Results Generated From:
EMBASE <1980 to 2010 Week 01>
EMBASE (updates since 2010-01-04)
<1>
Accession Number
2009600742
Authors
Lahtinen P. Musialowicz T. Hyppola H. Kiviniemi V. Kurola J.
Institution
(Lahtinen, Musialowicz, Kurola) Department of Anaesthesiology and
Intensive Care, Kuopio University Hospital, Kuopio, Finland.
(Hyppola) Department of Internal Medicine, Kuopio University Hospital,
Kuopio, Finland.
(Kiviniemi) IT Centre, Kuopio University, Finland.
Title
Is external jugular vein cannulation feasible in emergency care? A
randomised study in open heart surgery patients.
Source
Resuscitation. 80(12)(pp 1361-1364), 2009. Date of Publication: December
2009.
Publisher
Elsevier Ireland Ltd
Abstract
The optimal intravenous catheterisation site for emergencies is unknown.
The external jugular vein might be preferable route compared to cubital
veins in emergencies due to more rapid circulation time to heart and
faster cardiac responses. However, the feasibility of the different venous
catheterisation sites has not been compared in relation to catheterisation
time and success rate. Methods: We examined the time differences and
success rates of external jugular compared to antecubital vein
catheterisations. 32 paramedics and 28 emergency department residents
performed external jugular and antecubital venous catheterisations on
anesthetized patients scheduled for elective cardiac surgery. The primary
outcome was catheterisation time and the secondary outcomes the failure
rate and catheterisation times needed to succeed. Results: Antecubital
venous catheterisation was faster (113 +/- 89 s) compared to external
jugular vein catheterisation (156 +/- 112 s), p = 0.008 and the success
rate was higher (93% compared to 68%, respectively, p = 0.001). Less
attempts were needed for antecubital vein catheterisations compared to
external jugular vein catheterisations (p = 0.002). For the antecubital
vein, subjects needed two attempts in 6 patients and three attempts in 6
patients. For the external jugular vein, subjects needed two attempts in
13 patients and three attempts in 20 patients. Two (6%) paramedics and two
(7%) residents failed to catheterise the antecubital vein. Nine (28%)
paramedics and 10 (36%) residents failed to catheterise the external
jugular vein. Conclusions: Antecubital vein catheterisation was faster and
had a superior success rate compared to external jugular vein
catheterisation. copyright 2009 Elsevier Ireland Ltd. All rights reserved.
<2>
Accession Number
2009605630
Authors
Gunaydin S. Sari T. McCusker K. Schonrock U. Zorlutuna Y.
Institution
(Gunaydin) University of Kirikkale, Kirikkale, Turkey.
(Sari, Zorlutuna) Bayindir Hospital, Turkey.
(McCusker) Portsmouth Regional Hospital, Portsmouth, NH, United States.
(Schonrock) Klinikum Braunschweig, Germany.
(Gunaydin) University of Kirikkale, Department of Cardiovascular Surgery,
Angora Evleri G-8 Bl. No 1 Beysukent, 06800 Ankara, Turkey.
Title
Clinical evaluation of minimized extracorporeal circulation in high-risk
coronary revascularization: Impact on air handling, inflammation,
hemodilution and myocardial function.
Source
Perfusion. 24(3)(pp 153-162), 2009. Date of Publication: 2009.
Publisher
SAGE Publications Ltd
Abstract
Objective: We examined intraoperative microembolic signals (GME),
inflammatory response, hemolysis, perioperative regional cerebral oxygen
saturation (rSO2), myocardial protection and desorbed protein amount on
oxygenator fibers in high-risk patients undergoing coronary
revascularization (CABG) with minimized and conventional cardiopulmonary
bypass (CPB). Methods: Over a ten-month period, 40 Euroscore 6+ patients
undergoing CABG were prospectively randomized to one of the two perfusion
protocols (N=20): Group 1: minimized extracorporeal circuits (Mini-CPB)
(ROCsafe MPC, Terumo, Ann Arbor, MI, USA) and Group 2: conventional
extracorporeal circuits (CECC) (Capiox SX18, Terumo, USA). Serum
creatinine kinase-MB (CKMB), free hemoglobin, interleukin-6 (IL-6) and C3a
levels were measured. Blood samples were collected at T1: following
induction of anesthesia; T2: thromboelastography control; T3:15 min after
commencement of CPB; T4: before cessation of CPB; T5: 15 min after
protamine reversal and T6: ICU. Results: Serum IL-6 levels were
significantly lower in the Mini-CPB group at T4 and T5 and C3a levels were
significantly less in the Mini-CPB group at T3, T4 and T5 vs. CECC
(p<0.01). CKMB levels in coronary sinus blood demonstrated well preserved
myocardium in the Mini-CPB group. Percentage expression of neutrophil
CD11b/CD18 levels were significantly lower in the Mini-CPB group at T4 and
T5 (p<0.05). There were no significant differences in air handling
characteristics or free plasma hemoglobin levels in either circuit. rSO2
measurements were significantly better at T3 and T4 in the Mini-CPB vs.
