European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
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Eur J Cardiothorac Surg · Jan 2011
Automated detection of myocardial ischaemia by epicardial miniature ultrasound transducers--a novel tool for patient monitoring during cardiac surgery.
Early detection of myocardial ischaemia in cardiac surgery is important. We have developed an ultrasonic system for continuous myocardial monitoring by use of miniature transducers. The aim of this study was to investigate the system's ability to detect ischaemia in patients undergoing off-pump coronary artery bypass grafting (CABG), and whether automated signal analysis could detect ischaemia. ⋯ The ultrasonic system detected regional ischaemia during LAD occlusion. An automated analysis algorithm demonstrated excellent ability to detect ischaemia. This technology can develop into a useful tool to detect ischaemia in cardiac surgery.
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Eur J Cardiothorac Surg · Jan 2011
Preoperative prediction of intensive care unit stay following cardiac surgery.
Following cardiac surgery, a great variety in intensive care unit (ICU) stay is observed, making it often difficult to adequately predict ICU stay preoperatively. Therefore, a study was conducted to investigate, which preoperative variables are independent risk factors for a prolonged ICU stay and whether a patient's risk of experiencing an extended ICU stay can be estimated from these predictors. ⋯ Twelve independent preoperative risk factors for a prolonged ICU stay following cardiac surgery were identified and constructed into a proportional hazards model. Using this risk model, one can predict whether a patient will have a prolonged ICU stay or not.
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Eur J Cardiothorac Surg · Jan 2011
Comparative StudyComparison of urinary neutrophil glucosaminidase-associated lipocalin, cystatin C, and α1-microglobulin for early detection of acute renal injury after cardiac surgery.
Acute renal injury is a frequent complication after cardiac surgery that necessitates additional treatment and increases mortality. To apply measures for optimizing renal function in a well-directed and effective way, it is most important to detect acute kidney injury at an early stage. The present study compares three markers of renal tubular function for detection of acute renal injury according to the acute kidney injury (Acute Kidney Injury Network (AKIN)) criteria. ⋯ An increase in urinary NGAL is an early sign of acute kidney injury after cardiac surgery. After multiplication by the serum/urine creatinine ratio, urinary α1MG is also suitable for detection of acute kidney injury at an early stage.
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Eur J Cardiothorac Surg · Jan 2011
Comprehensive assessment of frailty for elderly high-risk patients undergoing cardiac surgery.
Cardiosurgical operative risk can be assessed using the logistic European system for cardiac operative risk evaluation (EuroSCORE) and the Society of Thoracic Surgeons (STS) score. Factors other than medical diagnoses and laboratory values such as the 'biological age' are not included in these scores. The aim of the study was to evaluate an additional assessment of frailty in routine cardiac surgical practice. ⋯ The comprehensive assessment of frailty is an additional tool to evaluate elderly patients adequately before cardiac surgical interventions. The Frailty score combines characteristics of the Fried criteria [1], of patient phenotype, of his physical performance and laboratory results. Further analysis on a larger patient population is warranted. A combination of the new Frailty score and the traditional scoring systems may facilitate a more accurate risk scoring in elderly high-risk patients scheduled for conventional cardiac surgery or trans-catheter aortic valve replacement.