Asian cardiovascular & thoracic annals
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Asian Cardiovasc Thorac Ann · May 2018
Comparative StudyOutcomes of emergency thoracotomy for trauma in a general hospital in Singapore.
Background An emergency thoracotomy can be performed either immediately at the site of trauma or in the emergency department or operating room for resuscitation of patients in extremis or life-saving treatment for patients with thoracic injury. It remains a procedure associated with high mortality rates, and there is a paucity of data from Asia. This study analyzed our six-year experience of emergency trauma thoracotomy in an acute general hospital in Singapore. ⋯ No patient who underwent a thoracotomy in the emergency department survived beyond 24 h. Conclusions Emergency thoracotomy is associated with high mortality rates, especially when required in the emergency department or for blunt trauma. Nevertheless, it is a potentially life-saving procedure that offers a chance of survival in selected patients.
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Asian Cardiovasc Thorac Ann · May 2018
Randomized Controlled TrialMyocardial protection following del Nido cardioplegia in pediatric cardiac surgery.
Background This study was designed to compare myocardial protection with del Nido cardioplegia and conventional blood cardioplegia in children undergoing cardiac surgery in Risk Adjustment for Congenital Heart Surgery categories 1 and 2. Methods Sixty patients were randomized into 2 groups receiving del Nido cardioplegia solution or conventional blood cardioplegia. Myocardial injury was assessed using biochemical markers (troponin I and creatine kinase-MB). ⋯ Duration of mechanical ventilation, intensive care unit stay, and hospital stay were comparable in the 2 groups. Conclusions Our results show that del Nido cardioplegia solution is as safe as conventional blood cardioplegia. Moreover, it provides the benefits of reduced dose requirement, lower consumption of allogenic blood on cardiopulmonary bypass, quicker resumption of spontaneous regular cardiac rhythm, and less inotropic support requirement on transfer to the intensive care unit and at 24 h, compared to conventional blood cardioplegia.
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Asian Cardiovasc Thorac Ann · May 2018
Case ReportsExtracorporeal membrane oxygenation in pheochromocytoma-induced cardiogenic shock.
Extracorporeal membrane oxygenation has been extensively used for cardiopulmonary support in cardiogenic shock. However, its clinical value in the management of pheochromocytoma crisis remains unclear. We report a rare case of life-threatening cardiogenic shock managed with peripheral venoarterial extracorporeal membrane oxygenation combined with endovascular left ventricular venting, in a 40-year-old female patient, in the setting of unknown adrenal pheochromocytoma. We highlight the life-saving role of extracorporeal membrane oxygenation in undiagnosed endocrine emergencies, allowing cardiac and end-organ recovery, and giving time for accurate diagnosis and specific treatment in such unusual situations.