The Journal of thoracic and cardiovascular surgery
-
J. Thorac. Cardiovasc. Surg. · Aug 2011
The Surgical Procedure Assessment (SPA) score predicts intensive care unit length of stay after cardiac surgery.
The ability to predict intensive care unit length of stay greatly facilitates triage and resource allocation for postoperative cardiac surgical patients in the intensive care unit. We developed a simple, intuitive Surgical Procedure Assessment score that integrates surgical complexity (1, low; 2, intermediate; 3, high) with patient comorbidity (A, minimal; B, substantial). We hypothesized that the Surgical Procedure Assessment score would predict intensive care unit length of stay, discriminate preoperatively between fast-track and prolonged-stay patients, and compare favorably with more complex risk scores. ⋯ The Surgical Procedure Assessment score predicts intensive care unit length of stay better than other comparable scores. It is simple, intuitive, and easily understood by all caregivers and can preoperatively discriminate fast-track from prolonged-stay patients. It is a useful tool to facilitate intensive care unit triage.
-
J. Thorac. Cardiovasc. Surg. · Aug 2011
Cerebral near-infrared spectroscopy during cardiopulmonary bypass predicts superior vena cava oxygen saturation.
Cerebral and flank near-infrared spectroscopy are used to monitor tissue oxygenation during cardiopulmonary bypass in pediatric patients. We sought to validate these noninvasive measurements as predictors of oxygen saturation in the superior and inferior venae cavae during cardiopulmonary bypass. ⋯ Cerebral near-infrared spectroscopy accurately predicts superior vena cava oxygen saturation and changes in superior vena cava oxygen saturation on cardiopulmonary bypass. The relationship between flank near-infrared spectroscopy and inferior vena cava saturation is not as strong.
-
J. Thorac. Cardiovasc. Surg. · Aug 2011
Detection of integrin-linked kinase in the serum of patients with malignant pleural mesothelioma.
Integrin-linked kinase, which is relevant to neoplastic transformation, is highly expressed in malignant pleural mesothelioma. Recently, detection of integrin-linked kinase in serum of patients with ovarian cancer has been reported. This study asks whether integrin-linked kinase can also be detected in serum of patients with malignant pleural mesothelioma and whether serum level has diagnostic or prognostic relevance for that disease. ⋯ Integrin-linked kinase can be detected in serum of patients with malignant pleural mesothelioma and may be a diagnostic marker for the disease.
-
J. Thorac. Cardiovasc. Surg. · Aug 2011
Learning curve analysis of mitral valve repair using telemanipulative technology.
To determine if the time required to perform mitral valve repairs using telemanipulation technology decreases with experience and how that decrease is influenced by patient and procedure variables. ⋯ Learning in mitral valve repair surgery using telemanipulative technology occurs at the East Carolina Heart Institute according to a logarithmic curve, with a learning percentage of 95%. From our regression output, we can make an approximate prediction of total robot time using an additive model. These metrics can be used by programs for benchmarking to manage the implementation of this new technology, as well as for capacity planning, scheduling, and capital budget analysis.