The Thoracic and cardiovascular surgeon
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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.
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Thorac Cardiovasc Surg · Dec 2013
Survival, functional capacity, and quality of life after cardiac surgery followed by long-term intensive care stay.
The rising prevalence of multimorbid patients undergoing cardiac surgery often leads to prolonged postoperative intensive care unit (ICU) treatment. The fate of these patients after discharge is poorly investigated. This study is aimed to assess survival, functional outcome, and quality of life (QOL) in patients after an ICU stay of at least 5 days. ⋯ Long-term ICU treatment after cardiac surgery is related to a high in-hospital and follow-up mortality. The physical and psychological recovery of the survivors is encouraging, justifying the extensive engagement of hospital resources.
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Thorac Cardiovasc Surg · Dec 2013
Observational StudyContinuing aspirin causes higher drainage even under full protection with antifibrinolytics.
The purpose of this study was to assess the impact of continuation of aspirin on bleeding complications following coronary artery bypass grafting (CABG) surgery operated by a single surgeon. ⋯ Continuing aspirin before CABG is associated with increased blood loss even when used in small doses and under full cover of antifibrinolytic agents. However, this blood loss is not harmful and does not negatively affect the patient's clinical progress.
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Thorac Cardiovasc Surg · Dec 2013
[Basic standards for a department of cardiac surgery. Quality requirements for the care of cardiac patients in connection with operations on the heart, the heart vessels and thoracic organ transplantation].
Current evolutions and substantial amendments of the German health care system in combination with distinguished progress in cardiac surgery over the past years require both a reflection of principles in patient-centered care and an update of basic standard requirements for a department of cardiac surgery in Germany. In due consideration of the data from the voluntary registry of the German Society for Thoracic and Cardiovascular Surgery, this article accurately defines core requirements for a cardiac surgical department (cardiac surgery on-site), subdivided into facilities, staff and processes. If based on these standards, one may anticipate that cardiac surgical care is performed under appropriate conditions leading to an intrinsic benefit for patients.