Intra-abdominal Hypertension Predicts Worse Hospital Outcomes in Children After Cardiac Surgery: A Pilot Study

February 8, 2024 No Comments

This study highlights the incidence and impact of postoperative intra-abdominal hypertension (IAH) in children undergoing open-heart surgery, showing that 24.7% of patients experienced IAH, with significant occurrences within the first 24 hours of ICU admission. Factors like right-sided heart lesions, redo sternotomies, and prolonged cardiopulmonary bypass were identified as predictors of IAH. The condition was associated with increased inotropic support needs, gastrointestinal complications, sepsis, multiple organ dysfunction syndrome, and extended stays in the ICU and hospital. This underscores the importance of monitoring and managing IAH to improve postoperative outcomes in pediatric cardiac surgery patients

Association Between Lactic Acidosis and Multiple Organ Dysfunction Syndrome After Cardiopulmonary Bypass

February 6, 2024 No Comments

The study investigates the link between lactic acidosis and multiple organ dysfunction syndrome (MODS) post-cardiopulmonary bypass (CPB). A post hoc analysis on cardiac surgery patients shows a correlation between lactic acidosis and higher incidences of MODS, with lactic acidosis patients experiencing the worst outcomes. The research suggests the need for intensive monitoring of lactic acidosis post-CPB to mitigate risks and improve patient care.

Protamine Dosing and Its Impact in Cardiac Surgery Transfusion Practice: A Retrospective Bi-institutional Analysis

February 5, 2024 No Comments

This study investigates the correlation between protamine dosing and transfusion requirements in cardiac surgery, analyzing data from 762 patients who underwent cardiopulmonary bypass (CPB)-assisted cardiac surgery across two institutions. Patients were categorized into low-ratio (Protamine: UFH ≤ 0.8) and high-ratio (Protamine: UFH > 0.8) groups, based on the amount of protamine used to neutralize unfractionated heparin. Results indicated a significant increase in blood transfusion requirements in the high-ratio group, encompassing red blood cells, plasma, platelets, and cryoprecipitate, highlighting the need for precise protamine dosing to reduce bleeding and transfusion rates post-surgery.

Predictors of Developing Postoperative Atrial Fibrillation in Patients Undergoing Coronary Artery Bypass Graft: A Systematic Review and Meta-Analysis

February 4, 2024 No Comments

This comprehensive meta-analysis aimed to identify predictors of postoperative atrial fibrillation (POAF) in coronary artery bypass graft (CABG) patients. Analyzing data from 16 studies involving 6200 patients, the research highlighted that advanced age, lower preoperative left ventricular ejection fraction, history of myocardial infarction, intra-aortic balloon pump use, and prolonged cardiopulmonary bypass time significantly increase the risk of developing POAF. These findings emphasize the need for targeted screening and management strategies for at-risk CABG patients.

Midterm Clinical Outcomes of Reimplantation Versus Remodeling Valve-Sparing Aortic Root Replacement in Patients With Connective Tissue Disorders: A Meta-Analysis

February 3, 2024 No Comments

This meta-analysis compared the midterm clinical outcomes of reimplantation versus remodeling techniques for valve-sparing aortic root replacement in patients with connective tissue disorders, finding no significant difference in mortality, reoperation rates, or postoperative aortic regurgitation. However, a sensitivity analysis excluding annuloplasty suggested that reimplantation may be superior to remodeling alone, indicating that further research is needed to fully evaluate these surgical techniques in this patient demographic.

Meta-Analysis of the Performance of AI-Driven ECG Interpretation in the Diagnosis of Valvular Heart Diseases

February 2, 2024 No Comments

Artificial intelligence (AI) applied to electrocardiogram (ECG) interpretation shows high accuracy for early detection of valvular heart diseases (VHDs), based on a meta-analysis of data from 713,537 patients, with pooled accuracy and sensitivity of 81% and 83%, respectively. However, the low positive predictive value (PPV) of 13% suggests that AI should be used in conjunction with clinical judgment for VHD screening in primary care settings.

Low-Volume Acute Normovolemic Hemodilution Does Not Reduce Allogeneic Red Blood Cell Transfusion in Cardiac Surgery in the Modern Era of Patient Blood Management: A Propensity Score-Matched Cohort Study

February 2, 2024 No Comments

In a retrospective cohort study of 542 elective cardiac surgery patients, acute normovolemic hemodilution (ANH) did not significantly reduce perioperative red blood cell transfusion rates compared to controls. This suggests that in the context of modern patient blood management practices, the benefits of ANH in minimizing transfusion requirements may be less significant than previously thought.

New Research Highlights Superior Long-Term Survival with Multi-Arterial Coronary Artery Bypass Grafting Over Single Arterial Grafting

February 2, 2024 No Comments

Research presented at The Society of Thoracic Surgeons’ 2024 Annual Meeting revealed that multi-arterial grafting (MAG) for coronary artery bypass grafting (CABG) results in better long-term survival than single arterial grafting (SAG), based on a study of over a million patients from 2008 to 2019. The findings, emphasizing MAG’s advantages across various patient groups except in severely obese and very elderly patients, offer critical guidance for cardiac surgeons in choosing the optimal revascularization strategy.

Perioperative Care in Cardiac Surgery: A Joint Consensus Statement by the Enhanced Recovery After Surgery (ERAS) Cardiac Society, ERAS International Society, and The Society of Thoracic Surgeons (STS)

January 31, 2024 No Comments

Enhanced Recovery After Surgery (ERAS) programs, which include protocolized evidence-based perioperative interventions, have been effective in reducing surgical stress, promoting quicker recovery, and improving clinical outcomes in various surgical specialties. An international expert panel has reviewed the literature and provided consensus statements on applying ERAS principles to cardiac surgery, laying the groundwork for best practices in managing adult cardiac surgery patients.

Development and Validation of Scores to Predict Prolonged Mechanical Ventilation after Cardiac Surgery

January 28, 2024 No Comments

This study aimed to improve the early prediction of prolonged postoperative mechanical ventilation (>24 hours) after cardiac surgery. It involved analyzing data from the ANZSCTS database, validating a modified existing prediction score, and developing the ANZ-PreVent score, which showed improved performance in identifying high-risk patients for targeted interventions.