Efficacy and Safety of Impella in Cardiogenic Shock Following Acute Myocardial Infarction: A Meta-Analysis of Randomized Controlled Trials

December 3, 2024 No Comments

This meta-analysis reviewed four randomized controlled trials (442 patients) to evaluate the use of Impella in managing cardiogenic shock (CS) following acute myocardial infarction (AMI). Impella reduced 6-month all-cause mortality (OR: 0.64, 95% CI: 0.43-0.95, P = .03) but showed no significant impact on 30-day mortality. However, Impella was linked to increased risks of major bleeding (OR: 3.61), limb ischemia (OR: 4.91), and sepsis (OR: 2.75). Future research is needed to balance survival benefits against these complications.

Comparing Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting in Non-ST-Segment Elevation Acute Coronary Syndromes: A Systematic Review and Meta-Analysis

November 29, 2024 No Comments

This systematic review and meta-analysis compared percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for treating non-ST-segment elevation acute coronary syndromes (NSTE-ACS). Analyzing data from 15 studies with 48,891 patients, results showed no significant mortality difference between PCI and CABG. However, CABG reduced the risk of myocardial infarction (RR = 0.56) and repeat revascularization (RR = 2.94), while PCI was associated with a lower risk of cerebrovascular accidents (RR = 0.58). These findings emphasize individualized treatment strategies based on patient-specific risk profiles.

A Historical Perspective and Update on Robotic Mitral Valve Surgery

November 19, 2024 No Comments

This study reviews the evolution of minimally invasive mitral valve repair, emphasizing the use of robotic platforms from 2005 to 2023. Analyzing 1,412 robotic repairs, it highlights improvements in outcomes, including reduced cross-clamp and bypass times and high repair durability. Degenerative disease was the most common indication, with 98.1% repair success and a ten-year survival rate exceeding 91%. The findings support robotic surgery as a durable, teachable, and safe option for mitral valve repair.

A Comparative Study of Femoral Artery and Combined Femoral and Axillary Artery Cannulation in Veno-Arterial Extracorporeal Membrane Oxygenation Patients

October 5, 2024 No Comments

This study investigates the clinical outcomes of two cannulation strategies—femoral artery (FA) cannulation and combined femoral and axillary artery (FA+AA) cannulation—in patients receiving veno-arterial extracorporeal membrane oxygenation (VA-ECMO) after cardiac surgery. The FA+AA group showed significant benefits in reducing chronic renal failure, platelet drop, and creatinine levels. Despite similar 30-day mortality rates, the combined approach led to fewer complications and faster recovery.

Low Frequency Ventilation During Cardiopulmonary Bypass to Protect Postoperative Lung Function in Cardiac Valvular Surgery: The PROTECTION Phase II Randomized Trial

October 1, 2024 No Comments

This trial assessed the safety and efficacy of low frequency ventilation (LFV) during cardiopulmonary bypass in patients undergoing valvular surgery. Sixty-three patients were randomized, and results showed LFV was associated with improved lung-specific biomarker levels and better-preserved lung function, including respiratory tests and walking ability. The study demonstrated LFV’s potential to protect lung function post-surgery, warranting further investigation in larger studies.

Extraction of Ketamine and Dexmedetomidine by Extracorporeal Life Support Circuits

September 26, 2024 No Comments

This study investigated the extraction of ketamine and dexmedetomidine by extracorporeal life support (ECLS) circuits such as ECMO and CRRT. Using an ex-vivo system, drug concentrations were measured over time in blood-primed circuits. Results showed significant reductions in drug recovery, with ketamine recovering only 43.8% from ECMO and 3.3% from CRRT after several hours. Dexmedetomidine recovery was similarly reduced, highlighting the need for dosage adjustments during ECLS support.

Impact of Extracorporeal Haemoadsorption During Prolonged Cardiopulmonary Bypass on the Incidence of Acute Kidney Injury

June 26, 2024 No Comments

This study investigates the effects of haemoadsorption (HA) therapy on inflammatory markers and renal damage indices during cardiopulmonary bypass (CPB) and the early postoperative period. Conducted at a single tertiary care center, the retrospective analysis compared three groups of patients who underwent CPB for over 120 minutes. The results showed that haemoadsorption therapy did not significantly reduce the incidence of acute kidney injury (AKI) but decreased the need for renal replacement therapy.

Multimodal Neurologic Monitoring in Patients Undergoing Extracorporeal Membrane Oxygenation

June 5, 2024 No Comments

This study investigates the safety and feasibility of noninvasive multimodal neurologic monitoring (MNM) in patients undergoing extracorporeal membrane oxygenation (ECMO) at Baylor St. Luke’s Medical Center. The observational study spanned from January 2017 to February 2019 and included patients undergoing ECMO. Results showed that MNM was safe and feasible, with no adverse events reported. Specific EEG and transcranial Doppler (TCD) findings were identified that could help in early detection of neurologic deterioration. MNM may aid in monitoring, prognostication, and clinical decision-making for ECMO patients.

LivaNova Reports Cyberattack Compromising US Patients’ Data

April 26, 2024 No Comments

LivaNova, a medical technology company, has reported a cyberattack on its U.S. subsidiary, compromising personal data of its patients. Detected on November 19, 2023, the breach involved unauthorized access to data including Social Security numbers, medical details, and contact information. The company has taken remedial action, offered identity protection services, and advises affected individuals to monitor their accounts and credit reports for fraud.

21st Century Critical Care Medicine: An Overview

April 23, 2024 No Comments

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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Efficacy and Safety of Impella in Cardiogenic Shock Following Acute Myocardial Infarction: A Meta-Analysis of Randomized Controlled Trials

Comparing Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting in Non-ST-Segment Elevation Acute Coronary Syndromes: A Systematic Review and Meta-Analysis

A Historical Perspective and Update on Robotic Mitral Valve Surgery

A Comparative Study of Femoral Artery and Combined Femoral and Axillary Artery Cannulation in Veno-Arterial Extracorporeal Membrane Oxygenation Patients

Low Frequency Ventilation During Cardiopulmonary Bypass to Protect Postoperative Lung Function in Cardiac Valvular Surgery: The PROTECTION Phase II Randomized Trial

Extraction of Ketamine and Dexmedetomidine by Extracorporeal Life Support Circuits

Impact of Extracorporeal Haemoadsorption During Prolonged Cardiopulmonary Bypass on the Incidence of Acute Kidney Injury

Multimodal Neurologic Monitoring in Patients Undergoing Extracorporeal Membrane Oxygenation

LivaNova Reports Cyberattack Compromising US Patients’ Data

21st Century Critical Care Medicine: An Overview

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