Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Nov 2014
Hypothermic cardiopulmonary bypass without exchange transfusion in sickle-cell patients: a matched-pair analysis.
Sickle-cell patients undergo cardiopulmonary bypass (CPB) surgery in our institution without perioperative exchange transfusion. We sought to determine whether this protocol increased mortality or important sickle-cell-related complications. ⋯ Perioperative exchange transfusion is not essential for a good outcome in sickle-cell patients undergoing CPB. A simple transfusion regimen to replace blood loss is safe in HbSS patients; blood transfusion requirements for HbSC and HbAS patients undergoing CPB are similar to those of matched HbAA controls. The use of systemic hypothermia during CPB does not increase sickle-cell-related complications. Cold crystalloid cardioplegia and topical hypothermia provide safe myocardial protection without the need for more sophisticated measures.
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Interact Cardiovasc Thorac Surg · Nov 2014
Recursive and non-linear logistic regression: moving on from the original EuroSCORE and EuroSCORE II methodologies.
EuroSCORE II, despite improving on the original EuroSCORE system, has not solved all the calibration and predictability issues. Recursive, non-linear and mixed recursive and non-linear regression analysis were assessed with regard to sensitivity, specificity and predictability of the original EuroSCORE and EuroSCORE II systems. ⋯ The original EuroSCORE and the EuroSCORE II risk models do not have adequate ROC and Hosmer-Lemeshow statistics to allow accurate assessment of cardiac surgeons in the modern era. A mixed recursive and non-linear regression model utilizing the EuroSCORE II risk model improves both the ROC and Hosmer-Lemeshow statistics.