Limb Amputation Following Extracorporeal Membrane Oxygenation Therapy Among Survivors: A Nationwide Cohort Study from South Korea
In South Korea, 1.6% of ECMO survivors underwent limb amputation within 365 days after initiating ECMO therapy; however, it was not significantly associated with the 3-year all-cause mortality. Our findings warrant future studies on the impact on the quality of life and morbidity-related implications among patients who undergo limb amputation due to ECMO therapy.
Mobile Devices and Wearable Technology for Measuring Patient Outcomes after Surgery: A Systematic Review
Despite the potential of DHI to improve postoperative patient care, current progress is severely restricted by limitations in methodological reporting. There is an urgent need to improve reporting for DHI following surgery to identify patient benefit, promote reproducibility and encoura
The Effect of Low Tidal Volume Ventilation on Inflammatory Cytokines During Cardiopulmonary Bypass
Our findings suggest that low tidal volume ventilation may reduce the inflammatory response during CPB. Although the benefit of low tidal volume ventilation in CPB has been shown to decrease postoperative lung complications such as pleural effusion, atelectasis and pneumonia, we still lack more definitive and clear proofs of inflammatory cytokines encountered during CPB.
Early Experience with Donation after Circulatory Death Heart Transplantation Using Normothermic Regional Perfusion in The United States
DCD heart transplantation outcomes have been excellent. Our DCD protocol is adoptable for more widespread use and will increase donor heart availability in the United States.
Adrenaline Improves Regional Cerebral Blood Flow, Cerebral Oxygenation and Cerebral Metabolism During CPR in A Porcine Cardiac Arrest Model Using Low-Flow Extracorporeal Support
This study shows that adrenaline administration during constant low systemic blood flow increases CePP, regional CBF, cerebral oxygenation and cerebral metabolism.
Neuroprotective Effects of Dynamic Bubble Trap Use in Patients Undergoing Pulmonary Endarterectomy: A Two-Arm Randomized Controlled Trial
DBT positively influences memory function after PEA. This effect is most likely caused by the reduction of gaseous microemboli.
Outcomes and their State-Level Variation in Patients Undergoing Surgery with Perioperative SARS-CoV-2 Infection in the USA: A Prospective Multicenter Study
Patients with perioperative SARS-CoV-2 infection have a significantly high risk for postoperative complications, especially elderly males. Postponing elective surgery and adopting non-operative management, when reasonable, should be considered in the USA during the pandemic peaks.
The Use of Cerebral NIRS Monitoring to Identify Acute Brain Injury in Patients With VA-ECMO
Our results support that cerebral NIRS is a useful, real-time bedside neuromonitoring tool to detect ABI in VA-ECMO patients. A >25% drop from the baseline was sensitive in predicting ABI occurrence. Further research is needed to assess how to implement this knowledge to utilize NIRS in developing appropriate intervention strategy in VA-ECMO patients.
The 10 Commandments of ERAS for Cardiac Surgery
These guidelines recommend 22 evidence-based care bundles for cardiac surgery. In addition to implementation of these bundles, the creation of a cardiac ERAS program involves pivoting the culture of care to a standardized, patient-centered philosophy with rigorous auditing and benchmarking. Adherence to several guiding principles described below is essential to build a successful cardiac ERAS program and improve outcomes.
Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: the RESTORE Randomized Clinical Trial
Among patients with symptomatic mild to moderate radiographic knee OA, intra-articular injection of PRP, compared with injection of saline placebo, did not result in a significant difference in symptoms or joint structure at 12 months. These findings do not support use of PRP for the management of knee OA.
The Challenge of Estimating Treatment Effects in Cardiac Surgery
For several decades the cardiac surgery community has relied on observational comparative studies, often due to the perception than randomized trials are too challenging and complex. We have described how only less than 10% of the available evidence on the 10 most commonly performed surgical procedures comes from randomized trials and how the number of published cardiac surgery trials has decreased significantly over the course of the last 20 years.
Data-Driven Individualized Surgical Decision-making: Beyond “Better on Average” Clinical Trial Results
Commonly used surgical risk models do not provide the probability of outcome resulting from a counterfactual scenario of not undergoing surgery, providing only half of the information needed to make informed treatment decisions. Risk models developed from RCT data could inform comparative risks and potential benefits of undergoing alternative treatment options.