CECC (p<0.05) and always higher in the Mini-CPB during follow-up. Blood
protein adsorption analysis of oxygenator membranes demonstrated a
significantly increased amount of microalbumin on CECC fibers (p<0.05).
Conclusion: Mini-CPB provided a comfort and safety level similar to
conventional control via satisfactory air handling, attenuated
inflammatory response and hemodilution, with a better clinical outcome in
patients undergoing high-risk CABG. copyright The Author(s), 2009.
<3>
Accession Number
2009635494
Authors
Rollman B.L. Herbeck Belnap B. LeMenager M.S. Mazumdar S. Houck P.R.
Counihan P.J. Kapoor W.N. Schulberg H.C. Reynolds III C.F.
Institution
(Rollman, Herbeck Belnap, LeMenager, Kapoor) Division of General Internal
Medicine, Center for Research on Health Care, University of Pittsburgh
School of Medicine, Pittsburgh, PA, United States.
(Houck, Reynolds III) Department of Psychiatry, University of Pittsburgh
School of Medicine, Pittsburgh, PA, United States.
(Counihan) Cardiovascular Institute, Department of Medicine, University of
Pittsburgh School of Medicine, Pittsburgh, PA, United States.
(Mazumdar) Department of Biostatistics, University of Pittsburgh Graduate
School of Public Health, Pittsburgh, PA, United States.
(Schulberg) Department of Psychiatry, Weill Cornell Medical College, White
Plains, NY, United States.
Title
Telephone-delivered collaborative care for treating post-CABG depression:
A randomized controlled trial.
Source
JAMA - Journal of the American Medical Association. 302(19)(pp
2095-2103), 2009. Date of Publication: 2009.
Publisher
American Medical Association
Abstract
Context: Depressive symptoms commonly follow coronary artery bypass graft
(CABG) surgery and are associated with less positive clinical outcomes.
Objective: To test the effectiveness of telephone-delivered collaborative
care for post-CABG depression vs usual physician care. Design, Setting,
and Participants: Single-blind effectiveness trial at 7 university-based
and community hospitals in or near Pittsburgh, Pennsylvania. Participants
were 302 post-CABG patients with depression (150, intervention; 152, usual
care) and a comparison group of 151 randomly sampled post-CABG patients
without depression recruited between March 2004 and September 2007 and
observed as outpatients until June 2008. Intervention: Eight months of
telephone-delivered collaborative care provided by nurses working with
patients' primary care physicians and supervised by a psychiatrist and
primary care physician from this study. Main Outcome Measures: Mental
health-related quality of life (HRQL) measured by the Short Form-36 Mental
Component Summary (SF-36 MCS) at 8-month follow-up; secondary outcome
measures included assessment of mood symptoms (Hamilton Rating Scale for
Depression [HRS-D]), physical HRQL (SF-36 PCS), and functional status
(Duke Activity Status Index [DASI]); and hospital readmissions. Results:
The intervention patients reported greater improvements in mental HRQL
(all P[less-than or equal to].02) (SF-36 MCS: Delta, 3.2 points; 95%
confidence interval [CI], 0.5-6.0), physical functioning (DASI: Delta, 4.6
points; 95% CI, 1.9-7.3), and mood symptoms (HRS-D: Delta, 3.1 points; 95%
CI, 1.3-4.9); and were more likely to report a 50% or greater decline in
HRS-D score from baseline (50.0% vs 29.6%; number needed to treat, 4.9
[95% CI, 3.2-10.4]) than usual care patients (P<.001). Men with depression
were particularly likely to benefit from the intervention (SF-36 MCS:
Delta, 5.7 points; 95% CI, 2.2-9.2; P=.001). However, the mean HRQL and
physical functioning of intervention patients did not reach that of the
nondepressed comparison group. Conclusion: Compared with usual care,
telephone-delivered collaborative care for treatment of post-CABG
depression resulted in improved HRQL, physical functioning, and mood
symptoms at 8-month follow-up. Trial Registration clinicaltrials.gov
Identifier: NCT00091962. copyright2009 American Medical Association. All
rights reserved.
<4>
Accession Number
2009631191
Authors
Khan T.A. Schnickel G. Ross D. Bastani S. Laks H. Esmailian F. Marelli D.
