scholarly journals Endotoxemia related to cardiopulmonary bypass is associated with increased risk of infection after cardiac surgery: a prospective observational study

Critical Care ◽  
2011 ◽  
Vol 15 (1) ◽  
pp. R69 ◽  
Author(s):  
David J Klein ◽  
Francoise Briet ◽  
Rosane Nisenbaum ◽  
Alexander D Romaschin ◽  
C David Mazer
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Risk Of Infection ◽  
Increased Risk

scholarly journals Vasoresponsiveness in patients with heart failure (VASOR): protocol for a prospective observational study

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Marieke E. van Vessem ◽  
Saskia L. M. A. Beeres ◽  
Rob B. P. de Wilde ◽  
René de Vries ◽  
Remco R. Berendsen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Observational Study ◽  
Vascular Reactivity ◽  
Prospective Observational Study ◽  
Ex Vivo ◽  
Phase 1 ◽  
Resistance Arteries ◽  
Patients With Heart Failure

Abstract Background Vasoplegia is a severe complication which may occur after cardiac surgery, particularly in patients with heart failure. It is a result of activation of vasodilator pathways, inactivation of vasoconstrictor pathways and the resistance to vasopressors. However, the precise etiology remains unclear. The aim of the Vasoresponsiveness in patients with heart failure (VASOR) study is to objectify and characterize the altered vasoresponsiveness in patients with heart failure, before, during and after heart failure surgery and to identify the etiological factors involved. Methods This is a prospective, observational study conducted at Leiden University Medical Center. Patients with and patients without heart failure undergoing cardiac surgery on cardiopulmonary bypass are enrolled. The study is divided in two inclusion phases. During phase 1, 18 patients with and 18 patients without heart failure are enrolled. The vascular reactivity in response to a vasoconstrictor (phenylephrine) and a vasodilator (nitroglycerin) is assessed in vivo on different timepoints. The response to phenylephrine is assessed on t1 (before induction), t2 (before induction, after start of cardiotropic drugs and/or vasopressors), t3 (after induction), t4 (15 min after cessation of cardiopulmonary bypass) and t5 (1 day post-operatively). The response to nitroglycerin is assessed on t1 and t5. Furthermore, a sample of pre-pericardial fat tissue, containing resistance arteries, is collected intraoperatively. The ex vivo vascular reactivity is assessed by constructing concentrations response curves to various vasoactive substances using isolated resistance arteries. Next, expression of signaling proteins and receptors is assessed using immunohistochemistry and mRNA analysis. Furthermore, the groups are compared with respect to levels of organic compounds that can influence the cardiovascular system (e.g. copeptin, (nor)epinephrine, ANP, BNP, NTproBNP, angiotensin II, cortisol, aldosterone, renin and VMA levels). During inclusion phase 2, only the ex vivo vascular reactivity test is performed in patients with (N = 12) and without heart failure (N = 12). Discussion Understanding the difference in vascular responsiveness between patients with and without heart failure in detail, might yield therapeutic options or development of preventive strategies for vasoplegia, leading to safer surgical interventions and improvement in outcome. Trial registration The Netherlands Trial Register (NTR), NTR5647. Registered 26 January 2016.

scholarly journals Association between preoperative serum homocysteine and delayed neurocognitive recovery after non-cardiac surgery in elderly patients: a prospective observational study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Zhen-Feng Zhang ◽  
Qing-Chun Sun ◽  
Yi-Fan Xu ◽  
Ke Ding ◽  
Meng-Meng Dong ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Observational Study ◽  
Elderly Patients ◽  
Sex Education ◽  
Prospective Observational Study ◽  
Cognitive Disorders ◽  
Vitamin B ◽  
Link Type ◽  
Preoperative Serum ◽  
Increased Risk

