keyword
https://read.qxmd.com/read/38536563/machine-learning-in-risk-prediction-of-continuous-renal-replacement-therapy-after-coronary-artery-bypass-grafting-surgery-in-patients
#1
JOURNAL ARTICLE
Qian Zhang, Peng Zheng, Zhou Hong, Luo Li, Nannan Liu, Zhiping Bian, Xiangjian Chen, Hengfang Wu, Sheng Zhao
OBJECTIVES: This study aimed to develop machine learning models for risk prediction of continuous renal replacement therapy (CRRT) following coronary artery bypass grafting (CABG) surgery in intensive care unit (ICU) patients. METHODS: We extracted CABG patients from the electronic medical record system of the hospital. The endpoint of this study was the requirement for CRRT after CABG surgery. The Boruta method was used for feature selection. Seven machine learning algorithms were developed to train models and validated using 10 fold cross-validation (CV)...
March 27, 2024: Clinical and Experimental Nephrology
https://read.qxmd.com/read/38531618/high-sensitive-troponint-interleukin-8-and-interleukin-6-link-with-post-surgery-risk-in-infant-heart-surgery
#2
JOURNAL ARTICLE
Elin M Thorlacius, Juho Keski-Nisula, Maria Vistnes, Tiina Ojala, Mattias Molin, Mats Synnergren, Birgitta S Romlin, Sven-Erik Ricksten, Håkan Wåhlander, Albert Gyllencreutz Castellheim
BACKGROUND: This study focuses on biomarkers in infants after open heart surgery, and examines the association of high-sensitive troponin T (hs-cTnT), interleukin-6 (IL-6), and interleukin-8 (IL-8) with postoperative acute kidney injury (AKI), ventilatory support time and need of vasoactive drugs. METHODS: Secondary exploratory study from a double-blinded clinical randomized trial (Mile-1) on 70 infants undergoing open heart surgery with cardiopulmonary bypass (CPB)...
March 26, 2024: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/38504912/postoperative-outcomes-after-total-sevoflurane-inhalation-sedation-using-a-disposable-delivery-system-sedaconda-acd-in-cardiac-surgery
#3
JOURNAL ARTICLE
François Labaste, Paul Cauquil, Magda Lestarquit, Pascale Sanchez-Verlaan, Abdulrahman Aljuayli, Bertrand Marcheix, Thomas Geeraerts, Fabrice Ferre, Fanny Vardon-Bounes, Vincent Minville
INTRODUCTION: The COVID-19 pandemic prompted our team to develop new solutions for performing cardiac surgery without intravenous anesthetics due to a shortage of these drugs. We utilized an anesthetic conserving device (Sedaconda-ACD) to administer total inhaled anesthesia because specific vaporizers were unavailable for administering inhaled agents during cardiopulmonary bypass (CPB) in our center. We documented our experience and postoperative cardiovascular outcomes. The primary outcome was the peak level of troponin, with secondary outcomes encompassing other cardiovascular complications...
2024: Frontiers in Medicine
https://read.qxmd.com/read/38500033/positive-effects-of-low-dose-s-ketamine-on-preventing-myocardial-injury-after-thoracoscopic-lobectomy-in-patients-aged-70-to-85
#4
JOURNAL ARTICLE
Ziqiang Bi, Lijuan Kong, Jiahui Zhao, Dongdong Song, Fengmei Duan
OBJECTIVE: To investigate the effects of low-dose S-ketamine on marker of myocardial injury (BNP, hs-cTnT and HFABP) after thoracoscopic lobectomy in patients aged 70 to 85. METHODS: One hundred patients (four cases excluded) aged 70-85 years, with body mass index 18-24 kg·m-2 and American Society of Anesthesiologists physical status II-III, scheduled for elective lobectomy from April 2022 to April 2023, were selected. The patients were divided into two groups by a random number table method, namely, the low-dose S-ketamine combined with GDFT group (group S) and the control group (group C), with 48 cases in each group...
