The Database Dilemma: An Imperfect but Critical Tool to Improve Quality and Benchmark Outcomes (Ed.)
The Society of Thoracic Surgeons (STS) database was created in 1989 as a patient safety initiative for adults undergoing cardiothoracic surgery. In 2005, pediatric and congenital cardiac patient data began being collected by a registry operated by the Congenital Cardiac Anesthesia Society.
Discriminatory Power of Scoring Systems for Outcome Prediction in Patients With Extracorporeal Membrane Oxygenation Following Cardiovascular Surgery
Although extracorporeal membrane oxygenation (ECMO) represents a rapidly evolving treatment option in patients with refractory heart or lung failure, survival remains poor and appropriate risk stratification challenging because established risk prediction models have not been validated for this specific population.
Red Blood Cell Dysfunction: a New Player in Cardiovascular Disease
The primary role of red blood cells (RBCs) is to transport oxygen to the tissues and carbon dioxide to the lungs. However, emerging evidence suggests an important role of the RBC beyond being just a passive carrier of the respiratory gases.
Quality of Life After Coronary Bypass: a Multicentre Study of Routinely Collected Health Data in the Netherlands
In this study, our aim was to explore how coronary artery bypass grafting affects quality of life, and how this varies with age, particularly with patients at risk of deterioration.
Cardiopulmonary Bypass and Dual Antiplatelet Therapy: a Strategy to Minimise Transfusions and Blood Loss
Patients with preoperative dual antiplatelet therapy prior to coronary artery bypass surgery are at risk of bleeding and blood component transfusion. We hypothesise that an optimised cardiopulmonary bypass strategy reduces postoperative blood loss and transfusions.
In-vitro Performance of a Low Flow Extracorporeal Carbon Dioxide Removal Circuit
Extracorporeal gas exchange requires the passage of oxygen and carbon dioxide (CO2) across an artificial membrane. Current European Union regulations do not require the transfer to be assessed in models using clinically relevant haemoglobin, making it difficult for clinicians to understand the CO2 clearance of a membrane, and how it changes in relation to sweep gas flow through the membrane.
Postoperative Pain Management in Pediatric Patients Undergoing Cardiac Surgery: Where Are We Heading?
Adequate postoperative pain management is crucial in pediatric patients undergoing cardiac surgery because pain can lead to devastating short- and long-term consequences. This review discusses the limitations of current postoperative pain assessment and management in children after cardiac surgery, the obstacles to providing optimal treatment, and concepts to consider that may overcome these barriers.
Dexmedetomidine Extraction by the Extracorporeal Membrane Oxygenation Circuit: Results From an in Vitro Study
Dexmedetomidine is a sedative administered to minimize distress and decrease the risk of life threatening complications in children supported with extracorporeal membrane oxygenation. The extracorporeal membrane oxygenation circuit can extract drug and decrease drug exposure, placing the patient at risk of therapeutic failure.
Determinants of the Effect of Extracorporeal Carbon Dioxide Removal in the SUPERNOVA Trial: Implications for Trial Design
To describe the variability and determinants of the effect of extracorporeal CO2 removal (ECCO2R) on tidal volume (Vt), driving pressure (ΔP), and mechanical power (PowerRS) and to determine whether highly responsive patients can be identified for the purpose of predictive enrichment in ECCO2R trial design.
Peritoneal Dialysis Vs Diuretics in Children After Congenital Heart Surgery
This study conducted a comprehensive search in Medline, EMBASE, Scopus, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews from the databases’ inception through April 24, 2018. Independent reviewers selected studies and extracted data. A random effects meta-analysis was performed to pool the outcomes of interest across studies.
Neurological Complications After Cardiac Surgery Anesthetic Considerations Based on Outcome Evidence
Neurological complications after cardiac surgery remain prevalent. This review aims to discuss the modifiable and outcome-relevant risk factors based on an up-to-date literature review, with a focus on interventions that may improve outcomes.
Predicting Outcome After Out-of-Hospital Cardiac Arrest: Lactate, Need for Vasopressors, and Cytochrome c
Outcome prediction after out-of-hospital cardiac arrest (OHCA) is difficult. We hypothesized that lactate and need for vasopressors would predict outcome, and that addition of a mitochondrial biomarker would enhance performance of the tool.