Abstract Background Homocysteine, folate, and vitamin B12 involved in 1-carbon metabolism are associated with cognitive disorders. We sought to investigate the relationships between these factors and delayed neurocognitive recovery (dNCR) after non-cardiac surgery. Methods This was a prospective observational study of patients (n = 175) who were ≥ 60 years of age undergoing non-cardiac surgery. Patients were evaluated preoperatively and for 1 week postoperatively by using neuropsychological tests and were divided into dNCR or non-dNCR groups according to a Z-score ≤ − 1.96 on at least two of the tests. The relationship between the occurrence of dNCR and preoperative levels of homocysteine, folate, and vitamin B12 was analyzed. Univariate and multivariable logistic regression analyses were conducted to identify factors associated with dNCR. Results Delayed neurocognitive recovery was observed in 36 of 175 patients (20.6%; 95% confidence interval [CI], 14.5–26.6%) 1 week postoperatively. Patients who developed dNCR had significantly higher median [interquartile range (IQR)] homocysteine concentrations (12.8 [10.9,14.4] μmol/L vs 10.6 [8.6,14.7] μmol/L; P = 0.02) and lower folate concentrations (5.3 [4.2,7.3] ng/mL vs 6.9 [5.3,9.5] ng/mL; P = 0.01) than those without dNCR. Compared to the lowest tertile, the highest homocysteine tertile predicted dNCR onset (odds ratio [OR], 3.9; 95% CI, 1. 3 to 11.6; P = 0.02), even after adjusting for age, sex, education, and baseline Mini Mental State Examination. Conclusions Elderly patients with high homocysteine levels who underwent general anesthesia for non-cardiac surgery have an increased risk of dNCR. This knowledge could potentially assist in the development of preventative and/or therapeutic measures. Trial registration NCT03084393 (https://www.clinicaltrials.gov)

Cerebrovascular autoregulation impairments during cardiac surgery with cardiopulmonary bypass are related to postoperative cognitive deterioration: prospective observational study

2019 ◽  
Vol 85 (6) ◽  
Author(s):  
Birute Kumpaitiene ◽  
Milda Svagzdiene ◽  
Edmundas Sirvinskas ◽  
Virginija Adomaitiene ◽  
Vytautas Petkus ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Cognitive Deterioration ◽  
Cerebrovascular Autoregulation

Frequent Door Openings During Cardiac Surgery Are Associated With Increased Risk for Surgical Site Infection: A Prospective Observational Study

2018 ◽  
Vol 69 (2) ◽  
pp. 290-294 ◽  
Author(s):  
Jan A Roth ◽  
Fabrice Juchler ◽  
Marc Dangel ◽  
Friedrich S Eckstein ◽  
Manuel Battegay ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Observational Study ◽  
Surgical Site Infection ◽  
Prospective Observational Study ◽  
Cox Regression ◽  
Multivariable Analysis ◽  
Skin Closure ◽  
Site Infection ◽  
Door Opening ◽  
Increased Risk

Abstract Background Preliminary studies that analyzed surrogate markers have suggested that operating room (OR) door openings may be a risk factor for surgical site infection (SSI). We therefore aimed to estimate the effect of OR door openings on SSI risk in patients undergoing cardiac surgery. Methods This prospective, observational study involved consecutive patients undergoing cardiac surgery in 2 prespecified ORs equipped with automatic door-counting devices from June 2016 to October 2017. Occurrence of an SSI within 30 days after cardiac surgery was our primary outcome measure. Respective outcome data were obtained from a national SSI surveillance cohort. We analyzed the relationship between mean OR door opening frequencies and SSI risk by use of uni- and multivariable Cox regression models. Results A total of 301 594 OR door openings were recorded during the study period, with 87 676 eligible door openings being logged between incision and skin closure. There were 688 patients included in the study, of whom 24 (3.5%) developed an SSI within 30 days after surgery. In uni- and multivariable analysis, an increased mean door opening frequency during cardiac surgery was associated with higher risk for consecutive SSI (adjusted hazard ratio per 5-unit increment, 1.49; 95% confidence interval, 1.11–2.00; P = .008). The observed effect was driven by internal OR door openings toward the clean instrument preparation room. Conclusions Frequent door openings during cardiac surgery were independently associated with an increased risk for SSI. This finding warrants further study to establish a potentially causal relationship between OR door openings and the occurrence of SSI.

scholarly journals Incidence, Indications, and Risk Factors of Reopening After Cardiac Surgery in Tertiary Cardiac Center, Sudan: Retrospective Observational Study

2020 ◽  
pp. 1-7
Author(s):  
Fatimah Azhari Gasmalla Gadeltayeb ◽  
◽  
Elfatih M Malik ◽  
Elamin E Elnur ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Observational Study ◽  
Nyha Class ◽  
Postoperative Bleeding ◽  
Retrospective Observational Study ◽  
Increased Risk ◽  
Cardiac Center

