorvastatin per day on the levels of cardiac troponin T (cTnT) and creatine kinase-MB (CK-MB) after an isolated CABG.
Association Between Cyanosis, Transfusion, and Thrombotic Complications in Neonates and Children Undergoing Cardiac Surgery
Children with congenital heart defects are at increased risk for perioperative bleeding and postoperative thrombosis. In this study, the authors sought to develop a predictive model for postoperative thrombotic complications that integrates intraoperative bleeding and the requirement for allogenic blood products in addition to known patient and surgical characteristics.
Changes in Nonlinear Dynamic Complexity Measures of Blood Pressure During Anesthesia For Cardiac Surgeries Using Cardiopulmonary Bypass
Nonlinear complexity measures computed from beat-to-beat arterial BP dynamics have shown associations with standard cardiac surgical risk indices. They reflect the physiological adaptability of a system and has been proposed as dynamical biomarkers of overall health status.
Tranexamic Acid and Convulsive Seizures After Off-pump Coronary Artery Bypass Surgery: the Role of Renal Insufficiency
There is evidence that, in adult cardiac surgical patients undergoing on-pump procedures, tranexamic acid (TXA) dose-dependently increases the risk of convulsive seizure (CS).
Norwood Procedure-Difficulty in Weaning From Cardiopulmonary Bypass and Implications for Outcomes
Difficulty weaning from cardiopulmonary bypass (CPB) or the need to return to CPB (collectively D-CPB) may occur after the Norwood procedure. We sought to evaluate the relationship between D-CBP and survival.
The Effect of Steroids in Patients Undergoing Cardiopulmonary Bypass: An Individual Patient Meta-Analysis of Two Randomized Trials
Steroids suppress the inflammatory response to cardiopulmonary bypass, but the impact on death at 30 days, myocardial infarction or injury, stroke, renal failure, respiratory failure, new atrial fibrillation, transfusion requirement, infection, and length of intensive care unit (ICU) and hospital stays are uncertain.
Extracorporeal Gas Exchange: When To Start And How To End?
In the last decade, primarily following the H1N1 pandemics , the extracorporeal respiratory assist is increasingly used [2, 3]. The acronym “ECMO”, i.e., ExtraCorporeal Membrane Oxygenation, is, however, somehow misleading as the artificial extracorporeal assist may affect both oxygenation and CO2 removal, as well as the hemodynamics, depending on how it is applied.
Perioperative Anemia Management as Part of PBM in Cardiac Surgery – A Narrative Updated Review
Anemia is common in patients with cardiac disease. Iron deficiency is the cause of anemia in about 80% of all cases. Preoperative anemia is associated with an increased morbidity and mortality in patients undergoing cardiac surgery.
Multidisciplinary Transcatheter Aortic Valve Replacement Heart Team Programme Improves Mortality In Aortic Stenosis
To analyse the effect of the implementation of a transcatheter aortic valve replacement (TAVR) and multidisciplinary heart team programme on mortality in severe aortic stenosis (AS).
Does Fenoldopam Protect Kidney in Cardiac Surgery? A Systemic Review and Meta-Analysis With Trial Sequential Analysis
To assess the benefits and harms of fenoldopam for nephroprotective effects in adult patients undergoing cardiac surgery. We conducted a systematic review with meta-analysis of randomized controlled trials (RCTs) comparing fenoldopam with placebo in cardiac surgery.
A 2-year Multicenter, Observational, Prospective, Cohort Study On Extracorporeal CO2 Removal In a Large Metropolis Area
Extracorporeal carbon dioxide removal (ECCO2R) is a promising technique for the management of acute respiratory failure, but with a limited level of evidence to support its use outside clinical trials and/or data collection initiatives. We report a collaborative initiative in a large metropolis.
Comparison Between Measured and Calculated Free Calcium Values at Different Serum Albumin Concentrations
Free ionic calcium is the metabolically active component of total calcium (TCa) in blood. However, most laboratories report TCa levels that are dependent on serum albumin concentration. Hence, several formulae have evolved to calculate free calcium levels from TCa after adjustment for albumin. However, free calcium can directly be measured using direction selective electrodes rather…
A Multi-Center Analysis Of Readmission After Cardiac Surgery: Experience Of The Northern New England Cardiovascular Disease Study Group
Readmissions after cardiac surgery are common and associated with increased morbidity, mortality and cost of care. Policymakers have targeted coronary artery bypass grafting to achieve value‐oriented health care milestones. We explored the causes of readmission following cardiac surgery among a regional consortium of hospitals.