March 19, 2024: BMC Anesthesiology
https://read.qxmd.com/read/38498395/predictive-value-of-nt-probnp-and-hs-tnt-for-outcomes-after-pediatric-congenital-cardiac-surgery
#5
JOURNAL ARTICLE
Huayan Shen, Qiyu He, Xinyang Shao, Ya-Hui Lin, Dongdong Wu, Kai Ma, Zheng Dou, Yuze Liu, Fengming Luo, Shoujun Li, Zhou Zhou
BACKGROUND: The available evidence regarding the predictive value of troponins and natriuretic peptides for early postoperative outcomes in pediatrics is limited, controversial, and based on small sample sizes. We aimed to investigate the association of N-terminal pro B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (hs-TnT) with the in-hospital adverse outcomes after congenital cardiac surgeries. METHODS: A secondary analysis based on a prospective study of pediatric congenital heart disease (CHD) patients was conducted to investigate the association of NT-proBNP and hs-TnT tested within 6 hours postoperatively with in-hospital adverse events...
March 18, 2024: International Journal of Surgery
https://read.qxmd.com/read/38491548/fulminant-myocarditis-during-postoperative-adjuvant-chemotherapy-for-lung-cancer-with-atezolizumab-a-case-report
#6
JOURNAL ARTICLE
Takuya Tokunaga, Masaya Aoki, Koki Maruyama, Yuto Nonaka, Kota Kariatsumari, Koichi Sakasegawa, Kazuhiro Ueda
BACKGROUND: Postoperative adjuvant systemic therapy with atezolizumab for lung cancer has been reported to be effective. Although myocarditis is a rare immune adverse event associated with atezolizumab, it can have a serious course and should be treated with caution. We herein report a case of fulminant myocarditis during adjuvant systemic therapy with atezolizumab. CASE PRESENTATION: The patient was a 49-year-old Asian woman. She was diagnosed with pT2aN1M0 stage IIB (Programmed Death Ligand 1(PD-L1), 50%) after surgery for right upper lobe lung adenocarcinoma...
March 16, 2024: Journal of Medical Case Reports
https://read.qxmd.com/read/38471194/postoperative-haemoglobin-and-anaemia-associated-ischaemic-events-after-major-noncardiac-surgery-a-sex-stratified-cohort-study
#7
JOURNAL ARTICLE
Bing-Cheng Zhao, Yi-Shan Xie, Wen-Chi Luo, Shao-Hui Lei, Jia-Ming Liu, Xiao Yang, Ye-Hong Dong, Wei-Feng Liu, Ke-Xuan Liu
STUDY OBJECTIVE: To determine the sex-specific associations between postoperative haemoglobin and mortality or complications reflecting ischaemia or inadequate oxygen supply after major noncardiac surgery. DESIGN: A retrospective cohort study with prospective validation. SETTING: A large university hospital health system in China. PATIENTS: Men and women undergoing elective major noncardiac surgery. INTERVENTIONS AND MEASUREMENTS: The primary exposure was nadir haemoglobin within 48 h after surgery...
March 11, 2024: Journal of Clinical Anesthesia
https://read.qxmd.com/read/38449953/the-significance-of-equipment-availability-and-anesthesia-educational-conferences-to-decision-making-for-ekg-lead-v5-abnormalities
#8
JOURNAL ARTICLE
Kimberly L Skidmore, Joseph Drinkard, Henson M Randall, Giustino Varrassi, Sahar Shekoohi, Alan D Kaye
Introduction To predict postoperative myocardial infarction rates in patients who undergo noncardiac surgery, the Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management recommends assessment of brain natriuretic peptide (BNP) in certain patients. Serial troponins are measured if the BNP level is elevated. In certain cases, Revised Cardiac Risk Index (RCRI) alone does not perform well, for example, during vascular surgery. Cardiac events occur in 20% of all vascular surgery patients...
