Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2018
Review Meta AnalysisMeta-Analysis of the Outcome After Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation in Adult Patients.
This study was planned to pool existing data on outcome and to evaluate the efficacy of postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO) in adult patients. ⋯ Pooled data showed that VA-ECMO may salvage one-third of patients unresponsive to any other resuscitative treatment after adult cardiac surgery.
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J. Cardiothorac. Vasc. Anesth. · Jun 2018
Randomized Controlled Trial Comparative StudyComparative Study Between Conventional Fasting Versus Overnight Infusion of Lipid or Carbohydrate on Insulin and Free Fatty Acids in Obese Patients Undergoing Elective On-pump Coronary Artery Bypass Grafting. A Prospective Randomized Trial.
Postoperative insulin resistance represents a major component of postoperative metabolic disorder. The authors compared the effects of preoperative infusion of lipid emulsion or carbohydrate to conventional preoperative fasting on postoperative insulin and free fatty acid (FFA) levels. ⋯ Preoperative lipid infusion lowered postoperative FFA, insulin, TG, VLDL, and random blood sugar in obese patients undergoing coronary artery bypass grafting surgeries.
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J. Cardiothorac. Vasc. Anesth. · Jun 2018
Observational StudyAssociation of red blood cell transfusion and short- and longer-term mortality after coronary artery bypass graft surgery.
Red blood cell (RBC) transfusion has been linked to increased morbidity and mortality. However, strict RBC transfusion recommendations recently have been questioned. The aim of this study was to investigate the short- and long-term mortality outcomes after RBC transfusion in patients undergoing coronary artery bypass graft surgery (CABG). ⋯ In the present study, patients undergoing CABG surgery and receiving <6 U of PRBC did not have statistically increased risk for in-hospital mortality and up to 2 years postoperatively. A modestly statistically significant difference was noted at 3 years. However, cumulatively, there was no statistical difference between the transfused and nontransfused groups at 4 years. Further studies are needed to confirm the findings and define the population that will benefit the most from blood transfusion.