scholarly journals Room C, 10/16/2000 2: 00 PM - 4: 00 PM (PS) The Impact of Ringer's Lactate Solution Versus 0.9% Sodium Chloride in Cardiac Surgery on Blood Lactate 

2000 ◽  
Vol 93 (3A) ◽  
pp. A-335
Author(s):  
Nathalie Massicotte ◽  
Raymond Martineau ◽  
Andre Denault ◽  
Sylvain Belisle ◽  
Raymond Cartier
Keyword(s):  
Cardiac Surgery ◽  
Sodium Chloride ◽  
Blood Lactate ◽  
Solution Versus ◽  
Ringer’S Lactate ◽  
The Impact ◽  
Lactate Solution

Hyperlactatemia during cardiopulmonary bypass: risk factors and impact on surgical results with a focus on the long-term outcome

Perfusion ◽  
2020 ◽  
Vol 35 (8) ◽  
pp. 756-762 ◽  
Author(s):  
Matteo Matteucci ◽  
Sandro Ferrarese ◽  
Cristiano Cantore ◽  
Giangiuseppe Cappabianca ◽  
Giulio Massimi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Blood Lactate ◽  
Surgical Results ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Arterial Blood ◽  
The Impact

Introduction: Lactate, a product of anaerobic metabolism, is a biomarker and indicator for tissue hypoperfusion and oxygen debt. An elevated blood lactate level has been associated with poor outcome in many clinical conditions, including cardiac surgery. Nevertheless, debate exists regarding which blood lactate concentration is most indicative of poor outcomes. We evaluate the impact of hyperlactatemia, defined as a peak arterial blood concentration ⩾2.0 mmol/L during cardiopulmonary bypass, on surgical results with a focus on long-term outcome. Methods: We reviewed 1,099 consecutive adult patients who underwent cardiac surgery on pump. The patients were divided into two groups based on the presence or not of hyperlactatemia. Pre- and intraoperative risk factors for hyperlactatemia were identified, and the postoperative outcome of patients with or without hyperlactatemia was compared. Results: Hyperlactatemia was present in 372 patients (33.8%). Factors independently associated with hyperlactatemia were urgent/emergency procedure, cardiopulmonary bypass duration and aortic cross-clamp time. Patients with hyperlactatemia had significantly higher rate of prolonged mechanical ventilation time, in-hospital stay and requirement of inotropes and intra-aortic balloon pump support (p < 0.001). Operative (30-day) mortality was higher in the group of patients with hyperlactatemia (7.8% vs. 1.1%; p < 0.001). Kaplan–Meier curve showed worse long-term survival (mean follow-up: 4.02 ± 1.58 years) in patients with hyperlactatemia. Conclusion: Hyperlactatemia during cardiopulmonary bypass has a significant association with postoperative morbidity and mortality. Correction of risk factors for hyperlactatemia, together with prompt detection and correction of this condition, may control complications and improve outcome.

The impact of protocolized communication during cardiac surgery

2009 ◽  
Author(s):  
S. Henrickson Parker ◽  
R. Wadhera ◽  
D. Wiegmann ◽  
T. M. Sundt
Keyword(s):  
Cardiac Surgery ◽  
The Impact

Efficacy of Near-Infrared Spectrometry for Monitoring the Cerebral Effects of Severe Dilutional Anemia

2014 ◽  
Vol 17 (3) ◽  
pp. 154 ◽  
Author(s):  
Arıtürk Cem ◽  
Ustalar Serpil ◽  
Toraman Fevzi ◽  
Ökten Murat ◽  
Güllü Ümit ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiac Surgery ◽  
Blood Lactate ◽  
Near Infrared ◽  
Bypass Graft ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Infrared Spectrometry ◽  
Control Group ◽  
Near Infrared Spectrometry

<p><strong>Introduction:</strong> Clear guidelines for red cell transfusion during cardiac surgery have not yet been established. The current focus on blood conservation during cardiac surgery has increased the urgency to determine the minimum safe hematocrit for these patients. The aim of this study was to determine whether monitoring of cerebral regional oxygen saturation (rSO<sub>2</sub>) via near-infrared spectrometry (NIRS) is effective for assessing the cerebral effects of severe dilutional anemia during elective coronary arterial bypass graft surgery (CABG).</p><p><strong>Methods:</strong> The prospective observational study involved patients who underwent cerebral rSO<sub>2</sub> monitoring by NIRS during elective isolated first-time CABG: an anemic group (<em>N</em>=15) (minimum Hemoglobin (Hb) N=15) (Hb &gt;8 g/dL during CPB). Mean arterial pressure (MAP), pump blood flow, blood lactate level, pCO<sub>2</sub>, pO<sub>2</sub> at five time points and cross-clamp time, extracorporeal circulation time were recorded for each patient. Group results statistically were compared.</p><p><strong>Results:</strong> The anemic group had significantly lower mean preoperative Hb than the control group (10.3 mg/dL versus 14.2 mg/dL; <em>P</em> = .001). The lowest Hb levels were observed in the hypothermic period of CPB in the anemic group. None of the controls exhibited a &gt;20% decrease in cerebral rSO<sub>2</sub>. Eleven (73.3%) of the anemic patients required an increase in pump blood flow to raise their cerebral rSO<sub>2</sub>.</p><p><strong>Conclusions:</strong> In this study, the changes in cerebral rSO<sub>2</sub> in the patients with low Hb were within acceptable limits, and this was in concordance with the blood lactate levels and blood-gas analysis. It can be suggested that NIRS monitoring of cerebral rSO<sub>2</sub> can assist in decision making related to blood transfusion and dilutional anemia during CPB.</p>

