Results Generated From:
Embase <1980 to 2016 Week 09>
Embase (updates since 2016-02-18)
<1>
Accession Number
20160003897
Author
Frontera J.A. Lewin III J.J. Rabinstein A.A. Aisiku I.P. Alexandrov A.W.
Cook A.M. del Zoppo G.J. Kumar M.A. Peerschke E.I.B. Stiefel M.F.
Teitelbaum J.S. Wartenberg K.E. Zerfoss C.L.
Institution
(Frontera) The Cerebrovascular Center, Neurological Institute, Cleveland
Clinic and Case Western Reserve University, 9500 Euclid Ave. S80,
Cleveland, OH 44195, United States
(Lewin III) The Departments of Pharmacy and Anesthesiology & Critical Care
Medicine, The Johns Hopkins Hospital and Johns Hopkins University School
of Medicine, Baltimore, MD, United States
(Rabinstein) The Department of Neurology, Mayo Clinic, Rochester, MN,
United States
(Aisiku) Harvard Medical School, Brigham and Women's Hospital, Boston, MA,
United States
(Alexandrov) The University of Tennessee Health Science Center, Memphis,
TN, United States
(Alexandrov) Australian Catholic University, Sydney, Australia
(Cook) Department of Pharmacy (UK Healthcare) & Department of Pharmacy
Practice & Science (UK College of Pharmacy), University of Kentucky,
Lexington, KY, United States
(del Zoppo) The Departments of Medicine (Hematology) and Neurology,
University of Washington School of Medicine, Seattle, WA, United States
(Kumar) The Departments of Neurology, Neurosurgery, Anesthesiology &
Critical Care, Perelman School of Medicine, Hospital of the University of
Pennsylvania, Philadelphia, PA, United States
(Peerschke) The Department of Laboratory Medicine and Pathology, Memorial
Sloan Kettering Cancer Center and Weill Cornell Medical School, New York,
NY, United States
(Stiefel) The Department of Neurosurgery, Westchester Medical Center, New
York Medical College, Valhalla, NY, United States
(Teitelbaum) Hopital du Sacre-Coeur and University of Montreal and
Montreal Neurological Institute and McGill University, Montreal, QC,
Canada
(Wartenberg) Klinik fur Neurologie, Martin-Luther-Universitat
Halle-Wittenberg, Halle, Germany
(Zerfoss) The Neuroscience and Neurosurgery Departments, Centra Lynchburg
General Hospital, Lynchburg, VA, United States
Title
Guideline for Reversal of Antithrombotics in Intracranial Hemorrhage: A
Statement for Healthcare Professionals from the Neurocritical Care Society
and Society of Critical Care Medicine.
Source
Neurocritical Care. 24 (1) (pp 6-46), 2016. Date of Publication: 01 Feb
2016.
Publisher
Humana Press Inc.
Abstract
Background: The use of antithrombotic agents, including anticoagulants,
antiplatelet agents, and thrombolytics has increased over the last decade
and is expected to continue to rise. Although antithrombotic-associated
intracranial hemorrhage can be devastating, rapid reversal of coagulopathy
may help limit hematoma expansion and improve outcomes. Methods: The
Neurocritical Care Society, in conjunction with the Society of Critical
Care Medicine, organized an international, multi-institutional committee
with expertise in neurocritical care, neurology, neurosurgery, stroke,
hematology, hemato-pathology, emergency medicine, pharmacy, nursing, and
guideline development to evaluate the literature and develop an
evidence-based practice guideline. Formalized literature searches were
conducted, and studies meeting the criteria established by the committee
were evaluated. Results: Utilizing the GRADE methodology, the committee
developed recommendations for reversal of vitamin K antagonists, direct
factor Xa antagonists, direct thrombin inhibitors, unfractionated heparin,
low-molecular weight heparin, heparinoids, pentasaccharides,
thrombolytics, and antiplatelet agents in the setting of intracranial
hemorrhage. Conclusions: This guideline provides timely, evidence-based
reversal strategies to assist practitioners in the care of patients with
antithrombotic-associated intracranial hemorrhage.
<2>
Accession Number
26387721
Author
Philpott J.M. Zemlin C.W. Cox J.L. Stirling M. Mack M. Hooker R.L. Morris
A. Heimansohn D.A. Longoria J. Gandhi D.B. McCarthy P.M.
Institution
(Philpott) Department of Surgery, Eastern Virginia Medical School,
Norfolk, Virginia; Mid-Atlantic Thoracic Surgeons, Sentara Heart Hospital,
Norfolk, Virginia
(Zemlin) Department of Electrical and Computer Engineering, Old Dominion
University, Norfolk, Virginia; Center for Bioelectrics, Old Dominion
University, Norfolk, Virginia. Electronic address: czemlin@odu.edu
(Cox) Washington University School of Medicine, Barnes-Jewish Hospital, St
Louis, Missouri
(Stirling) Munson Medical Center, Traverse City, Michigan
(Mack) Baylor Heart Hospital, Plano, Texas
(Hooker) Spectrum Health, Butterworth Hospital, Grand Rapids, Michigan
(Morris) Mercy Heart Institute, Sacramento, California
(Heimansohn) Heart Center of Indiana, Indianapolis, Indiana
(Longoria) Sutter Heart Institute, Sacramento, California
(Gandhi) McLaren Greater Lansing, Lansing, Michigan
(McCarthy) Northwestern University, Chicago, Illinois
Title
The ABLATE Trial: Safety and Efficacy of Cox Maze-IV Using a Bipolar
Radiofrequency Ablation System.
Source
The Annals of thoracic surgery. 100 (5) (pp 1541-6; discussion 1547-8),
2015. Date of Publication: 01 Nov 2015.
Abstract
BACKGROUND: The Cox Maze-IV procedure (CMP-IV) has replaced the Cox
Maze-III procedure as the most common approach for the surgical treatment
of atrial fibrillation (AF). The Food and Drug Administration-regulated
AtriCure Bipolar Radiofrequency Ablation of Permanent Atrial Fibrillation
(ABLATE) trial sought to demonstrate the safety and efficacy of the CMP-IV
performed with the Synergy ablation system (AtriCure, Inc, Cincinnati,
OH).