Beygui R. Shemin R. Watson L. Vartapetian I. Ardehali A.
Institution
(Khan, Schnickel, Bastani, Laks, Esmailian, Marelli, Beygui, Shemin,
Watson, Vartapetian, Ardehali) Division of Cardiothoracic Surgery,
Department of Surgery, UCLA School of Medicine, Los Angeles, CA, United
States.
(Ross) Division of Pulmonary and Critical Care Medicine, Department of
Medicine, UCLA School of Medicine, Los Angeles, CA, United States.
Title
A prospective, randomized, crossover pilot study of inhaled nitric oxide
versus inhaled prostacyclin in heart transplant and lung transplant
recipients.
Source
Journal of Thoracic and Cardiovascular Surgery. 138(6)(pp 1417-1424),
2009. Date of Publication: December 2009.
Publisher
Mosby Inc.
Abstract
Objective: Inhaled nitric oxide has been shown to reduce pulmonary
vascular resistance in patients undergoing cardiothoracic surgery, but it
is limited by toxicity, the need for special monitoring, and cost. Inhaled
prostacyclin also decreases pulmonary artery pressure, is relatively free
of toxicity, requires no specific monitoring, and is less expensive. The
objective of this study was to compare nitric oxide and prostacyclin in
the treatment of pulmonary hypertension, refractory hypoxemia, and right
ventricular dysfunction in thoracic transplant recipients in a
prospective, randomized, crossover pilot trial. Methods: Heart transplant
and lung transplant recipients were randomized to nitric oxide or
prostacyclin as initial treatment, followed by a crossover to the other
agent after 6 hours. Pulmonary vasodilators were initiated in the
operating room for pulmonary hypertension, refractory hypoxemia, or right
ventricular dysfunction. Nitric oxide was administered at 20 ppm, and
prostacyclin was administered at 20,000 ng/mL. Hemodynamic and oxygenation
parameters were recorded before and after initiation of pulmonary
vasodilator therapy. At 6 hours, the hemodynamic and oxygenation
parameters were recorded again, just before discontinuing the initial
agent. Crossover baseline parameters were measured 30 minutes after the
initial agent had been stopped. The crossover agent was then started, and
the hemodynamic and oxygenation parameters were measured again 30 minutes
later. Results: Heart transplant and lung transplant recipients (n = 25)
were randomized by initial treatment (nitric oxide, n = 14; prostacyclin,
n = 11). Nitric oxide and prostacyclin both reduced pulmonary artery
pressure and central venous pressure, and improved cardiac index and mixed
venous oxygen saturation on initiation of therapy. More importantly, at
the 6-hour crossover trial, there were no significant differences between
nitric oxide and prostacyclin in the reduction of pulmonary artery
pressures or central venous pressure, or in improvement in cardiac index
or mixed venous oxygen saturation. Nitric oxide and prostacyclin did not
affect the oxygenation index or systemic blood pressure. There were no
complications associated with nitric oxide or prostacyclin. Conclusion: In
heart transplant and lung transplant recipients, nitric oxide and
prostacyclin similarly reduce pulmonary artery pressures and central
venous pressure, and improve cardiac index and mixed venous oxygen
saturation. Inhaled prostacyclin may offer an alternative to nitric oxide
in the treatment of pulmonary hypertension in thoracic transplantation.
copyright 2009 The American Association for Thoracic Surgery.
<5>
Accession Number
2009623390
Authors
Thielmann M. Wendt D. Eggebrecht H. Kahlert P. Massoudy P. Kamler M. Erbel
R. Jakob H. Sack S.
Institution
(Thielmann, Wendt, Massoudy, Kamler, Jakob) Department of Thoracic and
Cardiovascular Surgery, West German Heart Center Essen, University
Hospital Essen, Essen, Germany.
(Eggebrecht, Kahlert, Erbel, Sack) Department of Cardiology, West German
Heart Center Essen, University Hospital Essen, Essen, Germany.
Title
Transcatheter Aortic Valve Implantation in Patients With Very High Risk
for Conventional Aortic Valve Replacement.
Source
Annals of Thoracic Surgery. 88(5)(pp 1468-1474), 2009. Date of
Publication: November 2009.
