Results Generated From:
Embase <1980 to 2015 Week 03>
Embase (updates since 2015-01-09)
<1>
Accession Number
2015637346
Authors
Peycelon M. Audry G. Irtan S.
Institution
(Peycelon, Audry, Irtan) Department of Paediatric Surgery, Trousseau
Hospital, 26 rue Arnold Netter, Paris 75012, France
(Audry, Irtan) Sorbonnes Universites, UPMC University, Paris, France
Title
Minimally invasive surgery in childhood cancer: A challenging future.
Source
European Journal of Pediatric Surgery. 24 (6) (pp 443-449), 2014. Date of
Publication: December 2014.
Publisher
Georg Thieme Verlag
Abstract
Introduction Minimally invasive surgery (MIS) has emerged as an
alternative to open approach for cancer diagnosis in children ~20 years
ago, but only recently for tumor resection. The purpose of this review is
to update the use of MIS in pediatric oncological surgery over the past
five years.
Methods The authors conducted a systematic review of papers published
between 2009 and 2014 focusing on indications and results of the
technique.
Results New indications in Wilms tumor, pheochromocytoma, and lung nodules
have emerged, thanks to the growing use of MIS in benign urological and
thoracic surgery with satisfactory results. Case control studies comparing
MIS to open approach have been published for the first time in more
classical indications such as neurogenic tumors, while robot-assisted
procedure has shown concern in results about its early experience in solid
tumors.
Conclusion MIS is a promising method for removal of thoracic and abdominal
malignancies as long as oncological principles are strictly followed.
Long-term follow-up is mandatory to further delineate objective
indications.
<2>
Accession Number
2015648879
Authors
Ozkul S. Turna A. Demirkaya A. Aksoy B. Kaynak K.
Institution
(Ozkul, Turna, Demirkaya, Aksoy, Kaynak) Department of Thoracic Surgery,
Istanbul University, Cerrahpasa Medical School, Istanbul, Turkey
Title
Rapid pleurodesis is an outpatient alternative in patients with malignant
pleural effusions: A prospective randomized controlled trial.
Source
Journal of Thoracic Disease. 6 (12) (pp 1731-1735), 2014. Date of
Publication: 2014.
Publisher
Pioneer Bioscience Publishing
Abstract
Background: Chemical pleurodesis can be palliative for recurrent,
symptomatic pleural effusions in patients who are not candidate for a
thoracic surgical procedure. We hypothesized that effective pleurodesis
could be accomplished with a rapid method of pleurodesis as effective as
the standard method. Methods: A prospective randomized 'non-inferiority'
trial was conducted in 96 patients with malignant pleural effusion (MPE)
who are not potentially curable and/or not amenable to any other surgical
intervention. They were randomly allocated to group 1 (rapid pleurodesis)
and to group 2 (standard protocol). In group 1, following complete fluid
evacuation, talc slurry was instilled into the pleural space. This was
accomplished within 2 h of thoracic catheter insertion, unless the drained
fluid was more than 1,500 mL. After clamping the tube for 30 min, the
pleural space was drained for 1 h, after which the thoracic catheter was
removed. In group 2, talc-slurry was administered when the daily drainage
was lower than 300 mL/day. Results: No-complication developed due to
talc-slurry in two groups. Complete or partial response was achieved in 35
(87.5%) and 33 (84.6%) patients in group 1 and group 2 respectively
(P=0.670). The mean drainage time was 40.7 and 165.2 h in group 1 and
group 2 respectively (P<0.001). Conclusions: Rapid pleurodesis with talc
slurry is safe and effective and it can be performed in an outpatient
basis.
<3>
Accession Number
2015646817
Authors
Green C.A. Yarborough B.J.H. Leo M.C. Yarborough M.T. Stumbo S.P. Janoff
S.L. Perrin N.A. Nichols G.A. Stevens V.J.
Institution
(Green, Yarborough, Leo, Yarborough, Stumbo, Janoff, Perrin, Nichols,
Stevens) Center for Health Research, Kaiser Permanente Northwest,
Portland, OR, United States
Title
The STRIDE weight loss and lifestyle intervention for individuals taking
antipsychotic medications: A randomized trial.
Source
American Journal of Psychiatry. 172 (1) (pp 71-81), 2015. Date of
Publication: 01 Jan 2015.
Publisher
American Psychiatric Association
Abstract
Objectives: The STRIDE study assessed whether a lifestyle intervention,
tailored for individuals with serious mental illnesses, reduced weight and
diabetes risk. The authors hypothesized that the STRIDE interventionwould
be more effective than usual care in reducing weight and improving glucose
metabolism. Method: The study design was a multisite, parallel two-arm
randomized controlled trial in community settings and an integrated health
plan. Participantswho met inclusion criteria were >;18 years old, were
taking antipsychotic agents for >;30 days, andhad a body mass index >;27.
Exclusionswere significant cognitive impairment, pregnancy/breastfeeding,
recent psychiatric hospitalization, bariatric surgery, cancer, heart
attack, or stroke. The intervention emphasizedmoderate caloric reduction,
the DASH (Dietary Approaches to Stop Hypertension) diet, and physical
activity. Blindedstaffcollecteddataatbaseline,6months,and12months.
Results: Participants (men, N=56; women, N=144; mean age=47.2 years
[SD=10.6]) were randomly assigned to usual care (N=96) or a 6-month weekly
group intervention plus six monthly maintenance sessions (N=104). A total
of 181 participants (90.5%) completed 6-month assessments, and 170 (85%)
completed 12-month assessments,without differential attrition.
Participants attended 14.5 of 24 sessions over 6 months. Intent-to-treat
analyses revealed that intervention participants lost 4.4 kg more than
control participants from baseline to 6 months (95% CI=-6.96 kg to -1.78
kg) and 2.6 kg more than control participants from baseline to 12 months
(95% CI=-5.14 kg to -0.07 kg). At 12 months, fasting glucose levels in the
control group had increased from 106.0 mg/dL to 109.5 mg/dL and decreased
in the intervention group from 106.3 mg/dL to 100.4 mg/dL. No serious
adverse events were study-related; medical hospitalizations were reduced
in the intervention group (6.7%) compared with the control group (18.8%).
Conclusions: Individuals taking antipsychotic medications can loseweight
and improve fasting glucose levels. Increasing reach of the intervention
is an important future step.
<4>
Accession Number
2015640937
Authors
Liu B. Duan C.-Y. Luo C.-F. Ou C.-W. Sun K. Wu Z.-Y. Huang H. Cheng C.-F.
Li Y.-P. Chen M.-S.
Institution
(Liu, Wu, Li, Chen) Department of Cardiovascular Medicine, Zhu Jiang
Hospital, Southern Medical University, China
(Liu, Ou, Chen) Southern Medical University, China
(Duan) Department of Biostatistics, Southern Medical University, China
(Luo, Huang, Cheng) Department of Cardiovascular Medicine, Second
Affiliated Hospital of Guangzhou Medical University, China
(Sun) Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun
Yat-sen University, China
Title
Effectiveness and safety of selected bone marrow stem cells on left
ventricular function in patients with acute myocardial infarction: A
meta-analysis of randomized controlled trials.
