Results Generated From:
Embase <1980 to 2018 Week 12>
Embase (updates since 2018-03-09)
<1>
Accession Number
619949956
Author
Zhang Z.J.; Zheng M.L.; Nie Y.; Niu Z.Q.
Institution
(Zhang, Zheng, Nie, Niu) Department of Anesthesiology, The Cangzhou
Central Hospital, Cangzhou, Hebei, China
Title
Comparison of Arndt-endobronchial blocker plus laryngeal mask airway with
left-sided double-lumen endobronchial tube in one-lung ventilation in
thoracic surgery in the morbidly obese.
Source
Brazilian Journal of Medical and Biological Research. 51 (2) (no
pagination), 2018. Article Number: e6825. Date of Publication: 2018.
Publisher
Associacao Brasileira de Divulgacao Cientifica (E-mail:
bjournal@fmrp.usp.br)
Abstract
This study aimed to evaluate the feasibility and performance of
Arndt-endobronchial blocker (Arndt) combined with laryngeal mask airway
(LMA) compared with left-sided double-lumen endobronchial tube (L-DLT) in
morbidly obese patients in one-lung ventilation (OLV). In a prospective,
randomized double-blind controlled clinical trial, 80 morbidly obese
patients (ASA I-III, aged 20-70) undergoing general anesthesia for
elective thoracic surgeries were randomly allocated into groups Arndt
(n=40) and L-DLT (n=40). In group Arndt, a LMATM Proseal was placed
followed by an Arndt-endobronchial blocker. In group L-DLT, patients were
intubated with a left-sided double-lumen endotracheal tube. Primary
endpoints were the airway establishment, ease of insertion, oxygenation,
lung collapse and surgical field exposure. Results showed similar ease of
airway establishment and tube/device insertion between the two groups.
Oxygen arterial pressure (PaO<inf>2</inf>) of patients in the Arndt group
was significantly higher than L-DLT (154+/-46 vs 105+/-52 mmHg; P<0.05).
Quality of lung collapse and surgical field exposure in the Arndt group
was significantly better than L-DLT (effective rate 100 vs 90%; P<0.05).
Duration of surgery and anesthesia were significantly shorter in the Arndt
group (2.4+/-1.7 vs 3.1+/-1.8 and 2.8+/-1.9 vs 3.8+/-1.8 h, respectively;
P<0.05). Incidence of hoarseness of voice and incidence and severity of
throat pain at the post-anesthesia care unit and 12, 24, 48, and 72 h
after surgery were significantly lower in the Arndt group (P<0.05).
Findings suggested that Arndt-endobronchial blocker combined with LMA can
serve as a promising alternative for morbidly obese patients in OLV in
thoracic surgery.<br/>Copyright © 2018, Associacao Brasileira de
Divulgacao Cientifica. All rights reserved.
<2>
Accession Number
620684293
Author
Li M.; Zou H.; Xu G.
Institution
(Li, Zou, Xu) Department of Nephrology, the Second Affiliated Hospital of
Nanchang University, No. 1, Minde Road, Donghu District, Nanchang, China
Title
Corrigendum to "The prevention of statins against AKI and mortality
following cardiac surgery: A meta-analysis" [Int. J. Cardiol. 222 (Nov 1
2016) 260-6](S0167527316315698)(10.1016/j.ijcard.2016.07.173).
Source
International Journal of Cardiology. 258 (pp 336), 2018. Date of
Publication: 01 May 2018.
Publisher
Elsevier Ireland Ltd
Abstract
The authors regret that the affiliation was mentioned incorrectly in the
original article and this has now been corrected. The authors would like
to apologise for any inconvenience caused.<br/>Copyright © 2018
Elsevier B.V.
<3>
Accession Number
620675740
Author
Bauer A.; Hausmann H.; Schaarschmidt J.; Scharpenberg M.; Troitzsch D.;
Johansen P.; Nygaard H.; Eberle T.; Hasenkam J.M.
