The Journal of thoracic and cardiovascular surgery
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J. Thorac. Cardiovasc. Surg. · Nov 2020
Resection following concurrent chemotherapy and high-dose radiation for stage IIIA non-small cell lung cancer.
Concern exists regarding surgery after thoracic radiation. We aimed to assess early results of anatomic resection following induction therapy with platinum-based chemotherapy and full-dose thoracic radiation for resectable N2+ stage IIIA non-small cell lung cancer. ⋯ Lobectomy was performed safely following full-dose concurrent chemoradiotherapy in these multi-institutional prospective trials; however, increased mortality was noted with extended resections.
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J. Thorac. Cardiovasc. Surg. · Nov 2020
Initial experience introducing an enhanced recovery program in congenital cardiac surgery.
We hypothesized that a new enhanced recovery after surgery (ERAS) program would accelerate functional recovery after congenital heart surgery and reduce length of stay and complications. ⋯ This represents the initial implementation experience of an enhanced recovery after surgery program after congenital surgery at a large pediatric hospital. Adherence to the program component metrics is not yet optimized, but monthly sharing of quality metrics allows multidisciplinary collaboration, provider engagement, and opportunities for research and process improvement.
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J. Thorac. Cardiovasc. Surg. · Nov 2020
Using urinary biomarkers to reduce acute kidney injury following cardiac surgery.
Prediction of acute kidney injury (AKI) following cardiac surgery is unreliable through the use of serum creatinine or urinary output alone. Cell cycle arrest urinary biomarkers insulin-like growth factor-binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinases-2 (TIMP2) provide early detection of kidney stress and possibly AKI. We sought to determine whether therapeutic interventions driven by elevated urinary biomarkers (UB) reduces post-cardiac surgery stage 2/3 AKI. ⋯ The routine measurement of UB and subsequent activation of an AKRT are useful post-cardiac surgery therapeutic adjuncts. They are associated with early detection of kidney stress, allowing for targeted proactive intervention, and a significant decrease in postoperative stage 2/3 AKI without increases in cost or length of stay.