Source
International Journal of Cardiology. 177 (3) (pp 764-770), 2014. Date of
Publication: 20 Dec 2014.
Publisher
Elsevier Ireland Ltd
Abstract
Background Concerns regarding the use of selected bone marrow stem cells
(BMSCs) in the field of cardiac repair after acute ischemic events have
been raised. The current meta-analysis aimed to assess the efficacy and
safety of selected BMSC transplantation in patients with acute myocardial
infarction (AMI) based on published randomized controlled trials (RCTs).
Methods A systematic literature search of PubMed, Ovid LWW, BIOSIS
Previews, and the Cochrane library from 1990 to 2014 was conducted.
Results from RCTs involving subjects with AMI receiving selected BMSC
therapy and followed up for at least 6 months were pooled.
Results Eight trials with a total of 262 participants were included. Data
were analyzed using a random effects model. Overall, selected BMSC therapy
improved left ventricular ejection fraction (LVEF) by 3.17% (95%
confidence interval [CI] 0.57-5.76, P = 0.02), compared with the controls.
There were trends toward reduced left ventricular end-systolic volume
(LVESV) and fewer major adverse cardiac events (MACEs). Subgroup analysis
revealed a significant difference in LVEF in favor of selected BMSC
therapy with bone marrow mesenchymal stem cells (BMMSCs) as the cell type.
Conclusions Transplantation of selected BMSCs for patients with AMI is
safe and induces a significant increase in LVEF with a limited impact on
left ventricular remodeling.
<5>
Accession Number
2015638799
Authors
Guida P. Mastro F. Scrascia G. Whitlock R. Paparella D.
Institution
(Guida, Mastro, Scrascia, Paparella) Division of Cardiac Surgery,
Department of Emergency and Organ Transplant, University of Bari Aldo
Moro, Piazza Giulio Cesare 11, Bari 70100, Italy
(Whitlock) Department of Surgery, McMaster University, Hamilton, Canada
(Whitlock) Population Health Research Institute, McMaster University and
Hamilton Health Sciences, Hamilton, Canada
Title
Performance of the European System for Cardiac Operative Risk Evaluation
II: A meta-analysis of 22 studies involving 145,592 cardiac surgery
procedures.
Source
Journal of Thoracic and Cardiovascular Surgery. 148 (6) (pp 3049-3057),
2014. Date of Publication: 01 Dec 2014.
Publisher
Mosby Inc.
Abstract
Objectives A systematic review of the European System for Cardiac
Operative Risk Evaluation (euroSCORE) II performance for prediction of
operative mortality after cardiac surgery has not been performed. We
conducted a meta-analysis of studies based on the predictive accuracy of
the euroSCORE II.
2014 The American Association for Thoracic Surgery Methods We searched
the Embase and PubMed databases for all English-only articles reporting
performance characteristics of the euroSCORE II. The area under the
receiver operating characteristic curve, the observed/expected mortality
ratio, and observed-expected mortality difference with their 95%
confidence intervals were analyzed.
Results Twenty-two articles were selected, including 145,592 procedures.
Operative mortality occurred in 4293 (2.95%), whereas the expected events
according to euroSCORE II were 4802 (3.30%). Meta-analysis of these
studies provided an area under the receiver operating characteristic curve
of 0.792 (95% confidence interval, 0.773-0.811), an estimated
observed/expected ratio of 1.019 (95% confidence interval, 0.899-1.139),
and observed-expected difference of 0.125 (95% confidence interval, -0.269
to 0.519). Statistical heterogeneity was detected among retrospective
studies including less recent procedures. Subgroups analysis confirmed the
robustness of combined estimates for isolated valve procedures and those
combined with revascularization surgery. A significant overestimation of
the euroSCORE II with an observed/expected ratio of 0.829 (95% confidence
interval, 0.677-0.982) was observed in isolated coronary artery bypass
grafting and a slight underestimation of predictions in high-risk patients
(observed/expected ratio 1.253 and observed-expected difference 1.859).
Conclusions Despite the heterogeneity, the results from this meta-analysis
show a good overall performance of the euroSCORE II in terms of
discrimination and accuracy of model predictions for operative mortality.
Validation of the euroSCORE II in prospective populations needs to be
further studied for a continuous improvement of patients' risk
stratification before cardiac surgery.
<6>
Accession Number
2015638825
Authors
Sepehri A. Beggs T. Hassan A. Rigatto C. Shaw-Daigle C. Tangri N. Arora
R.C.
Institution
(Sepehri) Faculty of Medicine, University of British Columbia, Vancouver,
BC, Canada
(Beggs) School of Medicine, Royal College of Surgns. in Ireland, Dublin,
Ireland
(Hassan) Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
(Rigatto, Tangri) Renal Program, Seven Oaks General Hospital, Winnipeg,
MB, Canada
(Rigatto, Tangri) Section of Nephrology, Department of Medicine,
University of Manitoba, Winnipeg, MB, Canada
(Shaw-Daigle) St Boniface General Hospital, Winnipeg, MB, Canada
(Arora) University of Manitoba Health Sciences Libraries, Winnipeg, MB,
Canada
Title
The impact of frailty on outcomes after cardiac surgery: A systematic
review.
Source
Journal of Thoracic and Cardiovascular Surgery. 148 (6) (pp 3110-3117),
2014. Date of Publication: 01 Dec 2014.
Publisher
Mosby Inc.
Abstract
Objective Current preoperative assessments for cardiac surgery, such as
the European System for Cardiac Operative Risk Evaluation II and the
Society of Thoracic Surgeons risk score, are limited in their ability to
predict postoperative outcomes. This is thought to be due to the reliance
on chronological age as a predictor of health. In geriatrics, frailty
assessments have been developed as a tool in determining physiologic
functioning capacity. Whether or not frailty predicts postoperative
outcomes independent of existing cardiac preoperative risk scores remains
unknown.
2014 The American Association for Thoracic Surgery Methods We performed a
systematic review to determine the association of frailty with negative
postoperative outcomes such as major adverse cardiac and cerebrovascular
events (MACCE) in patients undergoing cardiac surgery. We searched PubMed,
EMBASE, the Cochrane library, and Ageline from inception until July 2013
and screened 5913 abstracts for potential inclusion. Of these, 6 studies
examined the relationship between objective frailty assessments and
postoperative outcomes. Our included studies evaluated 4756 patients
undergoing cardiac surgery.
Results Frailty, defined using multiple criteria, had a strong positive
relationship with the risk of MACCE (odds ratio, 4.89; 95% confidence
interval, 1.64-14.60). Relationships were stronger in older patients
undergoing transcatheter aortic valve replacement (TAVR) than younger
patients undergoing coronary artery bypass grafting and valvular surgery
(hazard ratio for frailty in TAVR, 3.31-4.89 vs hazard ratio for non-TAVR,
1.10-3.16).