February 2024: Curēus
https://read.qxmd.com/read/38425620/myocardial-infarction-simulated-from-improper-telemetry-misfit-an-autobiographical-case-report
#9
Philip R Cohen, Brent M Gudenkauf
An electrocardiogram, used to not only assess the rate and rhythm of the heart but also to evaluate for injury to the heart, is performed by attaching 12 leads to the patient's body. A myocardial infarction can be mimicked by the misplacement of the leads. A 58-year-old man with long-distance running-associated bradycardia developed postoperative atrial fibrillation with a rapid ventricular response. He converted to normal sinus rhythm after a single oral dose of 30 milligrams of diltiazem; however, the automated reading of the electrocardiogram performed in the hospital showed new changes suggestive of a postero-lateral myocardial infarction, including Q waves in leads I and aVL, as well as early precordial R wave progression with R waves and positive T waves in V2 and V3 , and a dominant R wave (R wave to S wave ratio greater than one) in V2 ...
January 2024: Curēus
https://read.qxmd.com/read/38424311/association-between-high-sensitivity-troponin-levels-following-pediatric-orthotopic-heart-transplantation-and-intensive-care-unit-resource-utilization
#10
JOURNAL ARTICLE
Adam M Butensky, Shyam Desai, Michael Dilorenzo, Irene D Lytrivi, Benjamin S Mantell, Yun Zhang, Tarif A Choudhury
The utility of troponin levels, including high sensitivity troponin T (hs-TnT), after orthotopic heart transplant (OHT) is controversial. Conflicting data exist regarding its use as a marker of acute rejection. Few studies have examined possible associations of hs-TnT levels immediately after OHT with metrics of intensive care unit (ICU) resource utilization or risk of acute rejection. We performed a retrospective cohort chart review including all OHT recipients < 20 years of age at our center between June 2019 and December 2022...
February 29, 2024: Pediatric Cardiology
https://read.qxmd.com/read/38420786/european-association-of-cardio-thoracic-surgery-eacts-expert-consensus-statement-on-perioperative-myocardial-infarction-after-cardiac-surgery
#11
JOURNAL ARTICLE
Mario Gaudino, Marcus Flather, Davide Capodanno, Milan Milojevic, Deepak L Bhatt, Giuseppe Biondi Zoccai, William E Boden, P J Devereaux, Torsten Doenst, Michael Farkouh, Nicholas Freemantle, Stephen Fremes, John Puskas, Giovanni Landoni, Jennifer Lawton, Patrick O Myers, Björn Redfors, Sigrid Sandner
Cardiac surgery may lead to myocardial damage and release of cardiac biomarkers through various mechanisms such as cardiac manipulation, systemic inflammation, myocardial hypoxia, cardioplegic arrest and ischaemia caused by coronary or graft occlusion. Defining perioperative myocardial infarction (PMI) after cardiac surgery presents challenges, and the association between the current PMI definitions and postoperative outcomes remains uncertain. To address these challenges, the European Association of Cardio-Thoracic Surgery (EACTS) facilitated collaboration among a multidisciplinary group to evaluate the existing evidence on the mechanisms, diagnosis and prognostic implications of PMI after cardiac surgery...
February 1, 2024: European Journal of Cardio-thoracic Surgery
https://read.qxmd.com/read/38416798/high-sensitivity-cardiac-troponin-t-and-frailty-predict-short-term-mortality-in-patients-%C3%A2-75-years-undergoing-emergency-abdominal-surgery-a-prospective-observational-study
#12
JOURNAL ARTICLE
Elin Kismul Aakre, Kristin Moberg Aakre, Hans Flaatten, Karl Ove Hufthammer, Anette Hylen Ranhoff, Ib Jammer
BACKGROUND: An elevated cardiac troponin concentration is a prognostic factor for perioperative cardiac morbidity and mortality. In elderly patients undergoing emergency abdominal surgery, frailty is a recognized risk factor, but little is known about the prognostic value of cardiac troponin in these vulnerable patients. Therefore, we investigated the prognostic significance of elevated high-sensitivity cardiac troponin T (hs-cTnT) concentration and frailty in a cohort of elderly patients undergoing emergency abdominal surgery...
