scholarly journals A Prospective Clinical Comparison of Two Intravenous Polyurethane Cannulae

1996 ◽  
Vol 24 (6) ◽  
pp. 705-709 ◽  
Author(s):  
W. J. Russell ◽  
S. Micik ◽  
S. Gourd ◽  
H. Mackay ◽  
S. Wright
Keyword(s):  
Cardiac Surgery ◽  
Clinical Performance ◽  
Removal Rate ◽  
Patient Characteristics ◽  
Becton Dickinson ◽  
Early Removal ◽  
Clinical Comparison ◽  
Induction Of Anaesthesia

Tissue irritation, as evidenced by phlebitis, associated with Optiva™ (Johnson & Johnson Medical) and Insyte™ (Becton Dickinson) polyurethane cannulae was studied. The integrity of the cannulae on removal, the incidence of infection at the cannula site and the factors which influence phlebitis were also examined. One thousand and eight patients had a polyurethane cannula placed for induction of anaesthesia for cardiac surgery. After surgery, the cannula was examined every 24 hours. If evidence of phlebitis occurred, the cannula was removed and sent for culture. All remaining cannulae were removed at 72 hours and the site examined daily for a further three days. There were 503 Optiva™ and 505 Insyte™ cannulae studied. The distributions between the two cannulae with respect to patient characteristics, gauge of cannula, number of attempts and difficulty of insertion, cannula site and anaesthetist inserting were similar. The early removal rate for both groups was 47%. Overall phlebitis rate with Optiva™ was 31% and Insyte™ 33%. This difference is not statistically significant. The cumulative phlebitis rate increased with time but did not differ between the two types of cannulae. Minor tip distortion or shaft kinking of the cannulae occurred in 16.2% of Optiva™ and 23.5% of Insyte™. This difference is statistically significant and may relate to the slightly more acute taper at the Optiva™ cannula tip. Both cannulae were similar in clinical performance.

scholarly journals A Prospective Clinical Comparison of Two Intravenous Polyurethane Cannulae

1997 ◽  
Vol 25 (1) ◽  
pp. 42-47 ◽  
Author(s):  
W. J. Russell ◽  
S. Micik ◽  
S. Gourd ◽  
H. Mackay ◽  
S. Wright
Keyword(s):  
Cardiac Surgery ◽  
Clinical Performance ◽  
Removal Rate ◽  
Patient Characteristics ◽  
Becton Dickinson ◽  
Early Removal ◽  
Clinical Comparison ◽  
Induction Of Anaesthesia

Tissue irritation, as evidenced by phlebitis, associated with Optiva™ (Johnson & Johnson Medical) and Insyte™ (Becton Dickinson) polyurethane cannulae was studied. The integrity of the cannulae on removal, the incidence of infection at the cannula site and the factors which influence phlebitis were also examined. One thousand and eight patients had a polyurethane cannula placed for induction of anaesthesia for cardiac surgery. After surgery, the cannula was examined every 24 hours. If evidence of phlebitis occurred, the cannula was removed and sent for culture. All remaining cannulae were removed at 72 hours and the site examined daily for a further three days. There were 503 Optiva™ and 505 Insyte™ cannulae studied. The distributions between the two cannulae with respect to patient characteristics, gauge of cannula, number of attempts and difficulty of insertion, cannula site and anaesthetist inserting were similar. The early removal rate for both groups was 47%. Overall phlebitis rate with Optiva™ was 31% and Insyte™ 33%. This difference is not statistically significant. The cumulative phlebitis rate increased with time but did not differ between the two types of cannulae. Minor tip distortion or shaft kinking of the cannulae occurred in 16.2% of Optiva™ and 23.5% of Insyte™. This difference is statistically significant and may relate to the slightly more acute taper at the Optiva™ cannula tip. Both cannulae were similar in clinical performance.

