The Thoracic and cardiovascular surgeon
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Thorac Cardiovasc Surg · Oct 2010
Mild-to-moderate COPD as a risk factor for increased 30-day mortality in cardiac surgery.
Chronic obstructive pulmonary disease (COPD) is still a serious comorbidity in surgical procedures. We assessed the impact of mild to moderate COPD in a modern cardiac surgery unit. ⋯ COPD increases 30-day mortality, postoperative pulmonary complications, ICU stay and hospital stay. Proper identification and therapy may help to improve outcome in this high-risk population.
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Thorac Cardiovasc Surg · Oct 2010
Comparative StudyEarly reintubation after cardiac operations: impact of nasal continuous positive airway pressure (nCPAP) and noninvasive positive pressure ventilation (NPPV).
Due to an increasing number of comorbidities there is still a significant incidence of respiratory failure after primary postoperative extubation in patients who undergo cardiosurgery. We wanted to study whether nCPAP could improve pulmonary oxygen transfer and avoid the necessity for reintubation after cardiac surgery. Additionally, we compared this protocol to noninvasive positive pressure ventilation (NPPV). ⋯ We conclude that reintubation after cardiac operations should be avoided since nCPAP and NPPV are safe and effectively improve arterial oxygenation in the majority of patients with nonhypercapnic oxygenation failure. However, it is of great importance to pay special care to sternal wound complications in these patients.
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Thorac Cardiovasc Surg · Oct 2010
Prognostic value of daily cardiac surgery score (CASUS) and its derivatives in cardiac surgery patients.
We aimed to validate the usefulness of CASUS derivatives for cardiac surgery patients and their reliability for daily decision making. ⋯ CASUS derivatives including δ CASUS have a good prognostic value for cardiac surgery patients with regard to the prediction of mortality and survival during ICU stay, with the exception of total CASUS which was not informative.
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Thorac Cardiovasc Surg · Oct 2010
Case ReportsCavitating lymph node metastasis demonstrated by endobronchial ultrasound.
Cavitation of primary non-small cell lung carcinoma (NSCLC) occurs in a small number of patients. We report a case of cavitation of lymph node metastases in NSCLC. ⋯ Cystic necrosis was only demonstrable by EBUS. The incidence of such findings is unknown, however with the increasing use of EBUS for evaluation of the mediastinum such images may be more commonly encountered in the future.