METHODS: Fifty-five patients (aged 70.5 +/- 9.3 years), 92.7% of whom had
nonparoxysmal AF, underwent CMP-IV to terminate AF during a concomitant
cardiac surgical procedure. Lesions were created using the AtriCure
Synergy bipolar radiofrequency ablation system. All patients were seen for
follow-up visits after 30 days, 3 months, and 6 months, with 24-hour
Holter monitoring at 6 months. Late evaluation was performed by 48-hour
Holter monitoring at an average of 21 months.
RESULTS: The primary efficacy endpoint, absence of AF (30 seconds or less)
at 6-month follow-up off antiarrhythmic medications (Heart Rhythm Society
definition), indicated 76% (38 of 50) were AF free (95% confidence
interval: 62.6% to 85.7%). The primary safety endpoint, the rate of major
adverse events within 30 days, was 9.1% (5 of 55; 95% confidence interval:
3.9% to 19.6%), with 3.6% mortality (2 of 55). Secondary efficacy
endpoints included being AF free with antiarrhythmic drugs (6 months, 84%;
21 months, 75%), successful pulmonary vein isolation (100%), and AF burden
at 6 and 21 months. The results, together with those for the secondary
safety endpoint (6-month major adverse events), demonstrated that the
Synergy system performs comparably to the cut-and-sew Cox Maze-III
procedure.
CONCLUSIONS: The CMP-IV using the AtriCure Synergy system was safe and
effective for cardiac surgical patients who had persistent and
longstanding persistent AF.
<3>
Accession Number
26542516
Author
Velazquez E.J. Samad Z. Al-Khalidi H.R. Sangli C. Grayburn P.A. Massaro
J.M. Stevens S.R. Feldman T.E. Krucoff M.W.
Institution
(Velazquez) Duke Clinical Research Institute, Duke University Medical
Center, Durham, NC; Division of Cardiology, Duke University Medical
Center, Durham, NC. Electronic address: eric.velazquez@duke.edu
(Samad) Division of Cardiology, Duke University Medical Center, Durham, NC
(Al-Khalidi) Duke Clinical Research Institute, Duke University Medical
Center, Durham, NC
(Sangli) Abbott Vascular, Abbott Park, IL
(Grayburn) Baylor Heart and Vascular Institute, Dallas, TX
(Massaro) Harvard Clinical Research Institute, Boston, MA
(Stevens) Duke Clinical Research Institute, Duke University Medical
Center, Durham, NC
(Feldman) NorthShore University HealthSystem Evanston Hospital, Evanston,
IL
(Krucoff) Duke Clinical Research Institute, Duke University Medical
Center, Durham, NC; Division of Cardiology, Duke University Medical
Center, Durham, NC
Title
The MitraClip and survival in patients with mitral regurgitation at high
risk for surgery: A propensity-matched comparison.
Source
American heart journal. 170 (5) (pp 1050-1059), 2015. Date of Publication:
01 Nov 2015.
Abstract
BACKGROUND: We compared 30-day and 1-year survival among high-risk mitral
regurgitation (MR) patients treated with the MitraClip (Abbott Vascular,
Abbott Park, IL) with matched non-surgically treated patients from the
Duke Echocardiography Laboratory Database (DELD).
METHODS AND RESULTS: High-risk patients with 3+/4+ MR managed
non-surgically between years 2000 and 2010 in the longitudinal DELD were
matched to high-risk MitraClip patients. Patient matching was performed
using the method of nearest available Mahalanobis distance metric within
calipers defined by the propensity score. Kaplan-Meier estimates and
stratified Cox proportional hazards models were used to compare survival
at 30 days and 1 year. Among 953 high-risk DELD patients available for
matching, 30-day and 1-year mortality were 6.5% and 26.2%. Close matches
were obtained for 239 of the 351 MitraClip patients. The 30-day mortality
in MitraClip patients was lower (4.2%) when compared with matched DELD
patients (7.2%). The 1-year relative risk of mortality of the MitraClip
compared with non-surgical treatment was 0.64 (95% CI 0.45-0.91; log-rank
P = .013). These results in favor of the MitraClip remained significant
upon further adjustment for baseline differences between groups (P =
.043).
CONCLUSIONS: This matched comparison of severe MR patients at high
surgical risk supports the safety of the MitraClip relative to medical
therapy at 30 days and a survival benefit at 1 year.
<4>
Accession Number
26542513
Author
Dudek D. Dziewierz A. Widimsky P. Bolognese L. Goldstein P. Hamm C.
Tanguay J.-F. LeNarz L. Miller D.L. Brown E. Ten Berg J. Montalescot G.
Institution
(Dudek) Department of Interventional Cardiology, Jagiellonian University
Medical College, Krakow, Poland. Electronic address: mcdudek@cyfronet.pl
(Dziewierz) Department of Interventional Cardiology, Jagiellonian
University Medical College, Krakow, Poland
(Widimsky) Third Medical Faculty of Charles University and University
Hospital Royal Vineyards, Prague, Czech Republic
(Bolognese) Cardiovascular and Neurological Department, Azienda
Ospedaliera, Arezzo, Italy
(Goldstein) SAMU and Emergency Department, Lille University Hospital,
Lille, France
(Hamm) Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
(Tanguay) Montreal Heart Institute, Universite de Montreal, Montreal,
Quebec, Canada
(LeNarz) Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN,
USA
(Miller) Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN,
USA
(Brown) Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN,
USA
(Ten Berg) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
Netherlands
(Montalescot) ACTION Study Group, Institut de Cardiologie, Centre
Hospitalier Universitaire Pitie-Salpetriere (AP-HP), Universite Paris 6,
Paris, France
Title
Impact of prasugrel pretreatment and timing of coronary artery bypass
grafting on clinical outcomes of patients with non-ST-segment elevation
myocardial infarction: From the A Comparison of Prasugrel at PCI or Time
of Diagnosis of Non-ST-Elevation Myocardial Infarction (ACCOAST) study.