February 26, 2024: Anesthesia and Analgesia
https://read.qxmd.com/read/38408904/mass-intraoperative-endothelial-glycocalyx-shedding-affects-postoperative-systemic-inflammation-response
#13
JOURNAL ARTICLE
JiaWan Wang, Yan Wu
BACGROUND: Off-pump coronary artery bypass graft (OPCABG) has a high incidence of postoperative systemic inflammation response syndrome (SIRS), and perioperative endothelial glycocalyx layer (EGL) disruption can be one of the predisposing factors. We hypothesized that EGL shedding happened earlier in OPCABG which can influence on postoperative SIRS, and sevoflurane might preserve EGL better than propofol. METHODS: We randomly allocated 50 patients undergoing OPCABG to receive either sevoflurane-sufentanil or propofol-sufentanil anesthesia...
February 26, 2024: BMC Anesthesiology
https://read.qxmd.com/read/38392644/individualized-perioperative-hemodynamic-management-using-hypotension-prediction-index-software-and-the-dynamics-of-troponin-and-ntprobnp-concentration-changes-in-patients-undergoing-oncological-abdominal-surgery
#14
JOURNAL ARTICLE
Jolanta Cylwik, Małgorzata Celińska-Spodar, Mariusz Dudzic
INTRODUCTION: Abdominal oncologic surgeries pose significant risks due to the complexity of the surgery and patients' often weakened health, multiple comorbidities, and increased perioperative hazards. Hypotension is a major risk factor for perioperative cardiovascular complications, necessitating individualized management in modern anesthesiology. AIM: This study aimed to determine the dynamics of changes in troponin and NTproBNP levels during the first two postoperative days in patients undergoing major cancer abdominal surgery with advanced hemodynamic monitoring including The AcumenTM Hypotension Prediction Index software (HPI) (Edwards Lifesciences, Irvine, CA, USA) and their association with the occurrence of postoperative cardiovascular complications...
February 16, 2024: Journal of Personalized Medicine
https://read.qxmd.com/read/38391907/levels-of-circulating-ketone-bodies-in-patients-undergoing-cardiac-surgery-on-cardiopulmonary-bypass
#15
JOURNAL ARTICLE
Anja Levis, Markus Huber, Déborah Mathis, Mark G Filipovic, Andrea Stieger, Lorenz Räber, Frank Stueber, Markus M Luedi
Ketone bodies (KBs) are energy-efficient substrates utilized by the heart depending on its metabolic demand and substrate availability. Levels of circulating KBs have been shown to be elevated in acute and chronic cardiovascular disease and are associated with severity of disease in patients with heart failure and functional outcome after myocardial infarction. To investigate whether this pattern similarly applies to patients undergoing cardiac surgery involving cardiopulmonary bypass (CPB), we analysed prospectively collected pre- and postoperative blood samples from 192 cardiac surgery patients and compared levels and perioperative changes in total KBs with Troponin T as a marker of myocardial cell injury...
February 6, 2024: Cells
https://read.qxmd.com/read/38370160/complexity-of-coronary-artery-disease-and-the-release-of-cardiac-biomarkers-after-cabg
#16
JOURNAL ARTICLE
Leo Pölzl, Ronja Lohmann, Philipp Sterzinger, Felix Nägele, Jakob Hirsch, Michael Graber, Clemens Engler, Jonas Eder, Hannes Abfalterer, Hanno Ulmer, Andrea Griesmacher, Michael Grimm, Nikolaos Bonaros, Elfriede Ruttmann-Ulmer, Johannes Holfeld, Can Gollmann-Tepeköylü
OBJECTIVE: In patients with complex coronary artery disease (CAD) undergoing cardiac surgery, myocardial protection might be impaired due to microvascular obstruction, resulting in myocardial injury and subsequent biomarker release. Therefore, this study investigated the correlation between the complexity of CAD, reflected by the SYNTAX Score, and the release of cardiac biomarkers after CABG. METHODS: In a consecutive series of 919 patients undergoing isolated CABG SYNTAX scores I and II were calculated to assess the complexity of CAD...