Publisher
Elsevier USA
Abstract
Background: We sought to determine whether transcatheter aortic valve
implantation is a reasonable treatment option in patients with a very or
extremely high risk for conventional aortic valve replacement, presenting
with a logistic EuroSCORE greater than 30% or a Society of Thoracic
Surgeons score greater than 15%. Methods: Between May 2005 and November
2008, 39 of 85 transcatheter aortic valve implantation patients with a
very high risk for aortic valve replacement underwent either transfemoral
(n = 15) or transapical (n = 24) transcatheter aortic valve implantation
with a mean estimated logistic EuroSCORE of 44.2% +/- 12.6% (mean +/-
standard deviation) and a Society of Thoracic Surgeons score of 17.9% +/-
6.1%. Transcatheter aortic valve implantation was performed in a hybrid
operative theater using the Cribier-Edwards or Edwards SAPIEN prosthesis.
Results: Valve implantation was successful in 97% of the patients.
Operative mortality was 2.6%, and mortality at 30 days was 17.9%. After
valve implantation, hemodynamic improvement was assessed by decreased mean
pressure gradient (p < 0.001) and increased aortic valve area (p < 0.001),
accompanied by improved New York Heart Association functional status (p <
0.01). Actuarial survival was 74.4% at 3 months, 74.4% at 6 months, and
64.1% at 12 months of follow-up. Echocardiography revealed aortic
regurgitation in 58% of the patients during hospital stay, 43% at 6 months
of follow-up, and 40% at 12 months of follow-up, but no structural valve
deterioration could be observed during the complete follow-up period.
Conclusions: Transcatheter aortic valve implantation in patients with
severe aortic stenosis and a very high risk for aortic valve replacement
is feasible and may be a reasonable treatment option in these patients.
copyright 2009 The Society of Thoracic Surgeons.
<6>
Accession Number
2009623386
Authors
Herrmann J.L. Abarbanell A.M. Weil B.R. Wang Y. Wang M. Tan J. Meldrum
D.R.
Institution
(Meldrum) Clarian Cardiovascular Surgery, Indiana University School of
Medicine, Indianapolis, IN, United States.
(Herrmann, Abarbanell, Weil, Wang, Wang, Tan, Meldrum) Department of
Surgery, Indiana University School of Medicine, Indianapolis, IN, United
States.
(Meldrum) Department of Cellular and Integrative Physiology, Indiana
University School of Medicine, Indianapolis, IN, United States.
(Meldrum) Center for Immunobiology, Indiana University School of Medicine,
Indianapolis, IN, United States.
Title
Cell-Based Therapy for Ischemic Heart Disease: A Clinical Update.
Source
Annals of Thoracic Surgery. 88(5)(pp 1714-1722), 2009. Date of
Publication: November 2009.
Publisher
Elsevier USA
Abstract
Progenitor cell therapy is a promising treatment for ischemic heart
disease. Early clinical trials of autologous bone marrow-derived
progenitor cell therapy for acute and chronic myocardial ischemia showed
modest functional improvements after cell delivery; however, the duration
of these benefits remains unclear. Ongoing investigations continue to
enhance our understanding of the mechanisms by which progenitor and stem
cells function and how their survival and cardioprotective abilities can
be improved. This review discusses: (1) relevant progenitor and stem cells
in myocardial regenerative therapy, (2) routes of cell delivery to
ischemic myocardium, (3) clinical trials investigating bone marrow-derived
progenitor cell therapy for myocardial ischemia, and (4) future directions
of the field. copyright 2009 The Society of Thoracic Surgeons.
<7>
Accession Number
2009622733
Authors
Nasso G. Piancone F. Bonifazi R. Romano V. Visicchio G. De Filippo C.M.
Impiombato B. Fiore F. Bartolomucci F. Alessandrini F. Speziale G.
Institution
(Nasso, Piancone, Bonifazi, Romano, Visicchio, Impiombato, Fiore,
Bartolomucci, Speziale) Cardiac Surgery Department, GVM Hospitals of Care
and Research, Bari, Italy.
(De Filippo, Alessandrini) Division of Cardiac Surgery, Centro di Ricerca
e Formazione ad Alta Tecnologia nelle Scienze Biomediche, Catholic
University of the Sacred Heart, Campobasso, Italy.
Title
Prospective, Randomized Clinical Trial of the FloSeal Matrix Sealant in
Cardiac Surgery.
Source
Annals of Thoracic Surgery. 88(5)(pp 1520-1526), 2009. Date of
Publication: November 2009.
