Intranasal Administration of 40 And 80 Units of Insulin Does Not Cause Hypoglycemia During Cardiac Surgery: A Randomized Controlled Trial
In patients with and without T2DM undergoing elective cardiac surgery, intranasal insulin administration at doses as high as 80 IU did not cause clinically important hypoglycemia.
Hemostasis Checklist Reduces Bleeding and Blood Product Consumption After Cardiac Surgery
Implementation of a simple and quickly performed hemostasis checklist has had a sustained impact over the 2 years after implementation, reducing the incidence of noteworthy mediastinal bleeding and reexploration, which has resulted in a major reduction in blood product consumption. Together, these have resulted in an associated reduction in intensive care unit and hospital length of stay, and a considerable financial savings. This highlights that perioperative bleeding is a preventable complication.
Effect of Cytokine Adsorption on Survival and Circulatory Stabilization in Patients Receiving Extracorporeal Cardiopulmonary Resuscitation
Due to small case numbers and the retrospective design of the study, our results neither disprove nor confirm a clinically relevant treatment effect of cytokine adsorption. Results from larger trials, preferably randomized-controlled trials are required to better understand the clinical benefit of cytokine adsorption after ECPR.
Surviving and Thriving 1 Year After Cardiac Surgery: Frailty and Delirium Matter
Preoperative frailty alone did not negatively affect cardiac surgery patients’ functional outcomes up to 1 year, but coexisting frailty and POD led to substantial loss of independence on 3 to 4 ADLs and a 30.2-fold higher likelihood of dying 1 year after surgery. Because frailty led to a 4.9-fold increase in POD risk, frailty may serve as a presurgical screen to identify patients who would likely benefit from delirium prevention and functional recovery programs to maximize 1-year postsurgical outcomes.
Long-term Outcomes After Pulmonary Endarterectomy in 499 Patients Over a 20-Year Period
Survival after hospital discharge is excellent for patients undergoing PEA. Postoperative PH is associated with more symptoms and poorer functional capacity. Patients who have clinically relevant postoperative PH should be monitored closely and may be candidates for additional medical therapy.
Red Blood Cell Transfusion Threshold and Mortality in Cardiac Intensive Care Unit Patients
These observational data suggest the use of a Hgb threshold <8 g/dL for RBC transfusion in most CICU patients, although we could not exclude a potential benefit of RBC transfusion at a nadir Hgb of 8 to 9.9 g/dL; we did not observe any benefit from RBC transfusion at a nadir Hgb ≥10 g/dL.
Improved Drainage Cannula Design to Reduce Thrombosis in Veno-Arterial Extracorporeal Membrane Oxygenation
This study suggests that simple geometrical changes can significantly alter the risk of thrombosis in ECMO drainage cannulas.
Extracorporeal Membrane Oxygenation Network Organisation and Clinical Outcomes During the COVID-19 Pandemic in Greater Paris, France: A Multicentre Cohort Study
Beyond associations with similar factors to those reported on ECMO for non-COVID-19 ARDS, 90-day survival among ECMO-assisted patients with COVID-19 was strongly associated with a centre's experience in venovenous ECMO during the previous year. Early ECMO management in centres with a high venovenous ECMO case volume should be advocated, by applying centralisation and regulation of ECMO indications, which should also help to prevent a shortage of resources.
Heparin-Induced Thrombocytopenia: Construction of A Pre-Test Diagnostic Score Derived from the Analysis of A Prospective Multinational Database, with Internal Validation
The objective, easy-to-collect, clinical features of HIT we evidenced were incorporated into a pre-test score, which may guide clinical decisions regarding diagnostic testing and anticoagulation.
Anticoagulation and In-Hospital Mortality From Coronavirus Disease 2019: A Systematic Review and Meta-Analysis
Our findings support the optimal efficacy and safety profiles of prophylactic dose AC in hospitalized COVID-19 patients.
How Would We Treat Our Own Heparin-Induced Thrombocytopenia During Cardiac Surgery?
The aim of this article is to provide a comprehensive review of the current state of knowledge on heparin-induced thrombocytopenia (HIT) in cardiac surgery.
Transport and Retrieval on Extracorporeal Membrane Oxygenation (ECMO): Setup and Activities of an Immersive Transport and Retrieval on ECMO Workshop
This article describes the authors’ experience of developing and running a simulation-based ECMO Transport and Retrieval workshop, with multiple immersive scenarios and opportunities for participants to familiarize themselves with the process and the ambulance equipment and environment.