Source
American heart journal. 170 (5) (pp 1025-1032), 2015. Date of Publication:
01 Nov 2015.
Abstract
OBJECTIVES: We evaluated impact of timing of coronary artery bypass
grafting (CABG) and prasugrel pretreatment in patients with non-ST-segment
elevation myocardial infarction undergoing CABG in the ACCOAST study.
METHODS: Of 4033 enrolled patients, 314 (7.8%) underwent isolated CABG
through 30 days. Primary efficacy end point for this analysis was any
cardiovascular death, myocardial infarction, stroke, urgent
revascularization, or glycoprotein IIb/IIIa inhibitor bailout through 30
days.
RESULTS: More CABG versus percutaneous coronary intervention or medically
managed patients were men, diabetic, or had peripheral arterial disease.
Per randomization, 157 of 314 patients received a 30-mg prasugrel loading
dose before CABG, and 157 of 314 received placebo. Patients were
stratified by tertile of time from randomization to CABG: <2.98 days (n =
104), >2.98 and <6.95 days (n = 106), and >6.95 days (n = 104). Primary
end point occurred in 12.5%, 4.7%, and 4.8%, respectively (<2.98 days vs
other tertiles, hazard ratio [HR] = 2.80; P = .011). Similarly, the rate
of all TIMI major bleeding was highest in the lowest tertile (26.0% vs
10.4% and 4.8%; P < .001), but no difference in all-cause death was
observed through 30 days (3.9% vs 1.9% and 1.9%; P = .30). Time from
randomization to CABG (HR = 0.84 for each day delay), left main disease
(HR = 1.76), region of enrollment (Non-Eastern Europe vs Eastern Europe;
HR = 3.83), but not prasugrel pretreatment and baseline troponin >3x upper
limit of normal, were independent predictors of combined 30-day end point
of all-cause death/myocardial infarction/stroke/TIMI major bleeding.
CONCLUSIONS: In ACCOAST, early (<2.98 days) surgical revascularization
carried increased risk of bleeding and ischemic complications without
affecting all-cause mortality through 30 days. Baseline troponin and
prasugrel pretreatment did not impact ischemic clinical outcomes.
<5>
Accession Number
20160128235
Author
Avery L.J. Szwajcer A. Zieroth S. Temple B. Sawatzky J.-A.V.
Institution
(Avery, Zieroth) College of Nursing, University of Manitoba, Canada
(Szwajcer) University of Manitoba Libraries, Canada
(Temple, Sawatzky) College of Nursing, University of Manitoba, Canada
Title
Caregiver experiences of providing care to adult individuals living with a
left ventricular assist device: A qualitative systematic review protocol.
Source
JBI Database of Systematic Reviews and Implementation Reports. 14 (1) (pp
44-54), 2016. Date of Publication: 2016.
Publisher
Joanna Briggs Institute
Abstract
Review question/objective This qualitative systematic review aims to
synthesize evidence on the experiences of informal caregivers in the
provision of care to adult individuals living with a left ventricular
assist device (LVAD). Specifically, the review questions are: What roles
and responsibilities do informal caregivers/support persons assume in
caring for adult persons living with a LVAD in a home setting? What are
the perceived physical, psychosocial or social consequences of caregiving
on informal caregivers/support persons caring for an adult individual with
a LVAD? What are the variables that contribute to the aforementioned
consequences on informal caregivers/support persons caring for an adult
individual with a LVAD? Certain known variables such as bridge-to
transplant (BTT) and destination therapy (DT) may warrant further
investigation if the evidence supports further analyses. What do informal
caregivers/support persons identify as important resources and/or coping
strategies in caring for an adult individual with a LVAD?.
<6>
Accession Number
20151062607
Author
Hu J. Chen R. Liu S. Yu X. Zou J. Ding X.
Institution
(Hu, Chen, Liu, Yu, Zou, Ding) Department of Nephrology, Zhongshan
Hospital, Shanghai Medical College, Fudan University, No 180 Fenglin Road,
Shanghai 200032, China
(Hu, Chen, Liu, Yu, Zou, Ding) Shanghai Institute of Kidney and Dialysis,
Shanghai, China
Title
Global Incidence and Outcomes of Adult Patients with Acute Kidney Injury
after Cardiac Surgery: A Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 30 (1) (pp 82-89),
2016. Date of Publication: 01 Jan 2016.
Publisher
W.B. Saunders
Abstract
Objectives To estimate the global incidence and outcomes of acute kidney
injury (AKI) after cardiac surgery in adult patients. Design A systematic
review and meta-analysis. Setting Cardiac surgery wards. Participants
Adult patients after cardiac surgery Interventions None. Measurements and
Main Results The authors searched PubMed, Web of Science, Cochrane
Library, OVID, and EMBASE databases for all articles on cardiac surgery
patients published during 2004 to 2014. Meta-analyses were conducted to
generate pooled incidence, mortality, ICU length of stay, and length of
hospital stay. The authors also described the variations according to
study design, criteria of AKI, surgical methods, countries, continents,
and their economies. After a primary and secondary screen, 91
observational studies with 320,086 patients were identified. The pooled
incidence rates of AKI were 22.3% (95% confidence interval [CI], 19.8 to
25.1) in total and 13.6%, 3.8%, and 2.7% at stages 1, 2, and 3,
respectively, whereas 2.3% of patients received renal replacement therapy.