Clinical application of a new ternary polymer, SEC-1 coat™, for pediatric cardiopulmonary bypass circuits: a prospective randomized pilot study

Perfusion ◽  
2020 ◽  
Vol 35 (8) ◽  
pp. 826-832
Author(s):  
Tomomi Hasegawa ◽  
Yoshihiro Oshima ◽  
Shinji Yokoyama ◽  
Asuka Akimoto ◽  
Yusuke Misaka ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Pilot Study ◽  
Interleukin 6 ◽  
Patient Characteristics ◽  
Serum Levels ◽  
Pediatric Cardiac Surgery ◽  
Interleukin 8 ◽  
Control Group ◽  
Platelet Counts

Objective: The use of biocompatible materials to reduce the systemic activation of inflammation and coagulation pathways is expanding rapidly. However, there have been few clinical studies of biocompatible circuits for pediatric cardiopulmonary bypass. This pilot study aimed to preliminarily evaluate the biocompatibility of SEC-1 coat™ (SEC) for cardiopulmonary bypass circuits in pediatric cardiac surgery. Methods: Twenty infants undergoing cardiac surgery for isolated ventricular septal defects at Kobe Children’s Hospital were assigned randomly to an SEC-coated (SEC group, n = 10) or heparin-coated (control group, n = 10) circuit. Perioperative data and the following markers were prospectively analyzed: platelet counts and interleukin-6, interleukin-8, C3a, β-thromboglobulin, and thrombin–antithrombin complex levels. Results: Neither patient characteristics nor postoperative clinical outcomes differed significantly between the SEC and control groups. Platelet counts markedly decreased during cardiopulmonary bypass in both groups, but were significantly better preserved in the SEC group. Fewer patients needed postoperative platelet transfusions in the SEC group. After cardiopulmonary bypass termination, serum levels of β-thromboglobulin and thrombin–antithrombin complex were significantly lower in the SEC than in the control group. Although the differences were not statistically significant, serum levels of interleukin-6, interleukin-8, and C3a had a tendency toward being lower in the SEC group, with good preservation of leukocyte counts, fibrinogen, and antithrombin III. Conclusion: SEC-1 coat™ for cardiopulmonary bypass circuits have good biocompatibility with regard to platelet preservation and in terms of attenuating inflammatory reaction or coagulation activation during pediatric cardiac surgery. It can be beneficial in pediatric as well as adult cardiac surgery.

Hyperglycemia After Cardiac Surgery

2014 ◽  
Vol 25 (3) ◽  
pp. 221-227
Author(s):  
Lynda Stoodley ◽  
Shu-Fen Wung
Keyword(s):  
Cardiac Surgery ◽  
Blood Glucose Control ◽  
Surgical Care ◽  
Patient Characteristics ◽  
Performance Measure ◽  
Adverse Outcomes ◽  
Retrospective Case ◽  
Improvement Project ◽  
History Of ◽  
Surgical Care Improvement Project

Background The Surgical Care Improvement Project #4 (SCIP#4) performance measure is used to evaluate achievement of target blood glucose control after cardiac surgery. Objectives The purpose of this study was to identify patient characteristics and outcomes in patients undergoing cardiac surgery who met the SCIP#4 performance measure versus those who did not. Methods A retrospective case-control design was used. Results Preoperative hemoglobin A1C (HbA1C) level and history of diabetes were 2 major risk factors for failing to meet the SCIP#4 measure. A trend toward a longer length of stay was observed, mortality was 3 times more prevalent, and renal failure was 4 times more frequent in patients who did not meet the SCIP#4 quality measure. Conclusions Not meeting the SCIP#4 measure is associated with adverse outcomes. History of diabetes and preoperative HbAIC level should be considered when evaluating strategies for managing postsurgical hyperglycemia.

Clinical Comparison of Bur- and Laser-prepared Minimally Invasive Occlusal Resin Composite Restorations: Two-year Follow-up

2010 ◽  
Vol 35 (5) ◽  
pp. 500-507 ◽  
Author(s):  
A. R. Yazici ◽  
M. Baseren ◽  
J. Gorucu
Keyword(s):  
Minimally Invasive ◽  
Clinical Relevance ◽  
Clinical Performance ◽  
Resin Composite ◽  
Promising Alternative ◽  
Composite Restorations ◽  
Clinical Comparison ◽  
Prepared Composite

Clinical Relevance The laser could be a promising alternative for minimally invasive occlusal resin composite cavity preparations, as its clinical performance was similar to bur-prepared composite restorations.

