The Thoracic and cardiovascular surgeon
-
Thorac Cardiovasc Surg · Dec 2013
Review Comparative Study Observational StudyThe predictive value of multiple electrode platelet aggregometry (multiplate) in adult cardiac surgery.
The purpose of this retrospective observational study is to analyze the value of multiple electrode platelet aggregometry (Multiplate analyzer, Verum Diagnostica, Munich) as a point-of-care (POC) device in adult cardiac surgical patients. ⋯ The ADPtest and the TRAPtest significantly predict the requirement of perioperative blood transfusion. Therefore, multiple electrode platelet aggregometry is beneficial for POC testing in cardiac surgical patients. Prospective, randomized, and controlled clinical studies are rare.
-
Thorac Cardiovasc Surg · Dec 2013
Review Case ReportsSevere ARDS induced by fusobacterial infections: a rare clinical presentation of Lemierre syndrome.
Acute respiratory distress syndrome (ARDS) poses a major challenge in intensive care settings. The main underlying causes of ARDS are trauma, pancreatitis, and pulmonary manifestation of systemic inflammatory response syndrome/sepsis. Lemierre syndrome represents a nearly forgotten entity arising from oropharyngeal infections with Fusobacterial species, and it is of renewed and increasing interest because of evolving antibiotic resistances. We report two cases of young female patients afflicted by Lemierre syndrome with additional severe ARDS and present an overview of the current literature.
-
Thorac Cardiovasc Surg · Dec 2013
Comparative StudyMortality prediction after cardiac surgery: blood lactate is indispensible.
Blood lactate is accepted as a mortality risk marker in intensive care units (ICUs), especially after cardiac surgery. Unfortunately, most of the commonly used ICU risk stratification scoring systems did not include blood lactate as a variable. We hypothesized that blood lactate alone can predict the risk of mortality after cardiac surgery with an accuracy that is comparable to those of other complex models. We therefore evaluated its accuracy at mortality prediction and compared it with that of other widely used complex scoring models statistically. ⋯ Blood lactate accurately predicts mortality at both individual patient risk and patient cohort levels. Its precision is higher than that of other commonly used "complex" scoring models. The proposed LacScale is a simple and highly reliable model. It can be used (at bedside without electronic calculation) as such or integrated in other models to increase their accuracy.
-
Thorac Cardiovasc Surg · Dec 2013
Prolonged intensive care unit stay of patients after cardiac surgery: initial clinical results and follow-up.
Prolonged intensive care unit (ICU) stay in cardiac surgery patients often results in a poorer clinical course and decreased survival postdischarge. Data on clinical outcomes and prognosis are limited. We aimed to identify perioperative factors that would predict prolonged ICU stay and to evaluate their impact on clinical outcomes. ⋯ Prolonged ICU stay is associated with a complicated clinical course and decreased overall survival. Treatment for patients with respiratory impairment should be aggressively optimized.