Conclusions Patients deemed frail, determined using an objective
assessment tool, have a higher likelihood of experiencing mortality,
morbidity, functional decline, and MACCE following cardiac surgery,
regardless of definition. Further study is needed to determine which
components of frailty are most predictive of negative postoperative
outcomes before integration in risk prediction scores.
<7>
Accession Number
2015638792
Authors
He S. Chen B. Li W. Yan J. Chen L. Wang X. Xiao Y.
Institution
(He, Chen, Li, Yan, Chen, Wang, Xiao) Department of Cardiovascular
Surgery, Xinqiao Hospital, Third Military Medical University, Xinqiao St,
Shapingba District, Chongqing 400037, China
(He) Department of Cardiovascular Surgery, Chengdu Military General
Hospital, Chengdu, China
Title
Ventilator-associated pneumonia after cardiac surgery: A meta-analysis and
systematic review.
Source
Journal of Thoracic and Cardiovascular Surgery. 148 (6) (pp 3148-3155),
2014. Date of Publication: 01 Dec 2014.
Publisher
Mosby Inc.
Abstract
Results Eleven studies on VAP after cardiac surgery were included. When
the results were merged the VAP rate was 21.27/1000 ventilator-days. The
prevalence reached 6.37% of all patients and 35.2% of patients who were on
mechanical ventilation for more than 48 hours. Among the isolated
pathogens, Pseudomonas aeruginosa had the highest detection rate, with an
average of 23.19%, followed by Staphylococcus aureus (20.15%), Haemophilus
influenzae (19.53%), Acinetobacter baumannii (10.68%), Escherichia coli
(10.18%), Klebsiella pneumoniae (9.52%), and Candida albicans (7.20%).
Risk factors were also analyzed. We found that New York Heart Association
cardiac function class IV, pulmonary hypertension, chronic obstructive
pulmonary disease, peripheral vascular disease, renal disease, emergency
surgery, intra-aortic balloon counterpulsation, cardiopulmonary bypass
time, aortic crossclamp time, mechanical ventilation time, reintervention,
and reintubation were closely related to the occurrence of VAP; there was
no association with gender and diabetes mellitus. Once patients had VAP,
mortality and length of stay in the intensive care unit were significantly
increased.
Conclusions VAP in patients after cardiac surgery is common and has a poor
prognosis. It is mainly caused by gram-negative bacteria, and could be
affected by a series of factors.
Objective Ventilator-associated pneumonia (VAP) is the most common and
serious nosocomial infection that threatens patients who have undergone
cardiac surgery. This article summarizes its clinical characteristics and
provides theoretical evidence for prevention and treatment.
2014 The American Association for Thoracic Surgery Methods A literature
search was conducted using PubMed, Embase, the Cochrane Library, and Web
of Knowledge databases and by manual search. Data involving the
prevalence, etiology, risk factors, or clinical outcomes were extracted
for systematic review and meta-analysis.
<8>
Accession Number
2015638823
Authors
Holly T.A. Bonow R.O. Arnold J.M.O. Oh J.K. Varadarajan P. Pohost G.M.
Haddad H. Jones R.H. Velazquez E.J. Birkenfeld B. Asch F.M. Malinowski M.
Barretto R. Kalil R.A.K. Berman D.S. Sun J.-L. Lee K.L. Panza J.A.
Institution
(Holly, Bonow) Northwestern University, Feinberg School of Medicine, 251
East Huron St, Galter 8-134, Chicago, IL 60611, United States
(Arnold) University of Western Ontario, London, ON, Canada
(Oh) Mayo Clinic, Rochester, MN, United States
(Varadarajan) Loma Linda University, Loma Linda, CA, United States
(Pohost) University of Southern California, Los Angeles, CA, United States
(Haddad) Ottawa Heart Institute, Ottawa, ON, Canada
(Jones, Velazquez, Sun, Lee) Duke University, Durham, NC, United States
(Birkenfeld) Department of Nuclear Medicine PUM, Szczecin, Poland
(Asch) MedStar Washington Hospital Center, Washington, DC, United States
(Malinowski) Medical University of Silesia, Katowice, Poland
(Barretto) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
(Kalil) Instituto de Cardiologia, Porto Alegre, Brazil
(Berman) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Panza) Westchester Medical Center, Valhalla, NY, United States
Title
Myocardial viability and impact of surgical ventricular reconstruction on
outcomes of patients with severe left ventricular dysfunction undergoing
coronary artery bypass surgery: Results of the Surgical Treatment for
Ischemic Heart Failure trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 148 (6) (pp 2677-2684),
2014. Date of Publication: 01 Dec 2014.
Publisher
Mosby Inc.
Abstract
Objectives In the Surgical Treatment for Ischemic Heart Failure trial,
surgical ventricular reconstruction plus coronary artery bypass surgery
was not associated with a reduction in the rate of death or cardiac
hospitalization compared with bypass alone. We hypothesized that the
absence of viable myocardium identifies patients with coronary artery
disease and left ventricular dysfunction who have a greater benefit with
coronary artery bypass graft surgery and surgical ventricular
reconstruction compared with bypass alone.
2014 The American Association for Thoracic Surgery Methods Myocardial
viability was assessed by single photon computed tomography in 267 of the
1000 patients randomized to bypass or bypass plus surgical ventricular
reconstruction in the Surgical Treatment for Ischemic Heart Failure.
Myocardial viability was assessed on a per patient basis and regionally
according to prespecified criteria.
Results At 3 years, there was no difference in mortality or the combined
outcome of death or cardiac hospitalization between those with and without
viability, and there was no significant interaction between the type of
surgery and the global viability status with respect to mortality or death
plus cardiac hospitalization. Furthermore, there was no difference in
mortality or death plus cardiac hospitalization between those with and
without anterior wall or apical scar, and no significant interaction
between the presence of scar in these regions and the type of surgery with
respect to mortality.
Conclusions In patients with coronary artery disease and severe regional
left ventricular dysfunction, assessment of myocardial viability does not
identify patients who will derive a mortality benefit from adding surgical
ventricular reconstruction to coronary artery bypass graft surgery.
<9>
Accession Number
2014628724
Authors
Cosse C. Sabbagh C. Kamel S. Galmiche A. Regimbeau J.-M.
Institution
(Cosse, Sabbagh, Kamel) INSERM U1088, Jules Verne University of Picardie,
Amiens 80054, France
(Cosse, Sabbagh, Regimbeau) Department of Digestive and Oncological
Surgery, Amiens University Hospital, Jules Verne University of Picardie,
Place Victor Pauchet, Amiens cedex 01 F-80054, France
(Cosse, Regimbeau) Clinical Research Center, Amiens University Hospital,
Amiens Cedex 01 80054, France
(Kamel, Galmiche) Department of Biochemistry, Amiens University Hospital,
Jules Verne University of Picardie, Amiens F-80054, France
(Regimbeau) EA4294, Jules Verne University of Picardie, Amiens F-80054,
France
Title
Procalcitonin and intestinal ischemia: A review of the literature.
Source
World Journal of Gastroenterology. 20 (47) (pp 17773-17778), 2014. Date of
Publication: 21 Dec 2014.