Institution
(Bauer, Schaarschmidt) MediClin Heart Centre Coswig, Department of
Cardiovascular Perfusion, Coswig, Saxony-Anhalt, Germany
(Bauer, Eberle) MediClin Heart Centre Coswig, Department of Anaesthesia
and Intensive Care Medicine, Coswig, Saxony-Anhalt, Germany
(Hausmann) MediClin Heart Centre Coswig, Department of Cardiothoracic and
Vascular Surgery, Coswig, Saxony-Anhalt, Germany
(Scharpenberg) University of Bremen, Competence Center for Clinical
Trials, Bremen, Germany
(Troitzsch) Zoll Lifebridge, Ampfing, Bayern, Germany
(Johansen) Department of Engineering, Aarhus University, Jutland, Denmark
(Nygaard, Hasenkam) Aarhus University, Department of Cardio Thoracic and
Vascular Surgery, Aarhus University Hospital and Department of Clinical
Medicine, Aarhus, Jutland, Denmark
Title
Shed-blood-separation and cell-saver: an integral Part of MiECC?
Shed-blood-separation and its influence on the perioperative inflammatory
response during coronary revascularization with minimal invasive
extracorporeal circulation systems - a randomized controlled trial.
Source
Perfusion (United Kingdom). 33 (2) (pp 136-147), 2018. Date of
Publication: 01 Mar 2018.
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Objective: The postoperative systemic inflammatory response after
cardiopulmonary bypass (CPB) is still an undesirable side-effect after
cardiac surgery. It is most likely caused by blood contact with foreign
surfaces and by the surgical trauma itself. However, the recirculation of
activated shed mediastinal blood is another main cause of blood cell
activation and cytokine release. Minimal invasive extracorporeal
circulation (MiECC) comprises a completely closed circuit, coated surfaces
and the separation of suction blood. We hypothesized that MiECC, with
separated cell saved blood, would induce less of a systemic inflammatory
response than MiECC with no cell-saver. The aim of this study was,
therefore, to investigate the impact of cell washing shed blood from the
operating field versus direct return to the ECC on the biomarkers for
systemic inflammation. Material and methods: In the study, patients with
MiECC and cell-saver were compared with the control group, patients with
MiECC and direct re-transfusion of the drawn blood shed from the surgical
field. Results: High amounts of TNF-alpha (+ 120% compared to serum blood)
were found in the shed blood itself, but a significant reduction was
demonstrated with the use of a cell-saver (TNF-alpha ng/l post-ECC 10 min:
9.5+/-3.5 vs. 19.7+/-14.5, p<0.0001). The values for procalcitonin were
not significantly increased in the control group (6h: 1.07+/-3.4 vs.
2.15+/-9.55, p=0.19) and lower for C-reactive protein (CRP) (24h:
147.1+/-64.0 vs.134.4+/-52.4 p=0.28). Conclusion: The use of a cell-saver
and the processing of shed blood as an integral part of MiECC
significantly reduces the systemic cytokine load. We, therefore, recommend
the integration of cell-saving devices in MiECC to reduce the
perioperative inflammatory response.<br/>Copyright © 2017, © The
Author(s) 2017.
<4>
Accession Number
620719225
Author
Gunaydin S.; Robertson C.; Budak A.B.; Gourlay T.
Institution
(Gunaydin, Budak) Department of Cardiovascular Surgery, Numune Training &
Research Hospital, Ankara, Turkey
(Robertson, Gourlay) Department of Biomedical Engineering, University of
Strathclyde, Glasgow, United Kingdom
Title
Comparative evaluation of blood salvage techniques in patients undergoing
cardiac surgery with cardiopulmonary bypass.
Source
Perfusion (United Kingdom). 33 (2) (pp 105-109), 2018. Date of
Publication: 01 Mar 2018.
