Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Oct 2008
Impact of pre-existing conditions, age and the length of cardiopulmonary bypass on postoperative outcome after repair of the ascending aorta and aortic arch for aortic aneurysms and dissections.
Repair of the ascending aorta and aortic arch carries a high morbidity and mortality, which can be complicated by the often emergent nature of the intervention. ⋯ Emergent operations are associated with high morbidity and mortality. Pre-existing heart failure, advanced age, and prolonged cardiopulmonary bypass are associated with prolonged monitoring in the ICU.
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Interact Cardiovasc Thorac Surg · Oct 2008
ReviewDoes the administration of mannitol prevent renal failure in open abdominal aortic aneurysm surgery?
A best evidence topic in cardiovascular surgery was written according to a structured protocol. The question addressed was whether mannitol might prevent renal failure in patients undergoing open repair of an abdominal aortic aneurysm. Altogether more than 25 papers were found using the reported search, of which eight represented the best evidence to answer the clinical question. ⋯ Of note also is that the earlier studies used urine output as their main indicator of renal failure in reaching their conclusions. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that no clinical trials to date have demonstrated any clinical reduction in the incidence of renal failure in patients undergoing repair of an abdominal aortic aneurysm who have been given mannitol.
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Interact Cardiovasc Thorac Surg · Oct 2008
ReviewIs manipulation of mediastinal chest drains useful or harmful after cardiac surgery?
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was: in patients who have undergone cardiothoracic surgery does manipulation of drainage tubes affect drainage volumes or post-surgical outcome? Altogether 681 papers were found using the reported search, of which four represented the best evidence to answer the clinical question. Duncan and Erickson in 1982 found that chest tube stripping can lead to very low negative intrathoracic pressures. ⋯ In our paper the authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that due to possible tissue damage and lack of demonstrable benefit, in most patients drainage tube manipulation should not be performed. No differences in either safety or efficacy have been demonstrated between the milking and stripping methods of manipulation.