Intraoperative Plasma Lactate as an Early Indicator of Major Postoperative Events in Pediatric Cardiac Patients
Hyperlactatemia and unmeasured anions (UMA) have been suggested to be useful predictors of outcomes after pediatric cardiac surgery in the ICU.
Acute Kidney Injury and Death Associated With Renin Angiotensin System Blockade in Cardiothoracic Surgery: A Meta-analysis of Observational Studies
In retrospective studies, preoperative use of RAS blockers was associated with increased odds of postoperative AKI and mortality in patients undergoing cardiovascular surgery.
Perfline.com acquired by Perfusion.com, Inc.
Perfline.com (The largest collection of cardiopulmonary bypass and related sciences resources in the Internet) based in Rio de Janeiro, Brazil has recently by acquired by Perfusion.com, Inc.
Cellsaver Use in Obstetrics
This study is a review of our experience of using the cell saver in obstetrics. The main aim was to determine its role in decreasing the need for homologous blood transfusion.
Introduction of Cell Salvage to a Large Obstetric Unit: The First Six Months
We introduced red-cell salvage to our obstetric unit following a two-month period of training and education.
The Affordable Care Act: The Ethical Call for Value-Based Leadership to Transform Quality
This article addresses the need for value-based leadership to transform the culture of health care organizations in order to be successful in navigating uncharted waters under the unprecedented challenges for change in the delivery of quality health care.
Comparing Mandated Health Care Reforms: the Affordable Care Act, Accountable Care Organizations, and the Medicare ESRD Program
This article reviews the new ESRD payment system and the Quality Incentive Program, comparing and contrasting them with ACOs.
Roles for Specialty Societies and Vascular Surgeons in Accountable Care Organizations
In this review, first, we will explore the development of ACOs within the context of prior attempts to control Medicare spending, such as the sustainable growth rate and managed care organizations. Second, we describe the evolution of ACOs, the demonstration projects that established their feasibility, and their current organizational structure. Third, because quality metrics are central to the use and implementation of ACOs, we describe current efforts to design, collect, and interpret quality metrics in vascular surgery. And fourth, because a "seat at the table" will be an important key to success for vascular surgeons in these efforts, we discuss how vascular surgeons can participate and lead efforts within ACOs.
Controversy Over the Use of Intraoperative Blood Salvage Autotransfusion During Liver Transplantation for Hepatocellular Carcinoma Patients
Intraoperative blood salvage autotransfusion (IBSA) is used in various surgical procedures. However, because of the risk of reinfusion of salvaged blood contaminated by tumor cells, the use of IBSA in hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT) is controversial.
Encouraging Value-Based Insurance Designs in State Health Insurance Exchanges
One of the main goals of the Affordable Care Act (ACA) is to control the costs of US healthcare. Channeling patients toward more effective services is one of many approaches being used to control costs while improving health outcomes. This paper reviews value-based insurance design (VBID) concepts and discusses options for states to encourage these designs in the new health insurance exchanges (HIEs).
Peripartum Use of Cell salvage: A University Practice Audit and Literature Review
The rising rate of obstetrical hemorrhage attributed to the repeated cesarean sections and invasive placental disorders, requiring blood transfusion has emphasized the need for alternatives to allogeneic blood donation.
Taking Our Medicine — Improving Adherence in the Accountability Era
The Affordable Care Act aims to shift reimbursement from fee for service toward rewarding of improved quality, outcomes, and efficiency. Payment and delivery-system models such as patient-centered medical homes (PCMHs), accountable care organizations (ACOs), and bundled payments encourage greater care coordination by holding providers accountable for total costs and outcomes in their patient populations.