European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Sep 2011
Hand-held minimised extracorporeal membrane oxygenation: a new bridge to recovery in patients with out-of-centre cardiogenic shock.
Cardiogenic shock is associated with mortality rates up to 70%, even if patients are treated with intensive care support or thrombolytic therapy. Early coronary revascularisation can be life-saving but it is oftentimes not available at the hospital to which the patient was initially taken. Up to now, transferring patients in a state of severe cardiogenic shock and/or cardiopulmonary resuscitation is mostly decided to be impossible. We report on the use of two newly developed minimised systems for hand-held-extracorporeal membrane oxygenation (ECMO) (ELS-System™ and CARDIOHELP™, both from MAQUET Cardiopulmonary AG, Germany), which we have used for rapid extracorporeal life support and interhospital transfer on Mini-ECMO. We characterise the emergency use, safety instructions and bridging function of these novel Mini-ECMO devices. ⋯ The use of hand-held Mini-ECMO systems enables for the first time the rapid onset of extracorporeal life support independent from the patient's current location. However, success is extremely time- and team dependent. Highly skilled interdisciplinary patient management is essential to let minimised-ECMO become a new and highly effective bridge to recovery in out-of-centre cardiogenic shock patients.
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Eur J Cardiothorac Surg · Sep 2011
Validation of the EuroSCORE risk models in Turkish adult cardiac surgical population.
The aim of this study was to validate additive and logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) models on Turkish adult cardiac surgical population. ⋯ The original EuroSCORE risk models overestimated mortality at all risk subgroups in Turkish population. Remodeling strategies for EuroSCORE or creation of a new model is warranted for future studies in Turkey.
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Eur J Cardiothorac Surg · Sep 2011
Does positron emission tomography scanning improve survival in patients undergoing potentially curative lung resections for non-small-cell lung cancer?
To determine if positron emission tomography (PET) scanning has resulted in an improvement in the short- and long-term survival of patients undergoing potentially curative resections for non-small-cell lung cancer. No publications exist to demonstrate an increased survival of patients with lung cancer due to the use of PET scanning. If PET scanning reduces unnecessary resections, the results from surgery should be improved with its introduction. ⋯ We concur with current guidelines for the use of PET scanning for stage III non-small-cell lung cancer. Our results need to be corroborated with other groups as potentially stage-Ia-, Ib-, and stage-II patients may not benefit from PET scanning.
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Eur J Cardiothorac Surg · Sep 2011
Surgery for patients with persistent pathological N2 IIIA stage in non-small-cell lung cancer after induction radio-chemotherapy: the microscopic seed of doubt.
The surgical treatment of residual N2 disease following induction radio-chemotherapy (IT) for locally advanced cIIIA-N2 non-small-cell lung cancer (NSCLC) is still debated. The long-term results after resection in a pN2 series are at the focus of this study. ⋯ The persistence of disease at the N2 level after IT and surgery for cIIIa-N2 NSCLC does not exclude favorable outcome after resection, in particular in those patients with minor residual disease.