Publisher
WJG Press
Abstract
Intestinal ischemia is common after emergency gastrointestinal or
cardiovascular surgery. At present, there are no diagnostic tools for the
early diagnosis of intestinal ischemia. In the last decade, procalcitonin
(PCT) has been suggested as a marker of this condition. Here, we review
the use of PCT as a diagnostic tool for intestinal ischemia. Two reviewers
independently searched the PubMed and EMBASE databases for articles on
intestinal ischemia and PCT. They then considered (1) the criteria
applicable to preclinical and clinical data; and (2) PCT's predictive
value in the diagnosis of intestinal ischemia. Article quality was rated
according to the STAndards for Reporting of Diagnostic accuracy. Between
1993 and 2014, seven studies (including two preclinical studies and five
clinical studies) dealt with the use of PCT to diagnose intestinal
ischemia. Procalcitonin's sensitivity, specificity, positive predictive
value and negative predictive value ranged between 72% and 100%; 68% and
91%; 27% and 90% and 81% and 100%, respectively. The area under the
receiver operating characteristic curve ranged from 0.77 to 0.92. In view
of the preclinical and clinical data, we consider that PCT can be used in
daily practice as a tool for diagnosing intestinal ischemia.
<10>
Accession Number
2014944699
Authors
Weisel R.D. Nussmeier N. Newman M.F. Pearl R.G. Wechsler A.S. Ambrosio G.
Pitt B. Clare R.M. Pieper K.S. Mongero L. Reece T.L. Yau T.M. Fremes S.
Menasche P. Lira A. Harrington R.A. Ferguson T.B.
Institution
(Weisel, Yau) Division of Cardiac Surgery, Toronto General Hospital,
University of Toronto, Toronto, ON, Canada
(Nussmeier) Massachusetts General Hospital, Harvard University, Boston,
MA, United States
(Newman, Clare, Pieper, Reece) Duke Clinical Research Institute, Duke
University Medical Center, Durham, NC, United States
(Pearl, Harrington) Stanford University School of Medicine, Palo Alto, CA,
United States
(Wechsler) Drexel University, College of Medicine, Philadelphia, PA,
United States
(Ambrosio) Division of Cardiology, University of Perugia School of
Medicine, Perugia, Italy
(Pitt) University of Michigan School of Medicine, Ann Arbor, MI, United
States
(Mongero) New York Presbyterian - Columbia University Medical Center, New
York, NY, United States
(Fremes) Division of Cardiac Surgery, Sunnybrook Health Sciences Centre,
University of Toronto, Toronto, ON, Canada
(Menasche) Departement de Chirurgie Cardiovasculaire, Assistance Publique
- Hopital Europeen Georges Pompidou, Universite Paris Descartes, Paris,
France
(Lira) Novartis, Basel, Switzerland
(Ferguson) East Carolina Heart Institute, Greenville, NC, United States
Title
Predictors of contemporary coronary artery bypass grafting outcomes.
Source
Journal of Thoracic and Cardiovascular Surgery. 148 (6) (pp 2720-2726),
2014. Date of Publication: 01 Dec 2014.
Publisher
Mosby Inc.
Abstract
Objectives The study objective was to identify the predictors of outcomes
in a contemporary cohort of patients from the Reduction in cardiovascular
Events by acaDesine in patients undergoing CABG (RED-CABG) trial. Despite
the increasing risk profile of patients who undergo coronary artery bypass
grafting, morbidity and mortality have remained low, and identification of
the current predictors of adverse outcomes may permit new treatments to
further improve outcomes.
2014 The American Association for Thoracic Surgery Methods The RED-CABG
trial was a multicenter, randomized, double-blind, placebo-controlled
study that determined that acadesine did not reduce adverse events in
moderately high-risk patients undergoing nonemergency coronary artery
bypass grafting. The primary efficacy end point was a composite of
all-cause death, nonfatal stroke, or the need for mechanical support for
severe left ventricular dysfunction through postoperative day 28. Logistic
regression modeling with stepwise variable selection identified which
prespecified baseline characteristics were associated with the primary
outcome. A second logistic model included intraoperative variables as
potential covariates.
Results The 4 independent preoperative risk factors predictive of the
composite end point were (1) a history of heart failure (odds ratio, 2.9);
(2) increasing age (odds ratio, 1.033 per decade); (3) a history of
peripheral vascular disease (odds ratio, 1.6); and (4) receiving aspirin
before coronary artery bypass grafting (odds ratio, 0.5), which was
protective. The duration of the cardiopulmonary bypass (odds ratio, 1.8)
was the only intraoperative variable that contributed to adverse outcomes.
Conclusions Patients who had heart failure and preserved systolic function
had a similar high risk of adverse outcomes as those with low ejection
fractions, and new approaches may mitigate this risk. Recognition of
patients with excessive atherosclerotic burden may permit perioperative
interventions to improve their outcomes. The contemporary risks of
coronary artery bypass grafting have changed, and their identification may
permit new methods to improve outcomes.
<11>
Accession Number
2014712950
Authors
Beohar N. Whisenant B. Kirtane A.J. Leon M.B. Tuzcu E.M. Makkar R.
Svensson L.G. Miller D.C. Smith C.R. Pichard A.D. Herrmann H.C. Thourani
V.H. Szeto W.Y. Lim S. Fischbein M. Fearon W.F. O'Neill W. Xu K. Dewey T.
Mack M.
Institution
(Beohar) Cardiac Catheterization Laboratory, Columbia University, Mount
Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL 33138, United States
(Whisenant) Intermountain Medical Center, Salt Lake City, UT, United
States
(Kirtane, Leon, Smith, Xu) Columbia University Medical Center, New York
Presbyterian Hospital, New York, NY, United States
(Tuzcu, Svensson) Cleveland Clinic Foundation, Cleveland, OH, United
States
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Miller, Fischbein, Fearon) Stanford University, Stanford, CA, United
States
(Pichard) Medstar Washington Hospital Center, Washington, DC, United
States
(Herrmann, Szeto) Hospital of the University of Pennsylvania,
Philadelphia, PA, United States
(Thourani) Emory University School of Medicine, Atlanta, GA, United States
(Lim) University of Virginia, Charlottesville, VA, United States
(O'Neill) Center for Structural Heart Disease, Henry Ford Healthcare
System, Detroit, MI, United States
(Dewey, Mack) Baylor Healthcare System, Dallas, TX, United States
Title
The relative performance characteristics of the logistic European System
for Cardiac Operative Risk Evaluation score and the Society of Thoracic
Surgeons score in the Placement of Aortic Transcatheter Valves trial.
Source
Journal of Thoracic and Cardiovascular Surgery. 148 (6) (pp 2830-2837),
2014. Date of Publication: 01 Dec 2014.
Publisher
Mosby Inc.
Abstract
Objectives The logistic European System for Cardiac Operative Risk
Evaluation (LES) score and the Society of Thoracic Surgeons (STS) score
are validated to predict 30-day outcomes following surgical aortic valve
replacement (SAVR) with or without coronary artery bypass grafting. Their
performance when applied to patients undergoing transcatheter aortic valve
replacement (TAVR) is controversial.
