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IPA

Category: Cardiac Surgery

Predication Models

A Systematic Review of Cardiac Surgery Clinical Prediction Models That Include Intra-operative Variables

This systematic review assesses clinical prediction models (CPMs) that incorporate intra-operative variables to predict outcomes following adult cardiac surgery. It highlights the identification of 24 CPMs, predominantly predicting acute kidney injury and peri-operative mortality, using common variables like cardiopulmonary bypass time. Despite acceptable discrimination in internally validated models, poor calibration and high bias risk limit their practical use. The review suggests potential improvement in model accuracy with intra-operative data, advocating for more robust studies.

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April 26, 2024
Coronary Clock

High Preoperative Systemic Immune-Inflammation Index Values Significantly Predicted Poor Outcomes After On-Pump Coronary Artery Bypass Surgery

A study investigating the role of the systemic immune-inflammation index (SII) in predicting outcomes for patients undergoing on-pump coronary artery bypass graft (CABG) surgery found significant correlations. High preoperative SII values were linked to prolonged surgery and cardiopulmonary bypass times, extended ICU and hospital stays, and increased risks of severe complications such as atrial fibrillation, cardiac arrest, and mortality.

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April 23, 2024
Critical Care Advances

21st Century Critical Care Medicine: An Overview

Critical care medicine has made significant advancements in the 21st century, notably improving patient outcomes in ICUs. Innovations such as Precision Medicine, Telemedicine, AI-driven tools, advanced Organ Support, new Infection Control tactics, refined Ventilation Strategies, and enhanced Sepsis Management reflect a dynamic landscape. These developments prioritize technology, research, and patient-centered approaches, showcasing a promising future for addressing modern medical challenges.

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April 23, 2024
Cardiac Rehab

Comprehensive Cardiac Rehabilitation Following Acute Myocardial Infarction Improves Clinical Outcomes Regardless of Exercise Capacity

This study evaluates the impact of comprehensive cardiac rehabilitation (CR) on patients with acute myocardial infarction (AMI) and varying exercise capacities. Involving 610 patients who underwent percutaneous coronary intervention, it found that those participating in CR showed a significantly lower incidence of major adverse cardiovascular events (MACE) over an average of 6.1 years compared to non-participants. This benefit was consistent across patients with both reduced and preserved exercise capacities, highlighting CR’s essential role in AMI recovery.

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April 22, 2024
Mad Kidney

Risk Prediction Models for Renal Function Decline After Cardiac Surgery Within Different Preoperative Glomerular Filtration Rate Strata

This study focuses on developing risk prediction models to identify patients at risk of renal function decline post-cardiac surgery. Using data from 24,904 patients at Fuwai Hospital, the study found significant variances in renal decline risks across different preoperative glomerular filtration rate (eGFR) strata. Notably, patients with higher eGFR levels pre-surgery showed increased risk. The research produced distinct nomograms for each eGFR category, demonstrating good predictive accuracy and providing a practical tool for postoperative renal monitoring.

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April 21, 2024
Brain Hemmorage

Impact of Postoperative Cerebral Complications in Acute Infective Endocarditis: A Retrospective Single-Center Study

This retrospective study at a single center explored the impact of preoperative cerebral complications on patients with acute infective endocarditis (IE). Among 31 patients analyzed, those with intracranial findings prior to surgery did not experience a worse postoperative course despite being older and having more complex clinical profiles. Notably, one patient without previous cerebral issues developed a cerebral hemorrhage postoperatively, highlighting the need for careful monitoring and preventative strategies for all IE patients, regardless of initial cerebral status.

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April 21, 2024
Exploding Aorta

Inflammation in Aortic Surgery: Postoperative Evolution of Biomarkers According to Pathologies and Segments of the Aorta

This study analyzes the postoperative trends of inflammatory biomarkers in 193 patients who underwent various types of aortic surgery. The research focused on the differing responses across four main surgical interventions: Type A aortic dissection repair, aortic root replacement, combined aortic arch and Frozen elephant trunk procedures, and descending/thoraco-abdominal aortic repair. Findings highlighted that inflammation levels, measured by WBC and CRP, vary significantly depending on the surgery type and aortic segment involved, with some groups showing prolonged inflammation.

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April 19, 2024
Heart Nurse

The Systemic Immune-Inflammation Index Predicts In-Hospital Mortality in Patients Who Underwent On-Pump Cardiac Surgery

This study explores the role of the Systemic Immune-Inflammation Index (SII), derived from platelet, neutrophil, and lymphocyte counts, as a predictor of in-hospital mortality for patients undergoing on-pump cardiac surgery. Analyzing data from 480 patients, it was found that a higher preoperative SII is independently associated with an increased risk of mortality. With a sensitivity and specificity of 65%, SII, along with neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), provides valuable prognostic information, potentially guiding more effective treatments.

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April 19, 2024
CABG Hema

Antithrombotic Drug Removal with Hemoadsorption During Off-Pump Coronary Artery Bypass Grafting

This study evaluates the efficacy of using a hemoadsorption cartridge to remove antithrombotic drugs during off-pump coronary artery bypass grafting (OPCAB). Ten patients, predominantly male and with a mean age of 67.4 years, were treated with antithrombotics like ticagrelor and rivaroxaban. Hemoadsorption was integrated into the perioperative management using either a dialysis device or a standalone apheresis pump, showing a mean treatment time of 145 minutes. Results indicated low rates of bleeding, no deaths, or further interventions during a mean follow-up of 19.5 months, demonstrating that this method is feasible and safe.

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April 18, 2024
TA

The Efficacy of Tranexamic Acid in Reducing Perioperative Drainage in Cardiac Surgery with Cardiopulmonary Bypass

This study evaluates the effectiveness of tranexamic acid in reducing bleeding during and after cardiac surgery involving cardiopulmonary bypass. It compared 40 patients who received tranexamic acid to 40 who did not, finding significant differences in bleeding and transfusion rates, and improvements in hematological parameters for the treated group. These results suggest tranexamic acid effectively minimizes bleeding in such surgeries.

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April 17, 2024
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