Publisher
SAGE Publications Ltd (E-mail: info@sagepub.co.uk)
Abstract
Background: The primary objective of this study was to test and compare
the efficacy of currently available intraoperative blood salvage systems
via a demonstration of the level of increase in percentage concentration
of red blood cells (RBC), white blood cells 9WBC) and platelets (Plt) in
the end product. Methods: In a prospective, randomized study, data of 80
patients undergoing elective cardiac surgery with cardiopulmonary bypass
in a 6-month period was collected, of which the volume aspirated from the
surgical field was processed by either the HemoSep Novel Collection Bag
(Advancis Surgical, Kirkby-in-Ashfield, Notts, UK) (N=40) (Group 1) or a
cell- saver (C.A.T.S Plus Autotransfusion System, Fresenius Kabi, Bad
Homburg, Germany) (N=40) (Group 2). Results: Hematocrit levels increased
from 23.05%+/-2.7 to 43.02%+/-12 in Group 1 and from 24.5+/-2 up to
55.2+/-9 in Group 2 (p=0.013). The mean number of platelets rose to
225200+/-47000 from 116400 +/-40000 in the HemoSep and decreased from
125200+/-25000 to 96500+/-30000 in the cell-saver group (p=0.00001). The
leukocyte count was concentrated significantly better in Group 1 (from
10100+/-4300 to 18120+/-7000; p=0.001). IL-6 levels (pg/dL) decreased from
223+/-47 to 83+/-21 in Group 1 and from 219+/-40 to 200+/-40 in Group 2
(p=0.001). Fibrinogen was protected significantly better in the HemoSep
group (from 185+/-35 to 455+/-45; p=0.004). Conclusions: Intraoperative
blood salvage systems functioned properly and the resultant blood product
was superior in terms of red blood cell species. The HemoSep group had
significantly better platelet and leukocyte concentrations and fibrinogen
content.<br/>Copyright © 2017, © The Author(s) 2017.
<5>
Accession Number
620620471
Author
Gu W.-J.; Hou B.-L.; Kwong J.S.W.; Tian X.; Qian Y.; Cui Y.; Hao J.; Li
J.-C.; Ma Z.-L.; Gu X.-P.
Institution
(Gu, Hou, Kwong, Qian, Cui, Hao, Li, Ma, Gu) Department of Anesthesiology,
Nanjing Drum Tower Hospital, Medical College of Nanjing University,
Nanjing 210008, China
(Tian) Department of Neurology, The First Affiliated Hospital of Chongqing
Medical University, Chongqing Key Laboratory of Neurology, Chongqing
400016, China
Title
Association between intraoperative hypotension and 30-day mortality, major
adverse cardiac events, and acute kidney injury after non-cardiac surgery:
A meta-analysis of cohort studies.
Source
International Journal of Cardiology. 258 (pp 68-73), 2018. Date of
Publication: 01 May 2018.
Publisher
Elsevier Ireland Ltd
Abstract
Background: The association between intraoperative hypotension (IOH) and
postoperative outcomes is not fully understood. We performed a
meta-analysis to determine whether IOH is associated with increased risk
of 30-day mortality, major adverse cardiac events (MACEs) and acute kidney
injury (AKI) after non-cardiac surgery. Methods: We searched PubMed and
Embase through May 2016 to identify cohort studies that investigated the
association between IOH and risk of 30-day mortality, MACEs, or AKI in
adult patients after non-cardiac surgery. Ascertainment of IOH and
assessment of outcomes were defined by the individual study. Considering
the level of clinical heterogeneity, adjusted odds ratios (ORs) with 95%
confidence interval (CIs) were pooled using a random-effects model. This
meta-analysis is registered on PROSPERO (CRD42016049405). Results: We
included 14 cohort studies that were heterogeneous in terms of definition
of IOH. IOH alone was associated with increased risk of 30-day mortality
(OR 1.29 [95% CI, 1.19-1.41]), MACEs (OR 1.59 [95% CI, 1.23-2.05]),
especially myocardial injury (OR 1.67 [95% CI, 1.31-2.13]), and AKI (OR
1.39 [95% CI, 1.09-1.77]). Triple low (IOH coincident with low bispectral
index and low minimum alveolar concentration) also predicts increased risk
of 30-day mortality (OR 1.32 [95% CI, 1.03-1.68]). Conclusions: IOH alone
significantly increases the risk of postoperative 30-day mortality, MACEs,
especially myocardial injury, and AKI in adult patients after non-cardiac
surgery. Triple low also predicts increased risk of 30-day mortality after
non-cardiac surgery. These findings provide evidence that IOH should be
recognized as an independent risk factor for postoperative adverse
outcomes after non-cardiac surgery.<br/>Copyright © 2018 Elsevier
B.V.
<6>
Accession Number
621187005
Author
Nouraei S.M.; Baradari A.G.; Jazayeri A.
Institution
(Nouraei) Thoracic and cardiovascular surgery department, Mazandran
University of Medical sciences, Sari, Iran
(Baradari) Anaesthesia department, Mazandran University of Medical
sciences, Sari, Iran
(Jazayeri) Student Research Committee, Mazandran University of Medical
sciences, Sari, Iran
Title
Does Remote Ischaemic Preconditioning Protect Kidney and Cardiomyocytes
After Coronary Revascularization? A Double Blind Controlled Clinical
Trial.