2014 The American Association for Thoracic Surgery Methods We compared
predicted and observed 30-day/in-hospital and 1-year mortality of patients
undergoing TAVR in the first Placement of Aortic Transcatheter Valves
trial and continued access registry (N = 2466). The performance of the LES
and STS scores (prospectively calculated) was evaluated using standard
assessments of discrimination and calibration. Performance of STS and LES
scores among 307 patients undergoing SAVR from the high-risk cohort of the
randomized trial were also examined.
Results In patients undergoing TAVR, the observed 30-day/in-hospital
mortality was 6.5%, whereas the predicted 30-day mortality was higher by
both STS score (11.4% +/- 3.9%) and LES score (26.6% +/- 16.2%). The
discrimination for both scores was poor for 30-day/in-hospital and 1-year
mortality. Calibration was better for STS score than for LES at 1 year but
poor for both at 30 days among TAVR cohort. These results were consistent
among the subgroups of patients undergoing transfemoral and transapical
access; however, the STS score had better performance among the high-risk
patients who underwent SAVR at 30 days but not 1 year.
Conclusions The STS and LES surgical risk scores overestimated
30-day/in-hospital mortality and were poor discriminators of post-TAVR
mortality, but the calibration of the STS score was better in these
high-risk patients. These data highlight the need for TAVR-specific risk
models to optimize patient selection.
<12>
Accession Number
2014758885
Authors
Decker M.R. Leverson G.E. Jaoude W.A. Maloney J.D.
Institution
(Decker, Leverson, Maloney) Wisconsin Surgical Outcomes Research Program,
Department of Surgery, University of Wisconsin, Madison, WI, United States
(Jaoude, Maloney) Division of Cardiothoracic Surgery, Department of
Surgery, University of Wisconsin, Madison, WI, United States
Title
Lung volume reduction surgery since the National Emphysema Treatment
Trial: Study of Society of Thoracic Surgeons Database.
Source
Journal of Thoracic and Cardiovascular Surgery. 148 (6) (pp 2651-2658),
2014. Date of Publication: 01 Dec 2014.
Publisher
Mosby Inc.
Abstract
Objectives The National Emphysema Treatment Trial demonstrated that lung
volume reduction surgery is an effective treatment for emphysema in select
patients. With chronic lower respiratory disease being the third leading
cause of death in the United States, this study sought to assess practice
patterns and outcomes for lung volume reduction surgery on a national
level since the National Emphysema Treatment Trial.
2014 The American Association for Thoracic Surgery Methods Aggregate
statistics on lung volume reduction surgery reported in the Society of
Thoracic Surgeons Database from January 2003 to June 2011 were analyzed to
assess procedure volume, preoperative and operative characteristics, and
outcomes. Comparisons with published data from the National Emphysema
Treatment Trial were made using chi-square and 2-sided t tests.
Results In 8.5 years, 538 patients underwent lung volume reduction
surgery, with 20 to 118 cases reported in the Society of Thoracic Surgeons
Database per year. When compared with subjects in the National Emphysema
Treatment Trial, subjects in the Society of Thoracic Surgeons Database
were younger (P <.001), a larger proportion underwent the procedure
thoracoscopically (P <.001), and forced expiratory volume in 1 second was
31% versus 28% of predicted (P <.001). When mortality was compared between
subjects in the Society of Thoracic Surgeons Database and all subjects in
the National Emphysema Treatment Trial randomized to surgery, there were
no significant differences. However, mortality was 3% higher in subjects
in the Society of Thoracic Surgeons Database when compared with the
non-high-risk National Emphysema Treatment Trial subset (P =.005).
Conclusions This study demonstrates the importance of patient selection
and the need to develop consensus on appropriate benchmarks for mortality
rates after lung volume reduction surgery. It underscores the need for
dedicated centers to increasingly address the heavy burden of chronic
lower respiratory disease in the United States in a multidisciplinary
fashion, particularly for preoperative evaluation and postoperative
management of emphysema.
<13>
Accession Number
2014739400
Authors
Benedetto U. Raja S.G. Amrani M. Pepper J.R. Zeinah M. Tonelli E.
Biondi-Zoccai G. Frati G.
Institution
(Benedetto, Raja, Amrani, Pepper) Department of Cardiac Surgery, Harefield
Hospital, London UB9 6JH, United Kingdom
(Zeinah) Ain Shams University, Cairo, Egypt
(Tonelli, Biondi-Zoccai, Frati) Department of Medico-Surgical Sciences and
Biotechnologies, Sapienza University of Rome, Latina, Italy
(Frati) Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli,
Italy
Title
The impact of arterial cannulation strategy on operative outcomes in
aortic surgery: Evidence from a comprehensive meta-analysis of comparative
studies on 4476 patients.
Source
Journal of Thoracic and Cardiovascular Surgery. 148 (6) (pp 2936-2943),
2014. Date of Publication: 01 Dec 2014.
Publisher
Mosby Inc.
Abstract
Objectives There is a growing perception that peripheral cannulation
through the femoral artery, by reversing the flow in the thoracoabdominal
aorta, may increase the risk of retrograde brain embolization in aortic
surgery. Central cannulation sites, including the right axillary artery,
have been reported to improve operative outcomes by allowing antegrade
blood flow. However, peripheral cannulation still remains largely used
because a consensus for the routine use of central cannulation approaches
has not been reached.
2014 The American Association for Thoracic Surgery Methods A
meta-analysis of comparative studies reporting operative outcomes using
central cannulation versus peripheral cannulation was performed. Pooled
weighted incidence rates for end points of interest were obtained using an
inverse variance model.
Results A total of 4476 patients were included in the final analysis.
Central cannulation was used in 2797 patients, and peripheral cannulation
was used in 1679 patients. Central cannulation showed a protective effect
on in-hospital mortality (risk ratio, 0.59; 95% confidence interval,
0.48-0.7; P <.001) and permanent neurologic deficit (risk ratio, 0.71; 95%
confidence interval, 0.55-0.90; P =.005) when compared with peripheral
cannulation. A trend toward an increased benefit in terms of reduced
in-hospital mortality was observed when only the right axillary artery was
used as the central cannulation approach (risk ratio, 0.35; 95% confidence
interval, 0.22-0.55; P <.001; I<sup>2</sup> = 0%).
Conclusions Central cannulation was superior to peripheral cannulation in
reducing in-hospital mortality and the incidence of permanent neurologic
deficit. This superiority was particularly evident when the axillary
artery was used for central cannulation.
<14>
Accession Number
2014741846
Authors
Cao C. Indraratna P. Ang S.C. Manganas C. Park J. Bannon P.G. Yan T.D.
