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IPA

Category: Cardiac Surgery

Inflammation Patient

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

This retrospective study at the National Cardiovascular Center Harapan Kita analyzed 1056 on-pump CABG procedures from January 2019 to December 2022, finding that high preoperative systemic immune-inflammation index (SII) values were significantly associated with poor perioperative outcomes. Patients with an SII value ≥528.715 × 103/mm3 experienced longer surgery and cardiopulmonary bypass times, prolonged mechanical ventilation, ICU and hospital stays, and an increased risk of postoperative complications such as atrial fibrillation, cardiac arrest, acute myocardial infarction, and mortality. The study underscores the importance of preoperative SII values as predictors of morbidity and mortality in on-pump CABG surgery

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February 14, 2024
Blood Cells Lich

Preoperative Anemia and Postoperative Outcomes in Cardiac Surgery: A Mediation Analysis Evaluating Intraoperative Transfusion Exposures

This study investigates the impact of preoperative anemia on postoperative outcomes in cardiac surgery, particularly focusing on acute kidney injury (AKI) and hospital stay duration. Analyzing over 4,000 patients, the findings reveal that preoperative anemia significantly increases the risk of AKI and extends hospital stays, with a notable portion of these effects directly attributed to anemia rather than mediated through intraoperative red blood cell transfusions. The research underscores the need for further exploration into anemia’s role in postoperative complications and highlights the importance of addressing preoperative anemia in cardiac surgery patients.

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February 11, 2024
Heart Failure

Novel Pan-ERR Agonists Ameliorate Heart Failure Through Enhancing Cardiac Fatty Acid Metabolism and Mitochondrial Function

This study introduces two pan-ERR agonists, SLU-PP-332 and SLU-PP-915, demonstrating their efficacy in improving heart function in a heart failure (HF) model. By activating ERRα and ERRγ, these agonists significantly enhance ejection fraction, reduce fibrosis, and increase survival without affecting cardiac hypertrophy. Their action activates metabolic genes, particularly those involved in fatty acid metabolism and mitochondrial function, leading to normalized metabolic profiles and increased mitochondrial oxidative capacity. ERRγ was identified as the primary mediator of these beneficial effects, offering potential for ERR agonists as novel HF therapeutics.

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February 10, 2024
Peep

Maintaining Moderate Versus Lower PEEP After Cardiac Surgery: A Propensity-Scored Matched Analysis

This retrospective study investigated the impact of applying moderate versus lower positive end-expiratory pressure (PEEP) in the early postoperative period for cardiac surgery patients in the ICU. It involved 334 patients, with 102 receiving moderate PEEP (≥ 7 cm H2O). After propensity-score matching, the moderate PEEP group showed marginally shorter mechanical ventilation durations and significantly better oxygenation compared to the lower PEEP group, without affecting ICU length of stay or the need for prone positioning. The findings suggest that moderate PEEP could facilitate earlier mechanical ventilation liberation due to improved oxygenation in selected cardiac surgery patients.

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February 9, 2024
CV Surgery Baby

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

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

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February 8, 2024
Lactic Acidosis

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

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.

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February 6, 2024
Blood CPB

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

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.

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February 5, 2024
A FIB 2024

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

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.

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February 4, 2024
Aortic Aneruysm

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

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.

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February 3, 2024
Chip Heart

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

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.

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February 2, 2024
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