Source
Medical archives (Sarajevo, Bosnia and Herzegovina). 70 (5) (pp 373-378),
2016. Date of Publication: 01 Oct 2016.
Abstract
OBJECTIVE: To investigate efficacy of remote ischaemic preconditioning on
reducing kidney injury and myocardial damage after coronary artery bypass
grafting surgery (CABG).
BACKGROUND: Ischaemic preconditioning of a remote organ reduces
ischaemia-reperfusion injury of kidney and myocardium after CABG.
METHOD: To reduce myocardial damage and kidney injury by applying Remote
Ischaemic Preconditioning we recruited 100 consecutive patients undergoing
elective coronary artery bypass grafting surgery. We applied three cycles
of lower limb tourniquet, inflated its cuff for 5 minutes in study group
or left un-inflated (sham or control group) before the procedure. The
primary outcome was serum creatinine, creatinine clearance and troponin-I
Levels at time 0, 6, 12, 24 and 48 h. Secondary outcomes were serum
C-reactive protein, inotrope score, ventilation time and ICU stay. Data's
were analyzed by MedCalc (MedCalc Software bvba, Acacialaan, Belgium). We
compared the two group by student t test, chi-square and Mann-Whitney
tests.
RESULTS: The two groups were not statistically different in terms of age,
gender, smoking habits, drug use, hypertension, hyperlipidemia and
diabetes mellitus. This study showed a higher CRP level in study group
comparing with control group (P=0.003), creatinine clearance was slightly
higher in study group specially 24 h after procedure but was not
statistically significant (p=0.11). Troponin-I level was significantly
lower in study group (p=0.001).
CONCLUSION: This study showed a lower Troponin-I level in study group
which suggest a cardio-myocyte protective function of RIPC. It also showed
slightly lower Creatinine clearance in control group, gap between two
group increases significantly 24 hours after procedure which may suggest a
potential kidney protection by RIPC. Serum CRP level was higher in study
group. A multi-center randomized controlled trial with a longer time for
creatinine clearance measurement may show the potential effectiveness of
this non-invasive inexpensive intervention on reducing kidney injury after
CABG.
<7>
Accession Number
621160347
Author
Wolff G.; Navarese E.P.; Brockmeyer M.; Lin Y.; Karathanos A.;
Kolodziejczak M.; Kubica J.; Polzin A.; Zeus T.; Westenfeld R.; Andreotti
F.; Kelm M.; Schulze V.
Institution
(Wolff, Brockmeyer, Lin, Karathanos, Polzin, Zeus, Westenfeld, Kelm,
Schulze) Department of Internal Medicine, Division of Cardiology,
Pulmonology and Vascular Medicine, Heinrich-Heine-University, Dusseldorf,
Germany
(Kolodziejczak, Kubica) Department of Cardiology and Internal Medicine,
Nicolaus Copernicus University, Bydgoszcz, Poland
(Andreotti) Department of Cardiovascular Science, Catholic University of
the Sacred Heart, Rome, Italy
(Wolff, Navarese, Brockmeyer, Lin, Kolodziejczak, Kubica, Kelm, Schulze)
Systematic Investigation and Research on Interventions and Outcomes
(SIRIO)-Medicine Research Network, United States
(Navarese) Interventional Cardiology and Cardiovascular Medicine Research,
Inova Heart And Vascular Institute, Fairfax Medical Campus, Falls Church,
VA, United States
Title
Perioperative aspirin therapy in non-cardiac surgery: A systematic review
and meta-analysis of randomized controlled trials.
Source
International Journal of Cardiology. 258 (pp 59-67), 2018. Date of
Publication: 01 May 2018.
Publisher
Elsevier Ireland Ltd
Abstract
Background: Aspirin is a key element in prevention of cardiovascular and
thromboembolic events. During non-cardiac surgery however, its balance of
bleeding risks and benefits remains unclear. Methods: A systematic review
and meta-analysis of randomized controlled trials was performed. Online
databases were screened for clinical trials randomizing aspirin to no
aspirin therapy in non-cardiac surgery. Clinical outcomes of all-cause
mortality and cardiovascular mortality, arterial ischemic events, venous
thromboembolic events and bleeding events were separately evaluated.
