European journal of anaesthesiology
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Observational Study
The base excess gap is not a valid tool for the quantification of unmeasured ions in cardiac surgical patients: A retrospective observational study.
The base excess gap (BE(gap)) method is commonly used for the quantification of unmeasured ions in critically ill patients. However, it has never been validated against the standard quantitative acid-base approach. ⋯ The BE gap method cannot reliably quantify the unmeasured ion excess in cardiac surgical patients. Clinicians should use the full Stewart-Figge model for quantitative acid-base assessments.
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Observational Study
How can we best predict acute kidney injury following cardiac surgery?: A prospective observational study.
Several models for predicting acute kidney injury following cardiac surgery have been published, and various end-point definitions have been used. ⋯ The risk of acute kidney injury can be accurately predicted using preoperative variables. Serum creatinine concentration was more accurate than estimated glomerular filtration rate or creatinine clearance. Intraoperative variables slightly improved the model, but did not seem to outweigh the advantages of a preoperative model.
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Observational Study
Anaesthesiological support in a cardiac electrophysiology laboratory: A single-centre, prospective observational study.
Implantation of cardiovascular implantable electronic devices (CIEDs) has greatly increased during the last decade and anaesthetic management of these patients remains an open question. ⋯ Patients requiring cardiovascular implantable electronic device (CIED) implantation were fragile with a high complication rate and a high rate of severe complications even with anaesthesiological support. These complications, as well as the need for deep sedation or general anaesthesia, clearly justify the involvement of a qualified anaesthesiologist.
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Long-term absolute and relative survival after aortic valve replacement: A prospective cohort study.
Aortic valve replacement is one of the most common cardiac surgical procedures, especially in elderly patients. Whether or not there is a net life gain over a long period of time is a matter for debate. ⋯ Patients who survived the first year after aortic valve replacement had a similar chance of survival as the matched normal population. Relative survival benefit was higher in the oldest age quartile.
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The pulse oximeter measurement pleth variability index (PVI) can detect hypovolaemia during positive pressure ventilation. ⋯ The PVI increased significantly for higher LBNP, but overlap was common regardless of breathing mode. The PVI can be used to indicate a hypovolaemic state during spontaneous breathing in groups but not in individuals.