Institution
(Cao, Indraratna, Ang, Park, Bannon, Yan) Systematic Review Unit,
Collaborative Research (CORE) Group, Macquarie University, Sydney,
Australia
(Cao, Bannon, Yan) Baird Institute for Applied Heart and Lung Surgical
Research, Sydney, Australia
(Cao, Manganas) Department of Cardiothoracic Surgery, St George Hospital,
Sydney, NSW 2011, Australia
(Bannon, Yan) Department of Cardiothoracic Surgery, Royal Prince Alfred
Hospital, Sydney, Australia
Title
Should clopidogrel be discontinued before coronary artery bypass grafting
for patients with acute coronary syndrome? A systematic review and
meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 148 (6) (pp 3092-3098),
2014. Date of Publication: 01 Dec 2014.
Publisher
Mosby Inc.
Abstract
Objective Patients presenting with acute coronary syndrome (ACS) are
treated with dual antiplatelet agents, including aspirin and clopidogrel,
to prevent mortality and recurrent ischemia. However, those who require
coronary artery bypass grafting (CABG) could have increased postoperative
bleeding and bleeding-related adverse outcomes. The current guidelines on
clinical management differ significantly. The present meta-analysis
examined the evidence for clopidogrel in the treatment of patients
presenting with ACS requiring CABG, with a focus on the timing of
medication cessation before surgery.
2014 The American Association for Thoracic Surgery Methods A systematic
review of 9 electronic databases was performed to identify all relevant
studies with comparable outcomes for patients with ACS treated with
clopidogrel before CABG. The endpoints included reoperation, major
bleeding, mortality, and a composite endpoint of mortality and recurrent
myocardial infarction.
Results Five relevant studies were identified according to the predefined
selection criteria. Patients who had received clopidogrel had a
significantly lower incidence of composite endpoints than those who had
not. However, patients who underwent CABG < 5 days after the last dose of
clopidogrel had a significantly greater incidence of reoperation, major
bleeding, and combined adverse outcomes than those who had had a washout
period >5 days.
Conclusions The results from the present meta-analysis suggest that
patients who present with ACS should be treated with dual antiplatelet
therapy, including clopidogrel. However, for patients subsequently
referred for CABG, a minimum washout period of 5 days should be observed
to minimize perioperative bleeding and bleeding-related complications,
unless emergency indications exist. These results differ from those of
previous studies and guidelines.
<15>
Accession Number
2014874368
Authors
Cai J. Xu R. Yu X. Fang Y. Ding X.
Institution
(Cai, Yu, Fang, Ding) Department of Nephrology, Zhongshan Hospital, Fudan
University, 180 Fenglin Rd, Shanghai 200032, China
(Xu) Department of Cardiology, Zhongshan Hospital, Fudan University,
Shanghai, China
(Cai, Yu, Fang, Ding) Kidney and Dialysis Institute of Shanghai, Shanghai,
China
(Yu, Fang, Ding) Kidney and Blood Purification Laboratory of Shanghai,
Shanghai, China
Title
Volatile anesthetics in preventing acute kidney injury after cardiac
surgery: A systematic review and meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. 148 (6) (pp 3127-3136),
2014. Date of Publication: 01 Dec 2014.
Publisher
Mosby Inc.
Abstract
Objective Acute kidney injury is a common clinical complication of cardiac
surgery. Volatile anesthetics have been shown to protect against it in
animal experiments. Clinically, however, the effect of volatile
anesthetics has been unclear. We conducted a systematic review and
meta-analysis of randomized, controlled trials to explore whether volatile
anesthetics could provide renal protection to patients undergoing cardiac
surgery.
2014 The American Association for Thoracic Surgery Methods Randomized,
controlled trials were identified in PubMed, Ovid, Excerpta Medica
Database, Cochrane Library, Current Controlled Trials Register, reviews,
and reference lists of relevant articles. Ten trials with 1600 total
participants were eligible. Data were analyzed with both fixed- and
random-effects models.
Results Relative to control data, volatile anesthetics significantly
reduced acute kidney injury incidence (relative risk [RR], 0.65; 95%
confidence interval [CI], 0.43-0.97; P =.04). Although there was no
significant difference between groups in absolute postoperative serum
creatinine level and mortality, patients receiving volatile anesthetics
had significantly (or borderline) lower increase in serum creatinine level
from baseline on the first (weighted mean difference, -0.04 mg/dL; 95% CI,
-0.07 to -0.01 mg/dL; P =.002) and second (weighted mean difference, -0.07
mg/dL, 95% CI, -0.14 to -0.00 mg/dL; P =.05) postoperative days and
reduced incidences of prolonged intensive care unit stay (RR, 0.46; 95%
CI, 0.34-0.64; P <.001) and hospitalization (RR, 0.47; 95% CI, 0.27-0.83;
P =.009).
Conclusions Current evidence shows that volatile anesthetics may provide
renal protection in patients undergoing cardiac surgery and supports
further randomized, controlled trials with larger sample sizes and high
methodologic quality.
<16>
Accession Number
2014723133
Authors
Liberman M. Khereba M. Goudie E. Kazakov J. Thiffault V. Lafontaine E.
Ferraro P.
Institution
(Liberman, Khereba, Goudie, Kazakov, Thiffault, Lafontaine, Ferraro) CETOC
- CHUM Endoscopic Tracheobronchial and Oesophageal Center, Department of
Surgery, University of Montreal, Montreal, QC, Canada
Title
Pilot study of pulmonary arterial branch sealing using energy devices in
an ex vivo model.
Source
Journal of Thoracic and Cardiovascular Surgery. 148 (6) (pp 3219-3223),
2014. Date of Publication: 01 Dec 2014.
Publisher
Mosby Inc.
Abstract
Objective Vascular endostaplers are bulky and can be dangerous when
dividing small pulmonary arterial (PA) branch vessels during
video-assisted thoracoscopic lobectomy. We aimed to evaluate and compare
the immediate efficacy of modern energy sealing devices in an ex vivo PA
sealing model.
2014 The American Association for Thoracic Surgery Methods Patients
undergoing anatomical lung resection or lung transplantation were
recruited for a prospective cohort pilot study. Four devices were
evaluated: Harmonic Ace (Ethicon, Cincinnati, Ohio), Thunderbeat (Olympus,
Tokyo, Japan), LigaSure (Covidien, Boulder, Colo), and Enseal (Ethicon;
Cincinnati, Ohio). After anatomical lung resection, the PA branches were
dissected in vitro. Sealing was then performed with 1 of the sealing
devices, the vessel was slowly pressurized, and the bursting pressure was
recorded.
Results Forty-nine PA branches were sealed in 14 patients. The mean PA
branch diameter was 7.4 mm (1.8-14.5 mm). Ten patients had normal PA
pressure and 3 had PA hypertension. The mean bursting pressure in each was
as follows: Harmonic Ace group, 415.5 mm Hg (137.1-1388.4 mm Hg),
Thunderbeat group, 875 mm Hg (237.1-2871.3 mm Hg); LigaSure group, 214.7
mm Hg (0-579.6 mm Hg); Enseal group, 133.7 mm Hg (0-315.38 mm Hg). There
were 2 complete sealing failures: LigaSure (diameter 6.78 mm) and Enseal
(diameter 8.3 mm).
