Role of Chest Ultrasound in Detection of Post-operative Pulmonary Complications After Cardiothoracic Surgery

Author(s):  
Antioxidants ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 675
Author(s):  
Ilekuttige Priyan Shanura Fernando ◽  
Mawalle Kankanamge Hasitha Madhawa Dias ◽  
Dissanayaka Mudiyanselage Dinesh Madusanka ◽  
Hyun-Soo Kim ◽  
Eui-Jeong Han ◽  
...  

At present air pollution in parts of East Asia is at an alarming level due to elevated levels of fine dust (FD). Other than pulmonary complications, FD was found to affect the pathogenesis of ROS-dependent inflammatory responses via penetrating barrier-disrupted skin, leading to degradation of extracellular matrix components through the keratinocyte-fibroblast axis. The present study discloses the evaluation of human dermal fibroblast (HDF) responses to FD preconditioned human keratinocyte media (HPM) primed without and with (-)-loliolide (HTT). HPM-FD treatment increased the ROS level in HDFs and activated mitogen-activated protein kinase-derived nuclear factor (NF)-κB inflammatory signaling pathways with a minor reduction of viability. The above events led to cell differentiation and production of matrix metalloproteinases (MMP), increasing collagenase and elastase activity despite the increase of tissue inhibitors of metalloproteinases (TIMP). Media from HTT primed keratinocytes stimulated with FD indicated ameliorated levels of MMPs, inflammatory cytokines, and chemokines in HDFs with suppressed collagenase and elastase activity. Present observations help to understand the factors that affect HDFs in the microenvironment of FD exposed keratinocytes and the therapeutic role of HTT as a suppressor of skin aging. Further studies using organotypic skin culture models could broaden the understanding of the effects of FD and the therapeutic role of HTT.


CHEST Journal ◽  
1991 ◽  
Vol 100 (5) ◽  
pp. 1436-1441 ◽  
Author(s):  
Lutz Freitag ◽  
Nosrat Firusian ◽  
Georg Stamatis ◽  
Dieter Greschuchna

2020 ◽  
Vol 33 (7-8) ◽  
pp. 522
Author(s):  
Ângela Barbosa Mendes ◽  
Constança Penedos ◽  
Luísa Vaz Rodrigues ◽  
Joana Varandas ◽  
Neusa Lages ◽  
...  

Coronavirus disease 2019 (COVID-19) refers to the respiratory tract infection caused by the newly emergent coronavirus SARS-CoV-2. The present pandemic, declared on the 11th of March 2020, was first recognized in Wuhan city, and rapidly spread throughout China and other countries, including Portugal. Regional anesthesia should be considered whenever surgery is planned for a patient with suspected or confirmed COVID-19, as it minimizes not only airway management, the intervention with the highest risk of aerosolization, but also potential personnel contamination and patient recovery time, while maximizing operation room efficiency. Anesthesia techniques should be aimed at preventing airway manipulation such as endotracheal intubation, which is associated with a higher risk of pulmonary complications in infected patients. These recommendations are structured in pre-, intra-, and post-operative management in suspected or confirmed infected patients with SARS-CoV-2, based in local hospital infection committee recommendations and the most recent literature available regarding regional anaesthesia. They are aimed at anesthesiology personnel, with the main goals being both teamand patient safety. The SARS-CoV-2 virus will be not the last novel virus to trigger global pandemics, so having a well-structured regional anesthesia plan to manage this kind of cases will ensure the best outcome possible to both patients and the perioperative team.


Author(s):  
Sean Ryan ◽  
Vasu Chirumamilla ◽  
Ricardo A. Bello ◽  
David A. D'Alessandro ◽  
Robert E. Michler ◽  
...  

Objective The education of patients in the informed consent process remains a challenge for many surgeons. In cardiothoracic surgery, emerging minimally invasive techniques including robotics add another level of complexity to the patient education process. We sought to evaluate our patients’ perceptions and informed knowledge after robotic-assisted cardiothoracic surgery. Methods A survey containing questions designed to elicit patients’ perceptions about robotic cardiothoracic surgery was given postoperatively by telephone 1 month to 12 months after surgery. The survey included questions about the type of procedure, function of the organ operated on, purpose of the operation, primary “surgeon” (robot vs. human), patients’ opinion about robotic-assisted surgery, educational level, and socioeconomic background. Continuous variables are reported as mean ± SD. Continuous and categorical variables were compared using the Student t test and Pearson χ2 test, respectively. Ordinal variables were compared using the Mann-Whitney U test. P values of <0.05 were considered significant. Results Between 2002 and 2007, 198 patients underwent robotic cardiothoracic surgery. One hundred fifty patients (76%) were contacted and 89 (45%) fully completed the survey. Of the respondents, there were 31 coronary artery bypasses, 33 pacemaker lead implantations, esophageal resections, 8 thymectomies, and 9 others. The mean age of the patients was 61.1 ± 15 years (range, 23–87) and there were 52 men (58.4%). A total of 96.6% of patients were satisfied with the information provided by the surgeon and 92.1% felt that they understood the information. The diagnosis, target organ, and procedure were correctly identified by 81 (91.0%), 83 (93.3%), and 76 (85.4%) of the patients, respectively. A total of 80 (89.9%) knew a robot was involved and 73.8% understood the role of the robot in the surgery. These results were independent of age, income, and education level achieved. Conclusions Overall, patients demonstrated an understanding of the role of the robot in their cardiothoracic surgery. Despite the increasing complexity of robotics, preoperative patient education can result in patients who are both satisfied and well educated about their cardiothoracic surgery procedures.


2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Yaling Liu ◽  
Peiying Li ◽  
Xinyu Cheng ◽  
Weifeng Yu ◽  
Liqun Yang ◽  
...  

Postoperative pulmonary complication (PPC) remains the most common postoperative complication in patients undergoing noncardiac thoracic surgery. We conducted the clinical study to determine the diagnostic role of miRNA-21 in noncardiac thoracic surgery. 368 patients undergoing noncardiac thoracic surgery were recruited. Blood samples were collected before anesthesia and 2 hours after incision during surgery for RT-PCR measurement of miRNA-21. PPC occurrence, extrapulmonary complications, duration of ICU stay, and death within 1 year were evaluated. The overall rate of PPCs following surgery was 10.32%. A high relative miRNA-21 level was an independent risk factor for PPCs within 7 days (OR, 2.69; 95% CI, 1.25–5.66; andP<0.001). High miRNA-21 was also associated with an increased risk of extrapulmonary complications (OR, 3.62; 95% CI, 2.26–5.81; andP<0.001), prolonged ICU stay (OR, 6.54; 95% CI, 2.26–18.19; andP<0.001), increased death within 30 days (OR, 6.17; 95% CI, 2.11–18.08; andP<0.001), and death within 1 year (OR, 7.30; 95% CI, 2.76–19.28; andP<0.001). In summary, plasma miRNA-21 may serve as a novel biomarker of PPCs for patients undergoing noncardiac thoracic surgery.


BJA Education ◽  
2017 ◽  
Vol 17 (9) ◽  
pp. 295-300 ◽  
Author(s):  
Olivia J Davies ◽  
Tauqeer Husain ◽  
Robert CM Stephens

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