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.
Perioperative Anemia: Prevalence, Consequences and Pathophysiology
In major elective surgery, patient may be exposed to the effects of pre-operative anemia, blood loss and red cell transfusion, all of which may adversely influence post-operative rates of morbidity, mortality and readmission, and length of hospital stay.
Management Of The Patient Presenting With Anaemia In The Preoperative Setting
Preoperative anaemia is common, seen in a third of patients before major surgery. Both preoperative anaemia and blood transfusion are associated with increased patient risk and adverse outcome. Patient Blood Management (PBM) is the multidisciplinary, multimodal approach to optimising the care of patients who may require blood transfusion.
Patient Blood Management In The Cardiac Surgical Setting: An Updated Overview
In cardiac surgical patients it is a complex challenge to find the ideal balance between anticoagulation and hemostasis. Preoperative anemia and perioperative higher transfusion rates are related to increased morbidity and mortality. Patient blood management (PBM) is an evidence based patient specific individualized protocol used in the perioperative setting in order to reduce perioperative bleeding and transfusion rates and to improve patient outcomes.
The Influence Of Gaseous Microemboli On Various Biomarkers After Minimized Cardiopulmonary Bypass
Gaseous microemboli that originate from the cardiopulmonary bypass circuit may contribute to adverse outcome after cardiac surgery. We prospectively evaluated the influence of gaseous microemboli on the release of various biomarkers after use of a minimally invasive extracorporeal technology system.
Intraoperative Mechanical Ventilation And Postoperative Pulmonary Complications After Cardiac Surgery
In this retrospective analysis, the intraoperative ventilation bundle was associated with a lower rate of postoperative pulmonary complicationsLower modified driving pressure was independently associated with fewer pulmonary complications BACKGROUND:: Compared with historic ventilation strategies, modern lung-protective ventilation includes lower tidal volumes (VT), lower driving pressures, and application of positive end-expiratory pressure (PEEP). The contributions of each component to an overall intraoperative protective ventilation strategy aimed at reducing postoperative pulmonary complications have neither been adequately resolved, nor comprehensively evaluated within an adult cardiac surgical population.
Extracorporeal Life Support for Adults With Respiratory Failure and Related Indications: A Review
The substantial growth over the last decade in the use of extracorporeal life support for adults with acute respiratory failure reveals an enthusiasm for the technology not always consistent with the evidence. However, recent high-quality data, primarily in patients with acute respiratory distress syndrome, have made extracorporeal life support more widely accepted in clinical practice.
Patient Blood Management Is Not About Blood Transfusion: It Is About Patients’ Outcomes
Patient Blood Management (PBM) is “the timely application of evidence-based medical and surgical concepts designed to maintain hemoglobin concentration, optimize hemostasis and minimize blood loss in an effort to improve patient outcome”.
Mechanical or Biologic Prostheses for Aortic-Valve and Mitral-Valve Replacement
In patients undergoing aortic-valve or mitral-valve replacement, either a mechanical or biologic prosthesis is used. Biologic prostheses have been increasingly favored despite limited evidence supporting this practice.
Mitral Valve Repair: Moving Towards a Personalized Ring
Abstract BACKGROUND: Mitral valve repair with the use of an annuloplasty ring is the procedure of choice in patients with significant mitralregurgitation (MR) due to floppy mitral valve (FMV)/mitral valve prolapse (MVP). The mitral annular size, shape and motion may vary substantially among patients and thus, commercially available rings may not be suitable for each individual patient. METHODS: A “personalized ring” (PR) was easily constructed…
Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery
The effect of a restrictive versus liberal red-cell transfusion strategy on clinical outcomes in patients undergoing cardiac surgery remains unclear.
Radial-Artery or Saphenous-Vein Grafts in Coronary-Artery Bypass Surgery
We performed a patient-level combined analysis of randomized, controlled trials to compare radial-artery grafts and saphenous-vein grafts for coronary-artery bypass grafting (CABG).
Calculating Risk for Poor Outcomes After Transcatheter Aortic Valve Replacement
The object of this study is to outline the tools available to help understand the risk of transcatheter aortic valve replacement (TAVR) and the gaps in knowledge regarding TAVR risk estimation.
Impact of Repositioning During Transcatheter Aortic Valve Replacement on Embolized Debris
Abstract BACKGROUND: Use of the dual-filter cerebral embolic protection (CEP) device has been linked to a lower stroke rate in patients undergoing transfemoral transcatheter aortic valve replacement (TAVR). Captured debris is found in almost every filter. The impact of repositioning on number and area of captured debris has not been studied. METHODS: Consecutive patients (n…
Calculating Risk for Poor Outcomes After Transcatheter Aortic Valve Replacement
Abstract OBJECTIVE: To outline the tools available to help understand the risk of transcatheter aortic valve replacement (TAVR) and the gaps in knowledge regarding TAVR risk estimation. METHODS: Review of the literature. RESULTS: Two models developed and validated by the American College of Cardiology can be used to estimate the risk of short-term mortality, a 6-variable in-hospital…
Influence of Time Interval Between Coronary Angiography to Off-Pump Coronary Artery Bypass Surgery on Incidence of Cardiac Surgery Associated Acute Kidney Injury
The aim of this study was to assess influence of time interval between coronary angiography (CAG) to off-pump CABG (OPCABG) on incidence of cardiac surgery associated acute kidney injury (CSA-AKI).
Different Dose Regimes and Administration Methods of Tranexamic Acid in Cardiac Surgery: A Meta-Analysis of Randomized Trials
The efficacy of tranexamic acid (TXA) to reduce perioperative blood loss and allogeneic blood transfusion in cardiacsurgeries has been proved in previous studies, but its adverse effects especially seizure has always been a problem of concern.
Evaluation and Reconditioning of Donor Organs for Transplantation Through Ex Vivo Lung Perfusion
In this prospective study, we subjected five lungs considered to be high risk for transplantation to 4 hours of ex vivo lungperfusion, with evaluation of oxygenation capacity.
Comparative Study Between Different Modes of Ventilation During Cardiopulmonary Bypass and its Effect on Postoperative Pulmonary Dysfunction
BACKGROUND: Postoperative pulmonary dysfunction is a prevalent complication after cardiac surgery; it has many contributing considerations due to either the surgery itself, anomalies to gas exchange or maybe as a result of alterations in lung mechanics. The aim of this study was to compare pressure-controlled ventilation versus volume-controlled ventilation in the presence of no ventilation…
Simulation-Based Training in Cardiac Surgery
This study hypothesized that some skills could be learned efficiently and safely by using simulation with component task training, deliberate practice, progressive complexity, and experienced coaching to produce safer cardiac surgeons.
The Brazilian Society for Cardiovascular Surgery (SBCCV) and Brazilian Society for Extracorporeal Circulation (SBCEC) Standards and Guidelines for Perfusion Practice
A primary role for clinical medicine societies is to develop standards and guidelines for practice as an instrument to promote safe and effective patient care. The Brazilian Society for Cardiovascular Surgery (SBCCV) represented by its Department for Mechanical Circulatory Assistance (DECAM) and the the Brazilian Society for Extracorporeal Circulation (SBCEC) conducted a careful critical review…