The impact of exogenous nitric oxide during cardiopulmonary bypass for cardiac surgery

Perfusion ◽  
2021 ◽  
pp. 026765912110148
Author(s):  
Joseph Mc Loughlin ◽  
Lorraine Browne ◽  
John Hinchion
Keyword(s):  
Nitric Oxide ◽  
Systematic Review ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Troponin I ◽  
Length Of Hospital Stay ◽  
Cochrane Library ◽  
High Quality Research ◽  
Low Cardiac Output Syndrome ◽  
The Impact

Objectives: Cardiac surgery using cardiopulmonary bypass frequently provokes a systemic inflammatory response syndrome. This can lead to the development of low cardiac output syndrome (LCOS). Both of these can affect morbidity and mortality. This study is a systematic review of the impact of gaseous nitric oxide (gNO), delivered via the cardiopulmonary bypass (CPB) circuit during cardiac surgery, on post-operative outcomes. It aims to summarise the evidence available, to assess the effectiveness of gNO via the CPB circuit on outcomes, and highlight areas of further research needed to develop this hypothesis. Methods: A comprehensive search of Pubmed, Embase, Web of Science and the Cochrane Library was performed in May 2020. Only randomised control trials (RCTs) were considered. Results: Three studies were identified with a total of 274 patients. There was variation in the outcomes measures used across the studies. These studies demonstrate there is evidence that this intervention may contribute towards cardioprotection. Significant reductions in cardiac troponin I (cTnI) levels and lower vasoactive inotrope scores were seen in intervention groups. A high degree of heterogeneity between the studies exists. Meta-analysis of the duration of mechanical ventilation, length of ICU stay and length of hospital stay showed no significant differences. Conclusion: This systematic review explored the findings of three pilot RCTs. Overall the hypothesis that NO delivered via the CPB circuit can provide cardioprotection has been supported by this study. There remains a significant gap in the evidence, further high-quality research is required in both the adult and paediatric populations.

The impact of age on outcome of adult cardiac surgery patients

2004 ◽  
Vol 21 (Supplement 33) ◽  
pp. 14-15
Author(s):  
C. Naughton ◽  
J. Roxburgh ◽  
R. O. Feneck
Keyword(s):  
Cardiac Surgery ◽  
The Impact ◽  
Adult Cardiac Surgery

Obesity and Stroke After Cardiac Surgery: The Impact of Grouping Body Mass Index

2007 ◽  
Vol 84 (3) ◽  
pp. 720-722 ◽  
Author(s):  
Giovanni Filardo ◽  
Cody Hamilton ◽  
Baron Hamman ◽  
Paul Grayburn
Keyword(s):  
Body Mass Index ◽  
Cardiac Surgery ◽  
Body Mass ◽  
The Impact

Impact of the Coronavirus Disease 2019 Pandemic on Cardiac Surgical Education in North America

2021 ◽  
pp. 155698452110114
Author(s):  
Jessica G. Y. Luc ◽  
Tom C. Nguyen ◽  
Niv Ad
Keyword(s):  
Cardiac Surgery ◽  
North America ◽  
Geographic Distribution ◽  
Surgical Education ◽  
High Burden ◽  
Surgery Training ◽  
Virtual Institutions ◽  
Licensing Examination ◽  
The Impact ◽  
Adult Cardiac Surgery

Objective We report the impact of the coronavirus disease 2019 (COVID-19) pandemic on cardiac surgery trainee education in North America. Methods A survey was sent to participating academic adult cardiac surgery centers in North America. Data regarding the effect of COVID-19 on cardiac surgery training were analyzed. Results Responses were received from 53 academic institutions with diverse geographic distribution. Cardiac surgery trainee re-deployment to alternative clinical duties peaked at the height of the pandemic. We stratified institutions based on high ( n = 20) and low burden ( n = 33) of patients hospitalized with COVID-19. The majority of institutions have converted didactics (high burden 90% vs low burden 73%) and interviews for jobs/fellowships (high burden 75% vs low burden 73%) from in-person to virtual. Institutions were mixed in preference for administration of the licensing examination, with the most common preference for examinations to be held remotely on normal timeline (high burden 45% vs low burden 30%) or in person with more than 3-month delay (high burden 20% vs low burden 33%). Despite the challenges experienced during the COVID-19 pandemic on trainee clinical experience, re-deployment, and decreased operative volume, institutions expected their trainees to graduate on schedule (high burden 95% vs low burden 91%). Conclusions Our study demonstrates that actions taken during the COVID-19 pandemic has led to disruptions in cardiac surgery training with transition of didactics and interviews virtually and re-deployment to alternative duties. Despite this, institutions remain optimistic that their trainees will graduate on schedule.

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