Archives mensuelles: juillet2023

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ECMO simulation: How much, who to train, and a review of cost, fidelity and performance

Abstract Background Extracorporeal Membrane Oxygenation (ECMO) is a high-risk, low-volume procedure requiring repetition, skill and multiple disciplines with fidelity of communication. Yet many barriers exist to maintain proficiency and skills..

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The choice of perioperative inotropic support impacts the outcome of small infants undergoing complex cardiac surgery: an observational study

Abstract BACKGROUND: Vaso-inotropic agents are frequently used to prevent and/or treat low cardiac output syndrome in infants undergoing surgery for congenital heart disease. Due to the lack of comparative studies,..

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Evaluation of Left Ventricular Overload and Use of Unloading Techniques in Venoarterial Extracorporeal Life Support: A Nationwide Survey

Abstract Cardiogenic shock (CS) and cardiac arrest (CA) are among the most lethal complications of acute cardiovascular disease, affected by high in-hospital mortality rates. Venoarterial extracorporeal life support (VA ECLS)..

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What’s fishy about protamine? Clinical use, adverse reactions, and potential alternatives

Abstract Protamine, a highly basic protein isolated from salmon sperm, is the only clinically available agent to reverse the anticoagulation of unfractionated heparin. Following intravenous administration, protamine binds to heparin..

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Perspectives and Considerations of IABP in the Era of ECMO for Cardiogenic Shock

Abstract The development of mechanical circulatory support (MCS) has been rapid, and its use worldwide in patients with cardiogenic shock is increasingly widespread. However, current statistical data and clinical research..

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Prone Positioning During Extracorporeal Membrane Oxygenation in Patients With Severe ARDS

Abstract Importance  Prone positioning may improve outcomes in patients with severe acute respiratory distress syndrome (ARDS), but it is unknown whether prone positioning improves clinical outcomes among patients with ARDS who..

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How I use ultrasound in cardiac arrest

Abstract Advanced Cardiac Life Support (ACLS) guidelines recommend a standardized approach to manage cardiac arrest, including cardiopulmonary resuscitation (CPR), defibrillation, and administration of drugs such as epinephrine [1]. Ultrasound (US)..

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del Nido versus hematic cardioplegia in minimally invasive aortic valve surgery

Abstract Background The quality of a myocardial protection of a single-dose del Nido cardioplegia versus multiple dose blood-based cardioplegia on myocardial injury, outcomes and operative times in patients undergoing minimally..

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The Surface of a PMP Hollow Fiber Membrane Was Modified with a Diamond-like Carbon Film to Enhance the Blood Compatibility…

Abstract The contact between the blood and the surface of medical materials causes a series of rejection reactions. In this process, the plasma protein is adsorbed to the surface of..

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Using Machine Learning to Predict Bleeding after Cardiac Surgery

Abstract OBJECTIVES The primary objective was to predict bleeding after cardiac surgery with machine learning using the data from the ANZSCTS (Australia New Zealand Society of Cardiac and Thoracic Surgeons)..

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Cell salvage for minimising perioperative allogeneic blood transfusion in adults undergoing elective surgery

Abstract Background Concerns regarding the safety and availability of transfused donor blood have prompted research into a range of techniques to minimise allogeneic transfusion requirements. Cell salvage (CS) describes the..

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Extubation in the Operating Room After Coronary Artery Bypass Graft Surgery Reduces Hospital Stay

Abstract Objectives The aim of this analysis was to compare the effect of extubating in the operating room (OR) versus and the  (ICU) among patients undergoing  (CABG). Design A retrospective . Setting Ten..

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Experiences in Emergency Cardiac Surgery of COVID-19-Positive Patients: A Case Series

Abstract The coronavirus disease-2019 (COVID-19) pandemic has placed many restrictions on medical care. The timing of surgical treatment has been particularly affected, with patients experiencing delayed operation dates. This report..

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Efficacy of perioperative prophylactic administration of corticosteroids in pediatric cardiac surgeries using cardiopulmonary bypass: a systematic review with meta-analysis

Abstract An updated systematic review with meta-analysis comparing perioperative prophylactic administration of corticosteroids with placebo in  cardiac surgeries using  was conducted. The Cochrane Central Register of Controlled Trials and MEDLINE (via PubMed)..

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Role of Intraoperative Neurophysiological Monitoring in Preventing Stroke After Cardiac Surgery

Abstract Background Perioperative stroke after cardiac surgical procedures carries significant morbidity. Dual  with electroencephalography (EEG) and somatosensory-evoked potentials detects cerebral hypoperfusion and predicts postoperative stroke in noncardiac procedures. We further evaluated..

