Journal of cardiac surgery
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Review Meta Analysis
Does the use of preoperative aspirin increase the risk of bleeding in patients undergoing coronary artery bypass grafting surgery? Systematic review and meta-analysis.
The traditional recommendation has been to stop Aspirin seven to 10 days prior to coronary artery bypass surgery to reduce the potential risk of bleeding. A few reports have shown that Aspirin did not increase the risk of bleeding and may be beneficial to be continued until the time of surgery. The objective of this review was to evaluate the effect of preoperative Aspirin on bleeding in patients undergoing elective bypass surgery. ⋯ Aspirin is associated with increased chest tube drainage and may be associated with a greater requirement for blood products. High-quality prospective studies are warranted to reassess the effect of Aspirin on important postoperative outcomes.
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Cardiopulmonary bypass (CPB) is a relatively common procedure in cardiac surgery. At the end, the heart is electrically defibrillated if not already beating. External and internal cardioversion by specific catheters do not raise plasma troponin concentration, but the possible repercussion on troponin of the direct cardioversion of the heart has not been documented. ⋯ With more than two cardioversions post-CPB, both troponin I and CK-MB may present an additional increase.
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We report a case of acute hemothorax caused by the rupture of a mammary artery aneurysm in a patient with neurofibromatosis type I.
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Despite recent advances in critical care management, the mortality of acute respiratory distress syndrome (ARDS) remains high. The final rescue therapy for patients with severe hypoxia refractory to conventional therapy modalities is the extracorporeal gas exchange. ⋯ Quick encouragement of ECMO for the temporary management of gas exchange may increase survival rates in trauma patients with ARDS.