Heart & lung : the journal of critical care
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Mediastinitis, a serious complication after cardiac surgery, increases morbidity, mortality, and cost of care. Accumulating evidence implicates blood transfusions in the development of mediastinitis. ⋯ The findings of this systematic review suggest that allogeneic red blood cell transfusions are associated with an increased risk of mediastinitis in patients undergoing cardiac surgery. Individual risks and benefits should be assessed in each patient before a red blood cell transfusion.
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Little is known about the practice patterns of nurses who work in the specialty of heart failure (HF). This specialty includes inpatient and outpatient sites for practice that incorporate intensive care to rehabilitation. The purpose of this study was to describe the current practice of nurses who are members of the American Association of Heart Failure Nurses (AAHFN). ⋯ This survey provides insight into the practice patterns of HF nurses. Continued monitoring of this role is warranted and can serve to assist the AAHFN in advancing HF knowledge and skills.
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We report on a man with Pseudomonas aeruginosa endocarditis causing an aortic root abscess. He underwent surgery with a homograft aortic root replacement and insertion of a tissue aortic valve. The patient then manifested recurrent aortic root infection and respiratory arrest, and eventually succumbed to sepsis. This case highlights the aggressive nature of an uncommon pathogen causing an atypical but lethal form of endocarditis, despite modern medical and surgical treatment.
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Randomized Controlled Trial Multicenter Study Comparative Study
The role of the endotracheal tube cuff in microaspiration.
The cuff of the endotracheal tube (ETT) is designed to provide a seal within the airway, allowing airflow through the ETT but preventing passage of air or fluids around the ETT. Deliberate or inadvertent movement of the ETT may affect cuff pressure or shift folds in the cuff, mobilizing pooled secretions. ⋯ These complications are costly in terms of morbidity and mortality, as well as hospital expense. We will discuss the role of the ETT cuff in microaspiration and identify potential directions for future research to improve outcomes in mechanically ventilated patients.