Conclusions In this pilot study to examine energy sealing of PA branches
in a simulated ex vivo model, vascular sealing using energy was effective
and was able to sustain high intraluminal bursting pressures. Further
research is needed to determine the in vivo and long-term safety of PA
branch energy sealing.
<17>
Accession Number
2015647750
Authors
Iliuta L. Rac-Albu M.
Institution
(Iliuta, Rac-Albu) "Carol Davila" University of Medicine and Pharmacy,
Bucharest, Romania
Title
Ivabradine Versus Beta-Blockers in Patients with Conduction Abnormalities
or Left Ventricular Dysfunction Undergoing Cardiac Surgery.
Source
Cardiology and Therapy. 3 (1-2) (pp 13-26), 2013. Date of Publication:
2013.
Publisher
Springer Healthcare
Abstract
Introduction: In patients with conduction abnormalities or left ventricle
(LV) dysfunction the use of beta-blockers for post cardiac surgery rhythm
control is difficult and controversial, with a paucity of information
about other drugs such ivabradine used postoperatively. The objective of
this study was to compare the efficacy and safety of ivabradine versus
metoprolol used perioperatively in cardiac surgery patients with
conduction abnormalities or LV systolic dysfunction.
Methods: This was an open-label, randomized clinical trial enrolling 527
patients with conduction abnormalities or LV systolic dysfunction
undergoing coronary artery bypass grafting or valvular replacement,
randomized to take ivabradine or metoprolol, or metoprolol plus
ivabradine. The primary endpoints were the composites of 30-day mortality,
in-hospital atrial fibrillation (AF), in-hospital three-degree
atrioventricular block and need for pacing, in-hospital worsening heart
failure (HF; safety endpoints), duration of hospital stay and
immobilization and the above endpoint plus in-hospital bradycardia,
gastrointestinal symptoms, sleep disturbances, cold extremities (efficacy
plus safety endpoint).
Results: Heart rate reduction and prevention of postoperative AF or
tachyarrhythmia with combined therapy was more effective than with
metoprolol or ivabradine alone during the immediate postoperative
management of cardiac surgery patients. In the Ivabradine group, the
frequency of early postoperative pacing and HF worsening was smaller than
in the Metoprolol group and in combined therapy group. The frequency of
primary combined endpoint was lower in the combined Ivabradine +
Metoprolol group compared with the monotherapy groups.
Conclusion: Considering efficacy and safety, the cardiac rhythm reduction
after open heart surgery in patients with conduction abnormalities or LV
dysfunction with ivabradine plus metoprolol emerged as the best treatment
in this trial.
<18>
Accession Number
2014622688
Authors
Neto A.S. Hemmes S.N.T. Barbas C.S.V. Beiderlinden M. Fernandez-Bustamante
A. Futier E. Hollmann M.W. Jaber S. Kozian A. Licker M. Lin W.-Q. Moine P.
Scavonetto F. Schilling T. Selmo G. Severgnini P. Sprung J. Treschan T.
Unzueta C. Weingarten T.N. Wolthuis E.K. Wrigge H. de Abreu M.G. Pelosi P.
Schultz M.J.
Institution
(Neto, Hemmes, Wolthuis, Schultz) Department of Intensive Care, Academic
Medical Centre, University of Amsterdam, Amsterdam, Netherlands
(Hemmes, Hollmann) Department of Anaesthesiology, Academic Medical Centre,
University of Amsterdam, Amsterdam, Netherlands
(Schultz) Laboratory of Experimental Intensive Care and Anaesthesiology,
Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands
(Neto, Sprung, Weingarten) Medical Intensive Care Unit, ABC Medical School
(FMABC), Santo Andre, Brazil
(Neto, Barbas) Department of Critical Care Medicine, Hospital Israelita
Albert Einstein, Sao Paulo, Brazil
(Beiderlinden, Treschan) Department of Anaesthesiology, Dusseldorf
University Hospital, Heinrich-Heine University, Dusseldorf, Germany
(Beiderlinden) Department of Anaesthesiology, Marienhospital Osnabruck,
Osnabruck, Germany
(Fernandez-Bustamante, Moine) Department of Anesthesiology, University of
Colorado, Aurora, CO, United States
(Futier) Department of Aneasthesiology and Critical Care Medicine, Estaing
University Hospital, Clermont-Ferrand, France
(Jaber) Department of Critical Care Medicine and Anaesthesiology (SAR B),
Saint Eloi University Hospital, Montpellier, France
(Kozian, Schilling) Department of Anaesthesiology and Intensive Care
Medicine, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
(Licker) Department of Anaesthesiology, Pharmacology and Intensive Care,
Faculty of Medicine, University Hospital of Geneva, Geneva, Switzerland
(Lin) State Key Laboratory of Oncology of South China, Sun Yat-sen
University Cancer Center, Guangzhou, Guangdong, China
(Scavonetto) Department of Anesthesiology and Anesthesia Clinical Research
Unit, Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, United
States
(Selmo) Department of Anaesthesia, Azienda Ospedaliera Fondazione Macchi,
Ospedale di Circolo, Varese, Italy
(Severgnini) Department of Biotechnology and Life Sciences, University of
Insubria, Varese, Italy
(Unzueta) Department of Anaesthesiology, Hospital de Sant Pau, Barcelona,
Spain
(Wrigge) Department Anaesthesiology and Intensive Care Medicine,
University of Leipzig, Leipzig, Germany
(de Abreu) Department of Anaesthesiology and Intensive Care Medicine,
University Hospital Carl Gustav Carus, Dresden, Germany
(Pelosi) Department of Surgical Sciences and Integrated Diagnostics, IRCCS
San Martino IST, University of Genoa, Genoa, Italy
Title
Incidence of mortality and morbidity related to postoperative lung injury
in patients who have undergone abdominal or thoracic surgery: A systematic
review and meta-analysis.
Source
The Lancet Respiratory Medicine. 2 (12) (pp 1007-1015), 2014. Date of
Publication: 01 Dec 2014.
Publisher
Lancet Publishing Group
Abstract
Background: Lung injury is a serious complication of surgery. We did a
systematic review and meta-analysis to assess whether incidence,
morbidity, and in-hospital mortality associated with postoperative lung
injury are affected by type of surgery and whether outcomes are dependent
on type of ventilation. Methods: We searched MEDLINE, CINAHL, Web of
Science, and Cochrane Central Register of Controlled Trials for
observational studies and randomised controlled trials published up to
April, 2014, comparing lung-protective mechanical ventilation with
conventional mechanical ventilation during abdominal or thoracic surgery
in adults. Individual patients' data were assessed. Attributable mortality
was calculated by subtracting the in-hospital mortality of patients
without postoperative lung injury from that of patients with postoperative
lung injury. Findings: We identified 12 investigations involving 3365
patients. The total incidence of postoperative lung injury was similar for
abdominal and thoracic surgery (34% vs 43%, p=0198). Patients who
developed postoperative lung injury were older, had higher American
Society of Anesthesiology scores and prevalence of sepsis or pneumonia,
more frequently had received blood transfusions during surgery, and
received ventilation with higher tidal volumes, lower positive
end-expiratory pressure levels, or both, than patients who did not.
