The heart surgery forum
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The heart surgery forum · Aug 2012
Simple technique to verify CO(2) diffusion with the CarbonAid™ device.
It has become common practice in cardiac surgery to flood the operative field with CO(2) to facilitate deairing of the heart. However, CO(2) delivery is variable and verification of CO(2) delivery can be challenging. We report a simple, reliable method to confirm CO(2) delivery. This technique ensures that the benefits of CO(2) delivery are provided to the patient during the operation.
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The heart surgery forum · Aug 2012
Case ReportsOne hundred ten days of extracorporeal membrane oxygenation in a young woman with postpartum cerebral venous thrombosis and acute respiratory distress syndrome.
Extracorporeal membrane oxygenation (ECMO) is often the last resort for serious acute respiratory distress syndrome (ARDS) when all non-invasive treatment options have failed to improve the patient's pulmonary condition. We present a successful long-term therapy with ECMO over 110 days in a 28-year-old woman. She developed postpartum cerebral venous thrombosis with severe respiratory insufficiency. Veno-venous ECMO rescued this young patient, allowing for full recovery.
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The heart surgery forum · Aug 2012
Controlled Clinical TrialSafety and efficacy of an ultrashort-acting β1-blocker on left ventricular dysfunction.
Landiolol hydrochloride, an ultrashort-acting β1-selective blocker, is a highly regulated drug. This study evaluated the safety and efficacy of this drug for cases of coronary artery bypass grafting (CABG) with left ventricular dysfunction. Between September 2006 and August 2009, 32 patients with a left ventricular ejection fraction of <40% underwent CABG. ⋯ No change was observed in other parameters; the hemodynamics were stable. The occurrence of atrial fibrillation during the intensive care unit stay (during landiolol hydrochloride administration) was significantly lower in the administration group. The difference remained significant after multiple logistic regression analysis; landiolol hydrochloride was the sole inhibitory factor.
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The heart surgery forum · Aug 2012
Case ReportsNear-infrared spectroscopy-detected cerebral ischemia resolved by cannulation of an axillo-femoral graft during surgical repair of type A aortic dissection.
We report the case of a patient who experienced near-infrared spectroscopy (NIRS)-detected transient regional cerebral desaturation during cardiopulmonary bypass for an operation to replace the aortic arch. Prompt institution of additional flow through an axillo-femoral graft was associated with restoration of regional cerebral saturation. The aortic surgery had no neurologic complications. Promptness in detecting and restoring cerebral perfusion appeared crucial in avoiding prolonged cerebral ischemia and reducing the likelihood of adverse neurologic events.
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The heart surgery forum · Aug 2012
Can we identify risk factors for postoperative delirium in cardiac coronary patients? Our experience.
Delirium is a temporary mental disorder that frequently occurs among elderly hospitalized patients. Patients who undergo cardiac operations have an increased risk of postoperative delirium, which is associated with higher mortality and morbidity rates, a prolonged hospital stay, and reduced cognitive and functional recovery. ⋯ Three of the four predictive factors significantly associated with delirium are preoperative. They are relatively easy to measure and can be used to identify patients at higher risk. Fast extubation of these patients and preventive interventions can be taken to prevent negative consequences of this postoperative complication.