The pooled short-term and long-term mortality were 10.7% and 30%,
respectively, and increased along with the severity of stages. The pooled
unadjusted odds ratio for short-term and long-term mortality in patients
with AKI relative to patients without AKI was 0.144 (95% CI, 0.108 to
0.192, p<0.001) and 0.342 (95% CI 0.287-0.407, p<0.001), respectively. The
pooled average ICU length of stay and length of hospital stay in the AKI
group were 5.4 and 15 days, respectively, while they were 2.2 and 10.5
days in the no-AKI group. Conclusions AKI is a great burden for patients
undergoing cardiac surgery and can affect short-term and long-term
prognoses of these patients.
<7>
Accession Number
20151062104
Author
Corredor C. Thomson R. Al-Subaie N.
Institution
(Corredor, Thomson, Al-Subaie) Cardiothoracic Intensive Care Unit, St.
Georges Hospital NHS Foundation Trust, Blackshaw Road, London SW170QT,
United Kingdom
Title
Long-Term Consequences of Acute Kidney Injury after Cardiac Surgery: A
Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 30 (1) (pp 69-75),
2016. Date of Publication: 01 Jan 2016.
Publisher
W.B. Saunders
Abstract
Objectives To determine the effect of acute kidney injury (AKI) associated
with cardiac surgery on long-term mortality. Design Systematic review and
meta-analysis of 9 observational studies extracted from the MEDLINE and
EMBASE electronic databases. Setting Hospitals undertaking cardiac
surgery. Participants The study included 35,021 cardiac surgery patients
from 9 observational studies. Interventions None. Measurements and Main
Results Nine studies including 35,021 patients reported incidence of AKI
data. The median incidence of AKI was 27.75% (IQR, 16.3%-38.86%). There
was significant variation in the reported incidence (range, 11.97%-54%),
which can be explained by the different AKI definitions used in the
included studies. Eight studies provided adjusted effect size data with
95% confidence intervals on the impact of the occurrence of postoperative
AKI and long-term mortality outcomes. Occurrence of postoperative AKI is
associated with a significantly increased risk of long-term mortality (HR,
1.68; 95% CI, 1.45-1.95; p<0.00001). Recovery of renal function before
hospital discharge is associated with a lower long-term mortality risk
(HR, 1.31; 95% CI, 1.16-1.47; p<0.00001) compared with patients who
experienced persistent abnormal renal function on hospital discharge (HR,
2.71; 95% CI, 1.26-5.82; p = 0.01). Conclusions There is wide variation in
the reported incidence of AKI after cardiac surgery, reflecting the
different AKI classification systems used. AKI after cardiac surgery is
associated with an increased risk of long-term mortality. Patients with
persistent renal dysfunction after hospital discharge carry a higher risk
of AKI.
<8>
Accession Number
20151042039
Author
Yildirim F. Iskesen I. Kurdal A.T. Ozturk T. Taneli F. Gozukara C.
Ozbakkaloglu A.
Institution
(Yildirim, Iskesen, Kurdal, Ozbakkaloglu) Department of Cardiovascular
Surgery, Celal Bayar University, School of Medicine, Manisa, Turkey
(Ozturk) Department of Anesthesiology, Celal Bayar University, School of
Medicine, Manisa, Turkey
(Taneli, Gozukara) Department of Biochemistry, Celal Bayar University,
School of Medicine, Manisa, Turkey
Title
Is "attenuation of Oxidative Stress" Helpful to Understand the Mechanism
of Remote Ischemic Preconditioning in Cardiac Surgery?.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 30 (1) (pp 134-140),
2016. Date of Publication: 01 Jan 2016.
Publisher
W.B. Saunders
Abstract
Objectives The aim of this study was to determine the effect of remote
ischemic preconditioning (RIPC) on markers of cardiac ischemia and
response to oxidative stress in patients undergoing coronary artery bypass
grafting (CABG) surgery. Design A prospective, randomized, and blinded
study. Setting A single-center university hospital. Participants This
study included patients who underwent isolated CABG surgery with
cardiopulmonary bypass who were selected carefully to prevent confounding
with factors known to affect markers of ischemia-reperfusion and response
to oxidative stress. Interventions The authors randomly assigned patients
to RIPC to the left lower extremity using a blood pressure cuff (study
group) or a cuff that was applied but not inflated or deflated (control
group). Measurements and Main Results At 6 hours after CABG surgery,
high-sensitivity cardiac troponin T levels were significantly lower in the
study group than in the control group. Levels of superoxide dismutase, an
antioxidant enzyme, were significantly greater 15 minutes after release of
the cross-clamp in the study group, whereas malondialdehyde levels were
lower (not significantly) at 1 and 15 minutes after release of the
cross-clamp. Hemodynamic parameters were not significantly different at
any time point during the study. Conclusions The authors' method of RIPC
before CABG surgery resulted in less myocardial ischemia, as indicated by
lower troponin levels. Changes in levels of endogenous antioxidant enzymes
supported the hypothesis that this protection from ischemia-reperfusion
injury was related to scavenging of free oxygen radicals. Future studies
might include a more heterogeneous population and medications that lower
the body's response to oxidative stress.
<9>
Accession Number
20151040618
Author
Weber U. Glassford N.J. Eastwood G.M. Bellomo R. Hilton A.K.