Death and quality in cardiac surgery

Clinical Risk ◽  
2010 ◽  
Vol 16 (4) ◽  
pp. 130-134 ◽  
Author(s):  
Samer AM Nashef
Keyword(s):  
Cardiac Surgery ◽  
Clinical Performance ◽  
Statistical Significance ◽  
Surgical Care ◽  
Quality Monitoring ◽  
Risk Models ◽  
Actual Outcome ◽  
The Difference ◽  
Care Evaluation

Quality monitoring in medicine was a neglected field until the last two decades. Doctors traditionally did their best, but how good that was could not be evaluated. This situation remains in some areas of medicine, but specialties with clearly-defined interventions and outcomes have progressed in quality of care evaluation, and cardiac surgery leads the way. Measuring the risk of an intervention allows prediction of the outcome and is essential for quality monitoring: without knowing the predicted outcome, the actual outcome cannot be evaluated. Cardiac surgery risk models like EuroSCORE and others have been adopted worldwide, so that measuring risk-adjusted performance is now an integral part of the delivery of good cardiac surgical care. When mortality for a procedure is higher for one surgeon (or hospital) than another, this can be due to one of three reasons, or a combination of the three: the difference is due to chance, or variation in risk profile, or better and safer service. We now have the tools to distinguish between the above factors. We can also observe performance over time: cusum curves plot the performance of surgeons and hospitals by showing hypothetical ‘lives saved’. This provides early warning of deterioration in performance before a problem reaches statistical significance. With the appropriate tools, it is possible not only to identify a problem, but also to anticipate and thus prevent a problem from happening. Monitoring clinical performance is an exciting and rewarding field for future development, and one that will yield real improvements in patient outcomes.

Electrophysiological and Clinical Comparison of Two Temporary Pacing Leads Following Cardiac Surgery

1999 ◽  
Vol 22 (8) ◽  
pp. 1221-1225 ◽  
Author(s):  
ARI O. HALLDORSSON ◽  
WICKII T. VIGNESWARAN ◽  
FRANCIS J. PODBIELSKI ◽  
DIANA M. EVANS
Keyword(s):  
Cardiac Surgery ◽  
Temporary Pacing ◽  
Clinical Comparison ◽  
Pacing Leads

scholarly journals In-Hospital Nonvariceal Upper Gastrointestinal Bleeding following Cardiac Surgery: Patient Characteristics, Endoscopic Lesions and Prognosis

Ulcers ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Marcos Amorim ◽  
Alan N. Barkun ◽  
Martin Larocque ◽  
Karl Herba ◽  
Benoit DeVarennes ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Cardiac Surgery ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Patient Characteristics ◽  
Hemodynamic Instability ◽  
Predictors Of Outcome ◽  
Surgery Patient ◽  
Endoscopic Characteristics ◽  
Upper Gastrointestinal

Background. Nonvariceal upper gastrointestinal bleeding (NVUGIB) can occur following cardiac surgery, with sparse contemporary data on patient characteristics and predictors of outcome in this setting. Aim. To describe the clinical and endoscopic characteristics of patients with NVUGIB following cardiac surgery and characterize predictors of outcome. Methods. Retrospective review of 131 consecutive patients with NVUGIB following cardiac surgery from 2002 to 2005. Demographic characteristics, therapeutic management, and predictors of outcomes were determined. Results. 69.5% were male, mean age: 68.8 ± 10.2 yrs, mean Parsonnet score: 24.6 ± 14.2. Commonest symptoms included melena (59.4%) or coffee ground emesis (25.8%). In-hospital medications included ASA (88.5%), heparin (95.4%, low molecular weight 6.9%), coumadin (48.1%), clopidogrel (22.9%), and NSAIDS (42%). Initial hemodynamic instability was noted in 47.1%. Associated laboratory results included hematocrit 26 ± 6, platelets 243 ± 133 109/L, INR 1.7 ± 1.6, and PTT 53.3 ± 35.6 s. Endoscopic evaluation (122 patients) yielded ulcers (85.5%) with high-risk lesions in 45.5%. Ulcers were located principally in the stomach (22.5%) or duodenum (45.9%). Many patients had more than one lesion, including esophagitis (28.7%) or erosions (26.8%). 48.8% received endoscopic therapy. Mean lengths of intensive care unit and overall stays were 10.4 ± 18.4 and 39.4 ± 46.9 days, respectively. Overall mortality was 19.1%. Only mechanical ventilation under 48 hours predicted mortality (O.R = 0.11; 95% CI = 0.04−0.34). Conclusions. This contemporary cohort of consecutive patients with NVUGIB following cardiac surgery bled most often from ulcers or esophagitis; many had multiple lesions. ICU and total hospital stays as well as mortality were significant. Mechanical ventilation for under 48 hours was associated with improved survival.

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