Background: Chest re-opening after cardiac surgery is a surgical approach that is performed for diagnosis and management of some postoperative complications. The rate of reopening varies from 2% to 6% of patients undergoing cardiac surgery. The most frequent indication for reopening, followed by cardiac tamponade, cardiac arrest and redo surgery. Several risk factors have been associated with reopening such as, age, sex, BMI, NYHA class, diabetes mellitus, cardiopulmonary bypass and aortic cross clamp time. The aim of this study is to determine the incidence, indications, and risk factors of reopening after cardiac surgery. Methods: In this retrospective observational study, a total of consecutive 638 patients who underwent cardiac surgery in Ahmed Gasim cardiac center in 2017 were included. Results: The incidence of reopening was found to be 61 per 1000 in all age groups, 90 per 1000 in adults, and 34 per 1000 in paediatrics. Out of 39 reopening cases, Bleeding was found to be the most frequent indication of reopening. multivariate analysis by logistic regression revealed that, having NYHA class II odd ratio OR = 24.767 (95% confidence interval CI = 1.048 – 585.3), past cardiac surgery OR = 13.9(95% CI = 1.013 – 193.3), having diabetes mellitus OR = 4.885 (95% CI = 1.251 –19.056 ),longer cardiopulmonary bypass time OR = 1.012 (95% CI = 1.00 – 1.024), preoperative aspirin OR = 3.528 (95% CI = 1.062 – 11.720), and warfarin OR = 12.790 (95% CI = 1.594 – 102.3) all are associated with increased risk of reopening after cardiac surgery. Conclusion : Incidence of reopening in Sudan was relatively higher than the international records. Reopening was mostly performed for postoperative bleeding management. Cardiac failure assessed by NYHA classification, previous cardiac surgery, diabetes mellitus, anti thrombotic therapy and longer bypass time were associated with increased risk of reopening

scholarly journals Endotoxemia related to cardiopulmonary bypass is associated with increased risk of infection after cardiac surgery

Critical Care ◽  
2011 ◽  
Vol 15 (S1) ◽  
Author(s):  
DJ Klein ◽  
F Briet ◽  
R Nisenbaum ◽  
A Romaschin ◽  
C Mazer
Keyword(s):  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Risk Of Infection ◽  
Increased Risk

scholarly journals Risk factors for prolonged intensive care unit stays in patients after cardiac surgery with cardiopulmonary bypass: A retrospective observational study

2021 ◽  
Vol 8 (4) ◽  
pp. 388-393
Author(s):  
Xueying Zhang ◽  
Wenxia Zhang ◽  
Hongyu Lou ◽  
Chuqing Luo ◽  
Qianqian Du ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Cardiac Surgery ◽  
Intensive Care ◽  
Cardiopulmonary Bypass ◽  
Observational Study ◽  
Retrospective Observational Study

Prospective Incidence Study of Bloodstream Infection in Infants and Children With Central Venous Catheters After Cardiac Surgery in Italy

2009 ◽  
Vol 30 (7) ◽  
pp. 698-701 ◽  
Author(s):  
Stefania Bezzio ◽  
C. Scolfaro ◽  
R. Broglia ◽  
R. Calabrese ◽  
F. Mignone ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Observational Study ◽  
Bloodstream Infection ◽  
Medical Staff ◽  
Prospective Observational Study ◽  
Central Venous Catheters ◽  
Central Venous ◽  
In Infants And Children ◽  
Catheter Related Bloodstream Infection

This prospective observational study was designed to assess the incidence of, risk factors for, and outcome of catheter-related bloodstream infection in children undergoing cardiac surgery. A staff specifically trained to handle the central venous catheters with proper aseptic techniques and an appropriate patient to medical staff ratio remain the most effective measures to prevent this infection.

scholarly journals Prediction of Prolonged ICU Stay in Cardiac Surgery Patients as a Useful Method to Identify Nutrition Risk in Cardiac Surgery Patients: A Post Hoc Analysis of a Prospective Observational Study

2018 ◽  
Vol 43 (6) ◽  
pp. 768-779 ◽  
Author(s):  
Christian Stoppe ◽  
Julia Ney ◽  
Vladimir V. Lomivorotov ◽  
Sergey M. Efremov ◽  
Carina Benstoem ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Nutrition Risk ◽  
Post Hoc Analysis ◽  
Icu Stay ◽  
Prolonged Icu Stay ◽  
Post Hoc
Sign in / Sign up

Export Citation Format

Share Document