Patients with postoperative lung injury spent longer in intensive care (80
[SD 124] vs 11 [37] days, p<00001) and hospital (209 [181] vs 147 [143]
days, p<00001) and had higher in-hospital mortality (203% vs 14% p<00001)
than those without injury. Overall attributable mortality for
postoperative lung injury was 19% (95% CI 18-19), and differed
significantly between abdominal and thoracic surgery patients (122%, 95%
CI 120-126 vs 265%, 262-270, p=00008). The risk of in-hospital mortality
was independent of ventilation strategy (adjusted HR 071, 95% CI 041-122).
Interpretation: Postoperative lung injury is associated with increases in
in-hospital mortality and durations of stay in intensive care and
hospital. Attributable mortality due to postoperative lung injury is
higher after thoracic surgery than after abdominal surgery.
Lung-protective mechanical ventilation strategies reduce incidence of
postoperative lung injury but does not improve mortality. Funding: None.
<19>
Accession Number
2014622674
Authors
Cypel M. Fan E.
Institution
(Cypel) Division of Thoracic Surgery, University of Toronto, Toronto, ON
M5G2C4, Canada
(Fan) Interdepartmental Division of Critical Care Medicine, University of
Toronto, Toronto, ON M5G2C4, Canada
Title
Lung injury after abdominal and thoracic surgery.
Source
The Lancet Respiratory Medicine. 2 (12) (pp 949-950), 2014. Date of
Publication: 01 Dec 2014.
Publisher
Lancet Publishing Group
<20>
Accession Number
2014616971
Authors
Efremov S.M. Lomivorotov V.V. Shmyrev V.A. Ponomarev D.N. Deryagin M.N.
Boboshko V.A. Shilova A.N.
Institution
(Efremov, Lomivorotov, Shmyrev, Ponomarev, Deryagin, Boboshko, Shilova)
Novosibirsk State Research Institute of Circulation Pathology,
Novosibirsk, Russian Federation
Title
Prevention of gastrointestinal injury by glutamine in cardiac surgery:
Negative results of pilot double-blind, placebo-controlled, randomized
study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 28 (6) (pp e51-e52),
2014. Date of Publication: 01 Dec 2014.
Publisher
W.B. Saunders
<21>
Accession Number
2014616962
Authors
Biancari F. Juvonen T. Onorati F. Faggian G. Heikkinen J. Airaksinen J.
Mariscalco G.
Institution
(Biancari, Juvonen, Heikkinen) Department of Surgery, Oulu University
Hospital, PL 21, Oulu 90029, Finland
(Onorati, Faggian) Division of Cardiac Surgery, University of Verona
Medical School, Verona, Italy
(Airaksinen) Heart Center, Turku University Hospital, Turku, Finland
(Mariscalco) Cardiac Surgery Unit, Varese University Hospital, Varese,
Italy
Title
Meta-analysis on the performance of the EuroSCORE II and the society of
thoracic surgeons scores in patients undergoing aortic valve replacement.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 28 (6) (pp 1533-1539),
2014. Date of Publication: 01 Dec 2014.
Publisher
W.B. Saunders
Abstract
Measurements and Main Results Ten studies validated these scores in 13,856
patients who underwent either TAVR or SAVR. Operative mortality was 5.9%
(SAVR 3.1%; TAVR 9.6%). ESII-expected mortality was 5.1% (O/E ratio: 1.15,
SAVR, O/E ratio 0.94; TAVR, O/E ratio 1.23) and STS-expected mortality was
6.3% (O/E ratio: 0.94, SAVR, O/E ratio 0.84; TAVR, O/E ratio 1.13). The
area under the ROC curve for ESII was 0.70 and for STS was 0.70 (SAVR
patients: 0.73 for ESII and 0.75 for STS; TAVR patients; 0.66 for ESII and
0.63 for STS). The difference between observed/expected mortality was not
significant for ESII (Peto's OR 0.99, p = 0.88) and was significant for
STS (Peto's OR 0.86, p = 0.008). ESII (Peto's OR 1.35, p<0.00001) and STS
(Peto's OR 1.23, p<0.00001) significantly underestimated the mortality
risk in TAVR patients. The STS (Peto's OR 0.74, p<0.0001) and, to a lesser
extent, the ESII (Peto's OR 0.86, p = 0.0.04) overestimated the mortality
risk in SAVR patients.
Conclusions The ESII and STS scores have good O/E ratios for either TAVR
or SAVR patients, but both scores significantly underpredicted the risk of
TAVR patients. ESII seemed to be accurate in predicting the risk of SAVR
patients.
Objective To evaluate the performance of the EuroSCORE II (ESII) and the
Society of Thoracic Surgeons (STS) scores in surgical (SAVR) or
transcatheter aortic valve replacement (TAVR).
Design Systematic review of the literature and meta-analysis.
Setting University hospitals.
Participants Studies reporting data on the performance of ESII and STS
scores in patients undergoing SAVR or TAVR.
Interventions SAVR or TAVR.
<22>
Accession Number
2014616956
Authors
Zuo Y. Cheng X. Gu E. Liu X. Zhang L. Cao Y.
Institution
(Zuo, Cheng, Gu, Liu, Zhang, Cao) Department of Anesthesiology, First
Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei
230022, China
Title
Effect of aortic root infusion of sufentanil on ischemia-reperfusion
injury in patients undergoing mitral valve replacement.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 28 (6) (pp 1474-1478),
2014. Date of Publication: 01 Dec 2014.
Publisher
W.B. Saunders
Abstract
Objective This study investigated the effects of aortic root infusion of
sufentanil on myocardial ischemia/reperfusion injury in patients
undergoing elective mitral valve replacement (MVR) with cardiopulmonary
bypass (CPB).
Design A prospective, randomized, clinical study.
Setting A university-affiliated teaching hospital.
Participants Fifty-three adult patients undergoing elective MVR with CPB.
Interventions Bolus infusions of sufentanil (0.2 mug/kg, n = 24) or normal
saline (n = 29) were administered through the aortic root cardioplegia
perfusion catheter 5 minutes before aortic unclamping.
Measurements and Main Results Plasma concentrations of CK-MB and cTnI and
variables including heart rate, mean arterial pressure, central venous
pressure, cardiac output, stroke volume, duration of mechanical
ventilation, length of ICU stay, length of hospital stay, and 24-hour
postoperative inotropic scores were recorded. Plasma concentrations of
CK-MB and cTnI were significantly lower 4 and 8 hours after aortic
unclamping in the sufentanil postconditioning group compared to control
(p<0.05). Inotropic drug use, duration of mechanical ventilation, and
length of ICU and hospital stays were reduced significantly in the
sufentanil postconditioning group compared to control (p< 0.05).
Conclusions The present study demonstrated that sufentanil can attenuate
myocardial ischemia-reperfusion injury in patients undergoing elective MVR
with CPB.
No comments:
Post a Comment