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Acute Respiratory Distress Syndrome in the Perioperative Period of Cardiac Surgery: Predictors, Diagnosis, Prognosis, Management Options, and Future Directions
More research in the setting of ARDS after cardiac surgery is needed at multiple levels (risk factors, diagnosis, treatment options). Prevention of lung injury appears to be of the utmost importance, and a better characterization of the risk factors is needed. Avoiding excessive perioperative transfusions and the optimization of ventilation and hemodynamics seem to be the most modifiable risk factors. In patients who develop ARDS after cardiac surgery, extracorporeal techniques may represent a valid choice in experienced hands. The use of NMBAs, prone positioning, and iNO can be considered on a case-by-case basis, whereas aggressive lung recruitment and oscillatory ventilation probably should be avoided.
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Urgent Coronary Artery Bypass Graft Surgery Supported by Veno-Arterial Extracorporeal Membrane Oxygenation: A Report of Two Cases
Our report indicates that VA-ECMO can be used instead of the cardiopulmonary bypass machine (CPB) to support the circulation during CABG surgery in patients with complex coronary anatomy and unstable haemodynamics. Future studies focusing on the long-term outcomes of such patients will probably help to establish the optimal management of this type of patients.
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Covid-19: General Guidelines For Cardiovascular Surgeons (standard guidelines – subject to change)
Important considerations should be given to our readers regarding cardiac surgery, surgical teams, our patients, and their possible contacts.
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