Institution
(Weber, Glassford, Eastwood, Hilton) Department of Intensive Care, Austin
Hospital, 145 Studley Road, Melbourne 3084, Australia
(Bellomo) Australian and New Zealand Intensive Care Research Centre,
Department of Epidemiology and Preventive Medicine, Monash University,
Melbourne, Australia
Title
A Pilot Assessment of Carotid and Brachial Artery Blood Flow Estimation
Using Ultrasound Doppler in Cardiac Surgery Patients.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 30 (1) (pp 141-148),
2016. Date of Publication: 01 Jan 2016.
Publisher
W.B. Saunders
Abstract
Objectives To estimate carotid and brachial artery blood flow with Doppler
ultrasound in cardiac surgery patients and relate such estimates to
cardiac index, lactate levels, and markers of renal function. Design A
prospective observational study. Setting A teaching hospital. Participants
Twenty-five elective cardiac surgery patients. Interventions The authors
measured bilateral carotid and brachial artery blood flows using Doppler
ultrasound and, simultaneously, cardiac index using a pulmonary artery
catheter; lactate and serum creatinine levels; and urine output. The
relationship between these indices and biomarkers was assessed
statistically. Measurements and Main Results Median carotid arterial blood
flow was estimated at 0.323 L/min (interquartile ratio [IQR], 0.256-0.429
L/min) on the right and 0.308 L/min (IQR, 0.247-0.376 L/min) on the left
at baseline. Median brachial arterial blood flow was estimated at 0.063
L/min (IQR, 0.039-0.115 L/min) on the right and 0.063 L/min (IQR,
0.039-0.081 L/min) on the left at baseline. There was a weak correlation
between right- and left-sided flows (brachial: rho = 0.285; carotid: rho =
0.384) and between brachial and carotid flow (right: rho = 0.135, left:
rho = 0.225). There also was a weak correlation between cardiac index and
brachial flow (right: rho = 0.215; left: rho = 0.320) and carotid flow
(left: rho = 0.159) immediately after surgery, and no correlation 1 day
after surgery (right brachial: rho = -0.010; left brachial: rho = -0.064;
left carotid: rho = -0.060). There were no significant correlations
between carotid or brachial flows and lactate and serum creatinine levels
or urine output. Conclusions In cardiac surgery patients,
Doppler-estimated carotid and brachial arterial blood flows have only a
weak correlation with cardiac index and no correlation with lactate or
creatinine levels or urine output. Thus, Doppler estimation of these blood
flows cannot be used to provide noninvasive estimates of cardiac index in
patients after cardiac surgery.
<10>
Accession Number
2015555647
Author
Chi X. Liao M. Chen X. Zhao Y. Yang L. Luo A. Yang H.
Institution
(Chi, Liao, Chen, Zhao, Yang, Luo, Yang) Huazhong University of Science
and Technology, Department of Anesthesiology, Tongji Hospital, Tongji
Medical College, 1095 JieFang Road, Wuhan, Hubei 430030, China
Title
Dexmedetomidine Attenuates Myocardial Injury in Off-Pump Coronary Artery
Bypass Graft Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 30 (1) (pp 44-50),
2016. Date of Publication: 01 Jan 2016.
Publisher
W.B. Saunders
Abstract
Objective To investigate the cardioprotective effect of the continuous
administration of dexmedetomidine using serum cardiac troponin I (cTnI)
and creatine kinase MB (CK-MB) concentrations as biomarkers during
off-pump coronary artery bypass grafting (OPCAB) surgery. Design A
prospective, randomized, parallel-group controlled study. Setting A
university hospital. Participants One hundred sixteen patients undergoing
OPCAB surgery. Interventions Patients were divided randomly into 3
experimental groups that were separated by the dexmedetomidine
administration protocol: a high-dose group (loading dose, 1 mug/kg;
maintenance dose, 0.6 mug/kg/h); low-dose group (loading dose, 0.6 mug/kg;
maintenance dose, 0.3 mug/kg/h); and control group (the same amount of
0.9% saline as placebo). Serum cTnI and CK-MB levels were measured before
surgery and 24 hours and 48 hours after surgery. Measurements and Main
Results Serum cTnI and CK-MB levels in patients of the high-dose group
were less than those of the other 2 groups 48 hours after surgery. The
administration of dexmedetomidine significantly decreased the heart rate.
Compared with the control group, there was a significantly reduced
requirement of sevoflurane in the other 2 groups (p<0.05). The
intraoperative and postoperative cumulative volumes of urine output in the
high-dose group were greater than those of the other 2 groups (p<0.05).
The authors also found that the extubation time and length of stay in the
intensive care unit were prolonged in the high-dose group. Conclusions
Myocardial damage was reduced by the administration of a 1 mug/kg loading
dose and a 0.6 mug/kg/h infusion dose of dexmedetomidine. However, further
studies are needed to understand the underlying mechanism and to confirm
that high doses of dexmedetomidine could be administered safely in
patients undergoing OPCAB surgery.
<11>
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Accession Number
20160117729
Author
Sucha D. Symersky P. Tanis W. Mali W.P.Th.M. Leiner T. Van Herwerden L.A.
Budde R.P.J.
Institution
(Sucha, Mali, Leiner, Budde) Departments of Radiology, University Medical
Center Utrecht, Huispostnummer E01.132. Heidelberglaan 100, Utrecht, GA
3508, Netherlands
(Van Herwerden) Departments of Cardiothoracic Surgery, University Medical
Center Utrecht, Utrecht, Netherlands
(Symersky) Department of Cardiothoracic Surgery, VU University Medical
Center, Amsterdam, Netherlands
(Tanis) Department of Cardiology, HagaZiekenhuis, The Hague, Netherlands
(Budde) Department of Radiology, Erasmus Medical Center, Rotterdam,
Netherlands
Title
Multimodality Imaging Assessment of Prosthetic Heart Valves.
Source
Circulation: Cardiovascular Imaging. 8 (9) (no pagination), 2015. Article
Number: e003703. Date of Publication: 01 Sep 2015.
Publisher
Lippincott Williams and Wilkins
Abstract
Echocardiography and fluoroscopy are the main techniques for prosthetic
heart valve (PHV) evaluation, but because of specific limitations they may
not identify the morphological substrate or the extent of PHV pathology.
Cardiac computed tomography (CT) and magnetic resonance imaging (MRI) have
emerged as new potential imaging modalities for valve prostheses. We
present an overview of the possibilities and pitfalls of CT and MRI for
PHV assessment based on a systematic literature review of all experimental
and patient studies. For this, a comprehensive systematic search was
performed in PubMed and Embase on March 24, 2015, containing CT/MRI and
PHV synonyms. Our final selection yielded 82 articles on surgical valves.
