Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Comparative Study
Proximal aortic compliance and diastolic function assessed by speckle tracking imaging.
Speckle tracking imaging (STI) is a recent technique that evaluates an echocardiographic image throughout the cardiac cycle and provides dynamic variables such as tissue velocities and strain rates. The objective of our study was to determine 1) if STI can be used to quantify proximal aortic compliance and 2) if decreased aortic compliance determined by STI will reproduce the previously reported correlation with diastolic function. ⋯ Speckle tracking can be used to describe the physical motion of the aortic wall and to calculate its compliance. We confirm that variation in diastolic function can be attributed, in part, to aortic compliance. Our novel approach of measuring compliance throughout the cardiac cycle, isolating radial and longitudinal contributions, and evaluating previously obtained images retrospectively provides advantages over previously reported measures of aortic compliance. Speckle tracking promises new insights into ventricular function, aortic mechanics, and the interaction between these structures.
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To investigate whether tracheostomy increases the risk of sternal wound infection (SWI) post cardiac surgery. ⋯ Our single-centre observational study of cardiac surgery patients found tracheostomy to be an independent risk factor for SWI. Our analysis showed a robust association when restricted to patients with respiratory failure and after the population was stratified by the propensity to have a tracheostomy.
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Comparative Study
Predictors of unanticipated admission following ambulatory surgery: a retrospective case-control study.
The primary objectives of this historical case-control study were to evaluate the incidence of and reasons and risk factors for adult unanticipated admissions in three tertiary care Canadian hospitals following ambulatory surgery. ⋯ Unanticipated admission after ambulatory surgery occurs mainly due to surgical, anesthetic, and medical complications. Length of surgery more than one hour, high ASA class, advanced age, and increased BMI were all predictors. No specific comorbid illness was associated with an increased likelihood of unanticipated admission. These findings support continued use of the ASA classification as a marker of patient perioperative risk rather than attributing risk to a specific disease process.