Asian cardiovascular & thoracic annals
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Asian Cardiovasc Thorac Ann · Feb 2014
ReviewRole of renal biomarkers as predictors of acute kidney injury in cardiac surgery.
Cardiac surgery is unique in using cardiopulmonary bypass in various clinical scenarios. Injury of vital organs is unavoidable in the perioperative period. Acute kidney injury is a consequence of the systemic inflammatory response after bypass, emboli, ischemia, and low cardiac output states, reportedly occurring in 30%-40% of open heart surgeries. ⋯ The recent emergence of biomarkers such as neutrophil gelatinase-associated lipocalin, cystatin C, liver-type fatty acid binding protein, interleukin-18, kidney injury molecule-1, and tetrahydrobiopterin have helped in detecting acute kidney injury long before the rise of serum creatinine. These biomarkers can also be used as tools for predicting therapeutic effects in acute kidney injury and for monitoring drug toxicity. This review consolidates the knowledge of biomarkers and their application in acute kidney injury management.
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Asian Cardiovasc Thorac Ann · Feb 2014
Comparative StudyEuroSCORE vs. EuroSCORE II vs. Society of Thoracic Surgeons risk algorithm.
This study presents a validation series for EuroSCORE II compared with the previous additive and logistic EuroSCORE and the Society of Thoracic Surgeons risk prediction algorithm. ⋯ The Society of Thoracic Surgeons risk prediction algorithm is a better risk assessment tool compared to additive and logistic EuroSCORE and EuroSCORE II in Pakistani patients.
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Asian Cardiovasc Thorac Ann · Feb 2014
Case ReportsUse of Rotaflow pump for left ventricular assist device bridging for 15 weeks.
Mechanical circulatory support systems have been described for short- and long-term left ventricular assistance. We report the use of a Rotaflow centrifugal pump in a 55-year-old man with ischemic cardiomyopathy and severe left ventricular dysfunction. He was successfully bridged to transplantation with 15 weeks of Rotaflow support, with no major adverse events.
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Asian Cardiovasc Thorac Ann · Feb 2014
Comparative StudyRecombinant activated factor VII in cardiac surgery: single-center experience.
The widespread off-label use of recombinant activated factor VII for the control of refractory postoperative hemorrhage continues despite a warning from the Food and Drug Administration. Although effective in reducing the need for transfusion of blood and blood products, safety concerns still prevail. ⋯ The efficacious dose of recombinant activated factor VII is much less in adults compared to children. Prophylactic use of recombinant activated factor VII decreases the dose required, the incidence of mediastinal exploration, and intensive care unit stay, with no survival benefit.
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Asian Cardiovasc Thorac Ann · Feb 2014
Case ReportsT-tube insertion for sclerotic subglottic stenosis.
T-tube insertion is effective treatment for subglottic stenosis, but it is generally difficult due to bending of the T-tube. In a 52-year-old woman with relapsing polychondritis, a T-tube was inserted after predilatation using Hegar dilators. We describe the details of our T-tube insertion methods for sclerotic subglottic stenosis.