CT allowed adequate assessment of most modern PHVs and complemented
echocardiography in detecting the obstruction cause (pannus or thrombus),
bioprosthesis calcifications, and endocarditis extent (valve dehiscence
and pseudoaneurysms). No clear advantage over echocardiography was found
for the detection of vegetations or periprosthetic regurgitation. Whereas
MRI metal artifacts may preclude direct prosthesis analysis, MRI provided
information on PHV-related flow patterns and velocities. MRI demonstrated
abnormal asymmetrical flow patterns in PHV obstruction and allowed
prosthetic regurgitation assessment. Hence, CT shows great clinical
relevance as a complementary imaging tool for the diagnostic work-up of
patients with suspected PHV obstruction and endocarditis. MRI shows
potential for functional PHV assessment although more studies are required
to provide diagnostic reference values to allow discrimination of normal
from pathological conditions.
<12>
Accession Number
20160128457
Author
Poirier Y. Voisine P. Plourde G. Rimac G. Barria Perez A. Costerousse O.
Bertrand O.F.
Institution
(Poirier, Voisine, Plourde, Rimac, Barria Perez, Costerousse, Bertrand)
Quebec Heart-Lung Institute, Laval University, Interventional Cardiology
Labs, 2725, Chemin Ste-Foy, Quebec, QC G1V4G5, Canada
Title
Efficacy and safety of preoperative intra-aortic balloon pump use in
patients undergoing cardiac surgery: A systematic review and
meta-analysis.
Source
International Journal of Cardiology. 207 (pp 67-79), 2016. Date of
Publication: 15 Mar 2016.
Publisher
Elsevier Ireland Ltd
Abstract
Background Intra-aortic balloon pump (IABP) can be used prior to coronary
artery bypass graft surgery (CABG) in high-risk patients. Whether this
technique remains safe and effective in contemporary practice is
controversial. Objective We have completed a systematic review and
meta-analysis of randomized trials and observational studies to evaluate
the safety and benefits of IABP prior to CABG surgery. Methods We searched
PubMed, EMBASE, Cochrane Library databases, with cross-referencing of
relevant articles for studies assessing the impact of IABP prior to and
after isolated CABG. Two investigators independently sorted the
potentially relevant studies, and three extracted data. The assessed
outcomes included in-hospital and 30-day mortality, IABP-related
complications and length of intensive care unit and hospital stay. Results
From 1977 to 2015 we included 11 randomized controlled trials (n = 1293)
(RCTs) and 22 observational studies, including a total of 46,067 patients.
Analyses from RCTs suggested that IABP prior to CABG was associated with a
significant reduction in hospital mortality (odds ratio (OR) 0.20; 95%
confidence interval (CI): 0.09-0.44; P < 0.0001) and 30-day mortality
compared to no preoperative IABP (OR 0.43, 95% CI: 0.25-0.76; P = 0.003).
IABP prior to CABG was also associated with shorter intensive care unit
(weighted mean difference (WMD) - 1.47 day; 95% CI: - 1.82 to - 1.12 day;
P < 0.00001) and hospital length of stay (WMD - 3.25 days; 95% CI: - 5.18
to - 1.33 days; P = 0.0009). However, there were significant bias and
limitations among included studies. Furthermore, results for similar
outcomes from observational studies remained inconclusive. Conclusions In
contemporary practice, evidence showing clinical benefit for preoperative
IABP in high-risk patients remains limited and requires further validation
in an appropriately sized multicenter randomized trial.
<13>
Accession Number
20160129483
Author
Ng V.G. Mori K. Costa R.A. Kish M. Mehran R. Urata H. Saku K. Stone G.W.
Lansky A.J.
Institution
(Ng, Kish, Lansky) Yale University Medical Center, New Haven, CT, United
States
(Mori, Urata) Fukuoka University Chikushi Hospital, Fukuoka, Japan
(Costa) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
(Mehran, Stone) Columbia University Medical Center, Cardiovascular
Research Foundation, New York, NY, United States
(Saku) Department of Cardiology, Fukuoka University School of Medicine,
Fukuoka, Japan
(Lansky) Yale University School of Medicine, PO Box 208017, New Haven, CT
06520-8017, United States
Title
Impact of gender on infarct size, ST-segment resolution, myocardial blush
and clinical outcomes after primary stenting for acute myocardial
infarction: Substudy from the EMERALD trial.
Source
International Journal of Cardiology. 207 (pp 269-276), 2016. Date of
Publication: 15 Mar 2016.
Publisher
Elsevier Ireland Ltd
Abstract
Background Women with AMI may have worse outcomes than men. However, it is
unclear if this is related to differences in treatment, treatment effect
or gender specific factors. We sought to determine whether primary
percutaneous intervention (PCI) has a differential impact on infarct size,
myocardial perfusion and ST segment resolution in men and women with acute
myocardial infarction (AMI). Methods A total of 501 AMI patients were
prospectively enrolled in the EMERALD study and underwent PCI with or
without distal protection. Post hoc gender subset analysis was performed.
Results 501 patients (108 women, 393 men) with ST-segment elevation AMI
presenting within 6 h underwent primary (or rescue) PCI with stenting and
a distal protection device. Women were older, had more hypertension, less
prior AMI, smaller BSA, and smaller vessel size, but had similar rates of
diabetes (30% versus 20.2%, p = 0.87), LAD infarct, and
time-to-reperfusion compared to men. Women more frequently had complete
ST-resolution (> 70%) at 30 days (72.8% versus 59.8%, p = 0.02), and
smaller infarct size compared to males (12.2 +/- 19.6% versus 18.4 +/-
18.5%, p = 0.006). At 6 months, TLR (6.9% versus 5.2%) and MACE (11.4%
versus 10.3%) were similar for women and men. Conclusions Despite worse
comorbidities, women with AMI treated with primary PCI with stenting
showed similar early and midterm outcomes compared to men.
