Interactive cardiovascular and thoracic surgery
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Interact Cardiovasc Thorac Surg · Aug 2014
ReviewPerioperative physiotherapy in patients undergoing lung cancer resection.
Physiotherapy is considered an important component of the perioperative period of lung resection surgery. A systematic review was conducted to assess evidence for the effectiveness of different physiotherapy interventions in patients undergoing lung cancer resection surgery. Online literature databases [Medline, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, SCOPUS, PEDro and CINAHL] were searched up until June 2013. ⋯ The most important finding of this systematic review is that presurgical interventions based on moderate-intense aerobic exercise in patients undergoing lung resection for lung cancer improve functional capacity and reduce postoperative morbidity, whereas interventions performed only during the postoperative period do not seem to reduce postoperative pulmonary complications or length of hospital stay. Nevertheless, no firm conclusions can be drawn because of the heterogeneity of the studies included. Further research into the efficacy and effectiveness of perioperative respiratory physiotherapy in this patient population is needed.
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Interact Cardiovasc Thorac Surg · Aug 2014
High levels of free haemoglobin in neonates and infants undergoing surgery on cardiopulmonary bypass.
Haemolysis is known to occur during surgery on cardiopulmonary bypass (CPB) and to be responsible for kidney injury. The aim of this study was to assess, in a cohort of infants, the reference levels of free haemoglobin (fHb) and their change over time postoperatively; the predicting variables of haemolysis in the intraoperative phase; and the association between fHb and renal function. ⋯ A high rate of fHb is released during paediatric surgery with CPB in infants. fHb mainly depends on the left atrial venting flow rate and CPB duration. However, such peaks of fHb levels were not associated with renal dysfunction.
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Interact Cardiovasc Thorac Surg · Aug 2014
Case ReportsDouble aortic arch with hypoplastic right aortic arch and type C atresia of left aortic arch.
We report the case of a 2-month-old baby with a double aortic arch, type C atresia of the left arch and severe hypoplasia of the right aortic arch between the right carotid and subclavian arteries, resulting in systemic obstruction, left ventricular dysfunction and congestive heart failure. Surgical augmentation of the right aortic arch ameliorated the obstruction with improvement in left ventricular function and symptoms.
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Interact Cardiovasc Thorac Surg · Aug 2014
The role of patient's profile and allogeneic blood transfusion in development of post-cardiac surgery infections: a retrospective study.
We aimed to investigate the association of patient characteristics and allogeneic blood transfusion products in development of post-cardiac surgery nosocomial infections. ⋯ Our data showed that post-cardiac surgery infections occur more frequently in patients with predetermined risk factors. The amount of blood transfusions was integrally related to every type of postoperative infection.
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Interact Cardiovasc Thorac Surg · Aug 2014
Outcomes and prognostic factors of non-small-cell lung cancer with lymph node involvement treated with induction treatment and surgical resection.
Induction therapy (IT) has gained popularity in recent years, becoming a standard of treatment in resectable lymph node-positive NSCLC. IT aims to downstage the disease (shrinkage of tumour and clearance of lymph node-metastases), clear distant micrometastases and prolong survival. Potential disadvantages are increased morbidity and/or mortality after surgery and risk of progression of disease that could have been initially resected. The purpose of this study was to evaluate the outcomes and prognostic factors in a series of patients with lymph node-positive NSCLC receiving IT followed by surgery. ⋯ The use of IT for lymph node-positive NSCLC seems justified by low morbidity and/or mortality and good survival rates. Patients with response to IT showed greater benefit in the long term.