2024: Frontiers in Cardiovascular Medicine
https://read.qxmd.com/read/38340803/the-correlation-between-high-sensitivity-troponin-t-and-cell-free-cardiac-dna-in-the-blood-of-patients-undergoing-noncardiac-predominantly-vascular-surgery
#17
COMPARATIVE STUDY
Tural Alekberli, Braha Lea Ohana, Hai Zemmour, Rudy Khader, Ruth Shemer, Yuval Dor, Giora Landesberg
OBJECTIVE: To present a novel method that uses an epigenetic fingerprint to measure changes in plasma concentrations of cardiac-specific cell-free DNA (CS-cfDNA) as a marker of myocardial cell death. METHODS: This prospective, analytic, observational comparative study included patients with heart disease or multiple risk factors for heart disease undergoing major noncardiac, mostly vascular surgery, requiring an arterial-line, and at least 24 h hospitalization in the post anaesthesia care unit or critical care unit after surgery...
February 2024: Journal of International Medical Research
https://read.qxmd.com/read/38330844/effect-of-continuing-angiotensin-converting-enzyme-inhibitors-or-angiotensin-ii-receptor-blockers-on-the-day-of-surgery-on-myocardial-injury-after-non-cardiac-surgery-a-retrospective-cohort-study
#18
JOURNAL ARTICLE
Jeayoun Kim, Seungwon Lee, Jisun Choi, Dae Kyun Ryu, Seunghyeon Woo, MiHye Park
STUDY OBJECTIVE: To evaluate the effect of continuing of angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) prescriptions 24 h before surgery on postoperative myocardial injury and blood pressure in patients undergoing non-cardiac surgery. DESIGN: A single-center, retrospective study. SETTING: Operating room and perioperative care area. PATIENTS: 42,432 patients who had been taking chronic ACEI/ARB underwent non-cardiac surgery from January 2012 to June 2022...
February 7, 2024: Journal of Clinical Anesthesia
https://read.qxmd.com/read/38315052/del-nido-vs-cold-blood-cardioplegia-for-high-risk-isolated-coronary-artery-bypass-grafting-in-patients-with-reduced-ventricular-function
#19
JOURNAL ARTICLE
Krzysztof Sanetra, Witold Gerber, Marta Mazur, Marta Kubaszewska, Ewa Pietrzyk, Piotr Paweł Buszman, Paweł Kaźmierczak, Andrzej Bochenek
INTRODUCTION: The evidence for using del Nido cardioplegia protocol in high-risk patients with reduced ejection fraction undergoing isolated coronary surgery is insufficient. METHODS: The institutional database was searched for isolated coronary bypass procedures. Patients with ejection fraction < 40% were selected. Propensity matching (age, sex, infarction, number of grafts) was used to pair del Nido (Group 1) and cold blood (Group 2) cardioplegia patients. Investigation of biomarker release, changes in ejection fraction, mortality, stroke, perioperative myocardial infarction, composite endpoint (major adverse cardiac and cerebrovascular events), and other perioperative parameters was performed...
February 5, 2024: Brazilian Journal of Cardiovascular Surgery
https://read.qxmd.com/read/38292644/subarachnoid-hemorrhage-misdiagnosed-as-acute-coronary-syndrome-leading-to-catastrophic-neurologic-injury-a-case-report
#20
Jun-Ming Lin, Xiao-Jun Yuan, Guang Li, Xin-Rong Gan, Wen-Hua Xu
BACKGROUND: Elevated levels of cardiac troponin and abnormal electrocardiogram changes are the primary basis for clinical diagnosis of acute coronary syndrome (ACS). Troponin levels in ACS patients can often be more than 50 times the upper reference limit. Some patients with subarachnoid hemorrhage (SAH) also show electrocardiogram abnormalities, myocardial damage, and elevated cardiac biomarkers. Unlike ACS patients, patients with SAH only have a slight increase in troponin, and the use of anticoagulants or antiplatelet drugs is prohibited...
January 6, 2024: World Journal of Clinical Cases
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