<14>
Accession Number
20160120104
Author
Meng M. Gao B. Wang X. Bai Z.-G. Sa R.-N. Ge B.
Institution
(Meng, Gao, Wang, Sa, Ge) Gansu Provincial Hospital, Department of
Pharmacy, Donggang West Road No. 204, Lanzhou, Gansu 730000, China
(Bai) Lanzhou University, Evidence-Based Medicine Center, Lanzhou, Gansu
730000, China
Title
Long-term clinical outcomes of everolimus-eluting stent versus
paclitaxel-eluting stent in patients undergoing percutaneous coronary
interventions: A meta-analysis.
Source
BMC Cardiovascular Disorders. 16 (1) (no pagination), 2016. Article
Number: 34. Date of Publication: February 09, 2016.
Publisher
BioMed Central Ltd.
Abstract
Background: Everolimus -eluting stent (EES) is common used in patients
undergoing percutaneous coronary interventions (PCI). Our purpose is to
evaluate long-term clinical outcomes of everolimus -eluting stent (EES)
versus paclitaxel-eluting stent (PES) in patients undergoing percutaneous
coronaryinterventions (PCI) in randomized controlled trials (RCTs).
Methods: We searched Medline, EMBASE, Cochrane Library, CNKI, VIP and
relevant websites (https://scholar-google-com.ezproxy.lib.usf.edu/ ) for
articles to compare outcomes between everolimus-eluting stent and
paclitaxel-eluting stent without language or date restriction. RCTs that
compared the use of everolimus -eluting stent and paclitaxel-eluting stent
in PCI were included. Variables relating to patient, study
characteristics, and clinical endpoints were extracted. Meta-analysis was
performed using RevMan 5.2 software. Results: We identified 6 published
studies (from three randomized trials) more on everolimus-eluting stent
(n=3352) than paclitaxel-eluting (n=1639), with follow-up duration ranging
from 3, 4 and 5years. Three-year outcomes of everolimus-eluting stent
compared to paclitaxel-eluting were as following: the everolimus-eluting
stent significantly reduced all-cause death (relative risk [RR]:0.63; 95%
confidence interval [CI]: 0.46. to 0.82), MACE (RR: 0.56; 95% CI: 0.41 to
0.77), MI (RR: 0.64; 95% CI: 0.48 to 0.86), TLR (RR: 0.72; 95% CI: 0.59 to
0.88), ID-TLR (RR: 0.74; 95% CI: 0.59 to 0.92) and ST (RR: 0.54; 95% CI:
0.32 to 0.90). There was no difference in TVR between the
everolimus-eluting and paclitaxel-eluting (RR: 0.76; 95% CI: 0.58 to
1.10); Four-year outcomes of everolimus-eluting compared to
paclitaxel-eluting: the everolimus-eluting significantly reduced MACE (RR:
0.44; 95% CI: 0.18 to 0.98) and ID-TLR (RR: 0.47; 95% CI: 0.23 to 0.97).
There was no difference in MI (RR: 0.48; 95% CI: 0.16 to 1.46), TLR (RR:
0.46; 95% CI: 0.20 to1.04) and ST ((RR: 0.34; 95% CI: 0.05 to 2.39).
Five-year outcomes of everolimus-eluting stent compared to
paclitaxel-eluting: There was no difference in ID-TLR (RR: 0.67; 95% CI:
0.45 to 1.02) and ST (RR: 0.71; 95% CI: 0.28 to1.80). Conclusions: In the
present meta-analysis, everolimus-eluting appeared to be safe and
clinically effective in patients undergoing PCI in comparison to PES in
3-year clinical outcomes; there was similar no difference in reduction of
ST between EES and PES in long-term(>4years) clinical follow-ups.
Everolimus-eluting is more safety than paclitaxel-eluting in long-term
clinical follow-ups, whether these effects can be applied to different
patient subgroups warrants further investigation.
<15>
Accession Number
2014724566
Author
Sakamoto A. Hamasaki T. Kitakaze M.
Institution
(Sakamoto) Department of Anesthesiology and Pain Medicine, Graduate School
of Medicine, Nippon Medical School, Tokyo 113-8603, Japan
(Hamasaki) Department of Biomedical Statistics, Osaka University Graduate
School of Medicine, Suita 565-0871, Japan
(Kitakaze) Department of Cardiovascular Medicine, Research and Development
Initiative Center, National Cerebral and Cardiovascular Center, Suita,
Osaka 565-8565, Japan
Title
Perioperative Landiolol Administration reduces Atrial Fibrillation after
Cardiac Surgery: A Meta-analysis of Randomized Controlled Trials.
Source
Advances in Therapy. 31 (4) (pp 440-450), 2014. Date of Publication: 01
Apr 2014.
Publisher
Springer Healthcare
Abstract
Introduction: Postoperative atrial fibrillation (POAF) is one of the most
common complications after cardiac surgery. Patients who develop POAF have
a prolonged stay in the intensive care unit and hospital and an increased
risk of postoperative stroke. Many guidelines for the management of
cardiac surgery patients, therefore, recommend perioperative
administration of beta-blockers to prevent and treat POAF. Landiolol is an
ultra-short acting beta-blocker, and some randomized controlled trials of
landiolol administration for the prevention of POAF have been conducted in
Japan. This meta-analysis evaluated the effectiveness of landiolol
administration for the prevention of POAF after cardiac surgery. Methods:
The Medline/PubMed and BioMed Central databases were searched for
randomized controlled trials comparing cardiac surgery patients who
received perioperative landiolol with a control group (saline
administration, no drug administration, or other treatment). Two
independent reviewers selected the studies for inclusion. Data regarding
POAF and safety outcomes were extracted. Odds ratios (ORs) with 95%
confidence intervals (CIs) were calculated using the Mantel-Haenszel
method (fixed effects model). Results: Six trials with a total of 560
patients were included in the meta-analysis. Landiolol administration
significantly reduced the incidence of POAF after cardiac surgery (OR
0.26, 95% CI 0.17-0.40). The effectiveness of landiolol administration was
similar in three groups: all patients who underwent coronary artery bypass
grafting (CABG) (OR 0.27, 95% CI 0.17-0.43), patients who underwent CABG
compared with a control group who received saline or nothing (OR 0.28, 95%
CI 0.17-0.45), and all patients who underwent cardiac surgery compared
with a control group who received saline or nothing (OR 0.27, 95% CI
0.17-0.42). Only two adverse events associated with landiolol
administration were observed (2/302, 0.7%): hypotension in one patient and
asthma in one patient. Conclusion: Landiolol administration reduces the
incidence of POAF after cardiac surgery and is well tolerated.