Results: Seven RCTs comprising 28,302 patients were included. All-cause
mortality (3.7% vs. 3.8%; odds ratio (OR) 0.97, CI 0.86-1.10) and
cardiovascular mortality (2.0% vs. 2.1%, OR 0.92; CI 0.78-1.09) were not
different in aspirin vs. no aspirin groups. Arterial ischemic events
showed no differences, including myocardial infarction (2.5% (aspirin) vs.
2.5% (no aspirin)), cerebrovascular events (0.6% (aspirin) vs. 0.6% (no
aspirin)) and peripheral arterial events (0.2% (aspirin) vs. 0.3% (no
aspirin)). Aspirin significantly reduced the risk for venous
thromboembolic events (VTE; 1.5% (aspirin) vs. 2.0% (no aspirin); OR 0.74,
CI 0.59-0.94, p = 0.02). Perioperative major bleeding was significantly
more frequent in aspirin groups (4.4% vs. 3.7%; OR 1.18, CI 1.05 to 1.33,
p = 0.007). Conclusion: Aspirin remained neutral with respect to overall
survival, cardiovascular mortality and arterial ischemic events. It
reduced venous thromboembolic events at the expense of perioperative major
bleedings. Thus, this analysis supports recommendations against
perioperative aspirin continuation/initiation in cardiovascular disease
patients at intermediate risk, as well as recommendations of aspirin for
VTE prophylaxis in orthopedic patients only.<br/>Copyright © 2017
Elsevier B.V.
<8>
Accession Number
621176178
Author
Raheja H.; Garg A.; Goel S.; Banerjee K.; Hollander G.; Shani J.; Mick S.;
White J.; Krishnaswamy A.; Kapadia S.
Institution
(Raheja, Banerjee, Mick, White, Krishnaswamy, Kapadia) Department of
Cardiovascular MedicineCleveland Clinic, 9500 Euclid AvenueCleveland, Ohio
(Garg) Department of Cardiology, Newark Beth Israel Medical CenterNewark,
New Jersey
(Goel, Hollander, Shani) Department of Cardiology, Maimonides Medical
CenterBrooklyn, New York
Title
Comparison of single versus dual antiplatelet therapy after TAVR: A
systematic review and meta-analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2018.
Date of Publication: 2018.
Publisher
John Wiley and Sons Inc. (P.O.Box 18667, Newark NJ 07191-8667, United
States)
Abstract
Objective: We aim to evaluate the efficacy of dual versus single
anti-platelet therapy (SAPT) after TAVR through a systematic review and
meta-analysis of published research. Background: Dual antiplatelet therapy
(DAPT) with aspirin and clopidogrel is a commonly practiced strategy after
transcatheter aortic valve replacement (TAVR). However, there is lack of
sufficient evidence supporting this approach. Method: We searched PubMed,
EMBASE, the Cochrane Central Register of Controlled trials, and the
clinical trial registry maintained at clinicaltrials.gov for randomized
control trials (RCT) and observational studies comparing DAPT with SAPT
post TAVR. Event rates were compared using a forest plot of relative risk
with 95% confidence intervals using a random-effects model assuming
inter-study heterogeneity. Results: A total of six studies (3 RCTs and 3
observational studies, n=840) were included in the final analysis.
Compared to SAPT, DAPT was associated with increased risk of significant
bleeding (life threatening and major) [RR=2.52 (95% CI 1.62-3.92,
P<0.0001)] with the number needed to harm for major or life-threatening
bleeding calculated to be 10.4. There was no significant difference in the
incidence of stroke [RR=1.06 (95% CI, 0.43-2.60, P=0.90)], spontaneous
myocardial infarction [RR=2.08 (95% CI, 0.56-7.70, P=0.27)] and all-cause
mortality [RR=1.18 (95% CI, 0.68-2.05, P=0.56] in the DAPT and SAPT
groups. Conclusion: In this small meta-analysis of DAPT versus SAPT after
TAVR, DAPT did not prevent stroke, myocardial infarction or death while
the risk of bleeding was higher. Results from ongoing trials are awaited
to determine the best anti-thrombotic approach after TAVR.<br/>Copyright
© 2018 Wiley Periodicals, Inc.
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