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Association of pulmonary artery catheter with in-hospital outcomes after cardiac surgery in the United States: National Inpatient Sample 1999–2019

Abstract To examine associations of pulmonary artery catheter (PAC) use with in-hospital death and hospital length of stay (days) overall and within subgroups of hospitalized cardiac surgery patients. Secondary analyses..

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Long-Term Sustainability and Adaptation of I-PASS Handovers

Abstract Background Inadequate communication during transitions of care is a major  and safety vulnerability. In 2013 Massachusetts General Hospital (MGH) embarked on a comprehensive training program using a standardized handover system..

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Timing and threshold of high sensitive troponin T measurement for the prediction of mortality after cardiac surgery: a retrospective cohort…

Abstract Background High sensitive cardiac troponin T (hsTnT) is a widely used biomarker of myocardial injury. Along with other high sensitive troponins, HsTnT can predict mortality in both cardiac and..

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Circuit change in neonatal and pediatric extracorporeal membrane oxygenation is associated with adverse outcomes

Abstract Introduction Extracorporeal membrane oxygenation (ECMO) circuits may be changed during the run for multiple reasons; however, these circuit changes may be associated with adverse events. Predictors for undergoing a..

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Methemoglobin as a marker of acute anemic stress in cardiac surgery

Abstract Biological evidence supports plasma methemoglobin as a biomarker for anemia-induced tissue hypoxia. In this translational planned substudy of the multinational randomized controlled transfusion thresholds in cardiac surgery (TRICS-III) trial,..

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Effect of Cardiopulmonary Bypass on SARS‐CoV‐2 Vaccination Antibody Levels

Abstract Background Adults undergoing heart surgery are particularly vulnerable to respiratory complications, including COVID‐19. Immunization can significantly reduce this risk; however, the effect of cardiopulmonary bypass (CPB) on immunization status..

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Encouraging results of blood conservation in neonatal open-heart surgery

Abstract Objective To report early outcomes of blood conservation in neonatal open-heart surgery. Methods Ninety-nine patients undergoing neonatal open-heart surgery during the implementation of a blood conservation program between May..

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Patient Safety 2.0: Slaying Dragons, Not Just Investigating Them

Abstract The purpose of patient safety work is to reduce avoidable patient harm. This requires us to slay dragons—to eliminate or at least mitigate risks to patients. Instead, current practice focuses..

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Hydroxocobalamin Versus Methylene Blue for the Treatment of Vasoplegic Shock Associated With Cardiopulmonary Bypass

Abstract Objectives To compare changes in vasopressor requirements and hemodynamic responses after hydroxocobalamin or methylene blue administration for vasoplegic shock (VS). Design Retrospective cohort analysis. Setting Single-center, academic medical center...

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The beneficial use of nitric oxide during cardiopulmonary bypass on postoperative outcomes in children and adult patients: a systematic review…

Abstract Purpose Investigate inhaled nitric oxide’s influence on mortality rates, mechanical ventilation and cardiopulmonary bypass duration, and length of stay in the intensive care unit and hospital when administered during..

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Pulmonary Vasodilator and Inodilator Drugs in Cardiac Surgery: A Systematic Review With Bayesian Network Meta-Analysis

Abstract Objective The authors performed a systematic review to evaluate the effect of pharmacologic therapy on pulmonary hypertension in the perioperative setting of elective cardiac surgery (PROSPERO CRD42023321041). Design Systematic..

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Incorporating a Patient Safety and Quality Course Into the Nursing Curriculum: An Assessment of Student Gains

Abstract Background  Training nursing students on quality and patient safety (PS) is crucial to ensuring safe healthcare practices given the key role nurses play on the healthcare team. The aim..

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The Additional Cost of Perioperative Medication Errors

Abstract The purpose of this report was to estimate the additional annual cost to the U.S. healthcare system attributable to preventable medication errors (MEs) in the operating room. The ME..

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Relationship between estimated and observed heparin sensitivity indices in cardiac and thoracic aortic surgery

Abstract Background Little evidence exists on the relationship between the estimated heparin sensitivity index (HSI) based on commonly available clinical and laboratory data and observed HSI in the adult population...

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Simultaneous Cesarean Section and Maternal Cardiac Surgery: Outcomes and Feasibility from a Tertiary Care Hospital in India

Abstract Introduction Cardiovascular disease is the leading cause of pregnancy-related mortality, and it has gradually increased over time; this rise has been attributed to numerous reasons including the growing number..

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