Publisher
Elsevier USA
Abstract
Background: Topical hemostatic agents composed of a gelatin-based matrix
and thrombin have been reported to be effective, in addition to
traditional means, in terminating bleeding during cardiac operations. We
compared a hemostatic matrix sealant agent (FloSeal; Baxter Inc,
Deerfield, IL) with alternative topical hemostatic agents in a mixed
cohort of elective cardiac and thoracic aortic operations. Methods:
Following sample size calculation, in a prospective randomized study
design, 209 patients were treated with FloSeal matrix sealant (FloSeal
group) and 206 patients received alternative agents as topical hemostatic
materials (comparison group). FloSeal is composed of a self-expandable
gelatin matrix component and purified bovine thrombin. Comparisons
included hemostatic patches or sponges composed of either oxidized
regenerated cellulose or purified porcine skin gelatin. Study endpoints
were the following: rate of successful intraoperative hemostasis
(identified by cessation of bleeding) and time required for hemostasis;
overall postoperative bleeding; rate of transfusion of blood products;
rate of surgical revision for bleeding; postoperative morbidity; and
intensive care unit stay. Results: Statistically higher rates of
successful hemostasis and shorter time-to-hemostasis were observed in the
FloSeal group (p < 0.001 both). Time-to-event analysis confirmed this
finding (p = 0.0025). Postoperative bleeding and rate of transfusion of
blood products were statistically decreased in the FloSeal group (p <
0.001 both). Rates of revision for bleeding and of minor complications
were not statistically different among groups in the overall cohort, but
were significantly lesser in the FloSeal group if only patients with overt
intraoperative bleeding are considered (p = 0.04 both). The advantages
observed in the FloSeal group were not offset in patients undergoing
systemic hypothermia. Conclusions: The topical hemostatic agent used in
the FloSeal group is effective in terminating intraoperative bleeding as
an adjunct to traditional surgical methods for stopping bleeding. Its
judicious use is associated with lesser need for transfusion of blood
products and rate of revision for bleeding. Its cost-utility profile
should be addressed in dedicated trials. copyright 2009 The Society of
Thoracic Surgeons.
<8>
Accession Number
2009622721
Authors
Krishnamoorthy B. Najam O. Khan U.A. Waterworth P. Fildes J.E. Yonan N.
Institution
(Krishnamoorthy, Waterworth, Yonan) Department of Cardiothoracic Surgery,
University Hospital, South Manchester NHS Foundation Trust, Manchester,
United Kingdom.
(Najam, Khan, Fildes, Yonan) The Transplant Centre, University Hospital,
South Manchester NHS Foundation Trust, Manchester, United Kingdom.
(Fildes) The School of Translational Medicine, Faculty of Human and Life
Sciences, University of Manchester, Manchester, United Kingdom.
Title
Randomized Prospective Study Comparing Conventional Subcuticular Skin
Closure With Dermabond Skin Glue After Saphenous Vein Harvesting.
Source
Annals of Thoracic Surgery. 88(5)(pp 1445-1449), 2009. Date of
Publication: November 2009.
Publisher
Elsevier USA
Abstract
Background: Dermabond (Ethicon UK, Edinburgh, United Kingdom) is a topical
skin adhesive used for surgical wound closure, with purported advantages
over conventional sutures on cosmetic outcomes, cost benefits, and
operative times. This study compared results of skin closure using
Dermabond and subcuticular sutures after coronary artery bypass grafting
(CABG). Methods: The study prospectively enrolled and randomized 106
patients who underwent CABG. The groups received closure with Dermabond
skin glue or subcuticular sutures (n = 53 each) after saphenous vein
harvesting using the bridging technique. Wound closure time for the two
methods was recorded. Cosmetic appearance was assessed using the
Hollander, the Vancouver, and the visual analog scale. Patient
satisfaction was recorded before discharge and at week 6. Results: There
were no significant differences in the total operative time between the
two groups (p = 0.43). Closure time was significantly shorter in the
Dermabond group (p = 0.017). Patients in the Dermabond group also reported
superior cosmetic outcome at weeks 1 (p < 0.001) and 6 (p = 0.001) and
improved patient satisfaction (p < 0.001). Conclusions: Dermabond has
demonstrated superiority over traditional subcuticular skin sutures in
terms of closure time, cosmetic appearance, and patient satisfaction. This
technique provides a novel method of wound closure after CABG. copyright
2009 The Society of Thoracic Surgeons.
<9>
Accession Number
2009631162
Authors
Benedetto U. Angeloni E. Refice S. Capuano F. Goracci M. Roscitano A.
Sinatra R.
Institution
(Benedetto, Angeloni, Refice, Capuano, Goracci, Roscitano, Sinatra)
Cardiac Surgery Department, II School of Medicine, University of Rome La
Sapienza, Rome, Italy.
Title
Is minimized extracorporeal circulation effective to reduce the need for
red blood cell transfusion in coronary artery bypass grafting?
Meta-analysis of randomized controlled trials.
Source
Journal of Thoracic and Cardiovascular Surgery. 138(6)(pp 1450-1453),
2009. Date of Publication: December 2009.
Publisher
Mosby Inc.
No comments:
Post a Comment