<16>
Accession Number
20160117191
Author
Garry D. Newton J. Colebourn C.
Institution
(Garry) Department of Anaesthetics, Oxford University Hospitals NHS Trust,
Oxford, United Kingdom
(Newton) Department of Cardiology, OUH NHS Trust, Oxford, United Kingdom
(Colebourn) Department of Critical Care Medicine, OUH NHS Trust, Oxford,
United Kingdom
Title
Tissue Doppler indices of diastolic function in critically ill patients
and association with mortality - A systematic review.
Source
Journal of the Intensive Care Society. 17 (1) (pp 51-62), 2016. Date of
Publication: February 2016.
Publisher
SAGE Publications Inc.
Abstract
Purpose: Systolic impairment is well reported in critically ill patients
but diastolic function has been relatively understudied. The objective of
this review was to assess tissue Doppler indices of diastolic function in
critically ill patients along with any association with mortality.
Methods: A systematic review of articles in English using Medline, EMBASE,
CINAHL and the Cochrane database of systematic reviews. Search terms
included diastolic function, diastolic dysfunction, diastolic abnormal*,
diastolic heart failure, diastolic filling, ventricular relaxation,
pulmonary artery occlusion pressure, left ventricular filling pressure,
cardiac dysfunction, intensive care, critical care, critically ill,
critical illness, sepsis and septic shock. Only studies of critically ill
adult patients (excluding post-cardiac surgical patients) whose diastolic
function was assessed using tissue Doppler imaging were included. Study
quality was assessed using a modified version of the Newcastle-Ottawa
Scale (NOS). Results: Nineteen studies were included, with a total of 1365
patients. All trials were observational. There was a large heterogeneity
in patient populations and the methodology of tissue Doppler assessment of
diastology resulting in a descriptive analysis. Patient groups included
severe sepsis or septic shock (5 studies), septic shock (5 studies),
systemic inflammatory response syndrome and shock (1 study), septic shock
and acute lung injury (1 study), cancer and septic shock (2 studies),
general ICU patients (1 study), combined medical and surgical ICU (2
studies) and sub-arachnoid haemorrhage patients (2 studies). Seventeen
studies scored 5/6 on the NOS with the remaining two scoring 4/6. Fourteen
studies reported on numbers of patients diagnosed with diastolic
dysfunction (500/999, mean 50%, range 20-92%). Three studies found that
diastolic dysfunction was an independent predictor of mortality.
Conclusions: Current data shows a large range in the incidence of
diastolic dysfunction in this patient population and a variable link with
mortality. Future research should focus on the definition of normal values
for diastolic function in critically ill patients along with the effects
of ICU therapies and consensus criteria for its assessment in this patient
population.
<17>
Accession Number
20160115997
Author
Pan W. Wang Y. Lin L. Zhou G. Hua X. Mo L.
Institution
(Pan, Wang, Lin, Zhou, Hua, Mo) Department of Anaesthesiology, First
Affiliated Hospital, Sun Yat-sen University, No. 58, Zhongshan 2nd Road,
Guangzhou 510080, China
Title
Outcomes of dexmedetomidine treatment in pediatric patients undergoing
congenital heart disease surgery: A meta-Analysis.
Source
Paediatric Anaesthesia. 26 (3) (pp 239-248), 2016. Date of Publication: 01
Mar 2016.
Publisher
Blackwell Publishing Ltd
Abstract
Background Dexmedetomidine decreases cardiac complications in adults
undergoing cardiovascular surgery. This systematic review assessed whether
perioperative dexmedetomidine improves congenital heart disease (CHD)
surgery outcomes in children. Methods The PubMed, Embase, and Cochrane
Library databases were searched for randomized controlled trials (RCTs) or
observational studies that were published until 16 April 2015 and compared
dexmedetomidine with placebo or an alternative anesthetic agent during
pediatric CHD surgery. The assessed outcomes included hemodynamics,
ventilation length, intensive care unit (ICU) and hospital stays, blood
glucose and serum cortisol levels, postoperative analgesia requirements,
and postoperative delirium. Results Five RCTs and nine observational
studies involving 2229 patients were included. In pooled analyses,
dexmedetomidine was associated with shorter length of mechanical
ventilation (mean difference: -93.36, 95% CI: -137.45, -49.27), lower
postoperative fentanyl (mean difference: -24.11, 95% CI: -36.98, -11.24)
and morphine (mean difference: -0.07, 95% CI: -0.14, 0.00) requirements,
reduced stress response (i.e., lower blood glucose and serum cortisol
levels), and lower risk of delirium (OR: 0.39, 95% CI: 0.21, 0.74). The
hemodynamics of dexmedetomidine-treated patients appeared more stable, but
there were no significant differences in the ICU or hospital stay
durations. Dexmedetomidine may increase the bradycardia and hypotension
risk (OR: 3.14, 95% CI: 1.47, 6.69). Conclusions Current evidence
indicates that dexmedetomidine improves outcomes in children undergoing
CHD surgery. However, this finding largely relies on data from
observational studies; high-quality RCTs are warranted because of the
potential for subject selection bias.
