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The Use of Corticosteroids for Cardiopulmonary Bypass in Adults
The perioperative application of corticosteroids did not improve mortality rates beyond standard care or other secondary outcomes, such as myocardial infarction, stroke, renal failure, and infection. The observed increased risk of myocardial damage in patients receiving corticosteroids in the SIRS trial is mainly related to the author-defined CK-MB threshold as indicator for early myocardial injury. Interestingly, the use of steroids may have some beneficial effects on secondary outcomes: they significantly decreased the risk of respiratory failure and pneumonia and shortened the length of ICU and hospital stay, but the mechanism involved in pulmonary injury is multifactorial and it is difficult to evaluate this result. Patients receiving steroids did not have a decreased incidence of atrial fibrillation shown by the two large trials unlike some previous small sample size trials have demonstrated.
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The Identification and Development of Canadian Coronary Artery Bypass Graft Surgery Quality Indicators
The study objective was to develop quality indicators for coronary artery bypass graft surgery that relate to quality of care, associate with preventable death, and could be reported on performance reports.
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Complications at the Time of Transcatheter Aortic Valve Implantation
Transcatheter aortic valve implantation (TAVI) improves the prognosis of patients with severe aortic stenosis who are deemed too high risk for surgical valve replacement.
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