scholarly journals Gut Microbiota as Early Predictor of Infectious Complications before Cardiac Surgery: A Prospective Pilot Study

2021 ◽  
Vol 11 (11) ◽  
pp. 1113
Author(s):  
Ekaterina Chernevskaya ◽  
Evgenii Zuev ◽  
Vera Odintsova ◽  
Anastasiia Meglei ◽  
Natalia Beloborodova
Keyword(s):  
Cardiac Surgery ◽  
Pilot Study ◽  
Bacterial Infection ◽  
Postoperative Period ◽  
Gut Microbiome ◽  
Fecal Microbiota ◽  
Infectious Complications ◽  
Early Postoperative Period ◽  
Microbial Composition ◽  
Close Relationship

Cardiac surgery remains a field of medicine with a high percentage of postoperative complications, including infectious ones. Modern data indicate a close relationship of infectious disorders with pathological changes in the composition of the gut microbiome; however, the extent of such changes in cardiac surgery patients is not fully clarified. In this prospective, observational, single center, pilot study, 72 patients were included, 12 among them with the infectious complications. We analyzed the features of the fecal microbiota before and in the early postoperative period, as one of the markers for predicting the occurrence of bacterial infection. We also discovered the significant change in microbial composition in the group of patients with infectious complications compared to the non-infectious group before and after cardiac surgery, despite the intra-individual variation in composition of gut microbiome. Our study demonstrated that the group of patients that had a bacterial infection in the early postoperative period already had an altered microbial composition even before the surgery. Further studies will evaluate the clinical significance of the identified proportions of individual taxa of the intestinal microbiota and consider the microbiota as a novel target for reducing the risk of infectious complications.

Incidence and risk factors for impaired mobility in older cardiac surgery patients during the early postoperative period

2014 ◽  
Vol 15 (3) ◽  
pp. 276-281 ◽  
Author(s):  
Lurdes Tse ◽  
John B Bowering ◽  
Stephan K W Schwarz ◽  
Randell L Moore ◽  
Richard Sztramko ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiac Surgery ◽  
Postoperative Period ◽  
Early Postoperative Period ◽  
Impaired Mobility

scholarly journals SYNTHETIC PATCH INFECTION IN CAROTID ENDARTERECTOMY

2019 ◽  
pp. 126-129
Author(s):  
I. S. Pulyaeva
Keyword(s):  
Postoperative Complications ◽  
Carotid Endarterectomy ◽  
Operative Treatment ◽  
Postoperative Period ◽  
Neurological Deficit ◽  
Internal Carotid ◽  
Clinical Status ◽  
Infectious Complications ◽  
Early Postoperative Period ◽  
Direct Results

Aim. To define tactics of treatment of patients with infecting of synthetic patch after carotid endarterectomia(CEA). Materials and methods. As a result of treatment of 123 patients with hemodynamically meaningful stenosises of carotids and/or presence of embolic plate in SI «Zaycev V.T. IGUS of NAMSU» from 2014 for 2018 51 CEA was executed with in seaming of patch. In 5 cases autove in used as a patch, at 46 patients were used synthetic patch. As a rule, this group was entered by patients with extensive stenosis (more than 2 cm) - 33 patients, patients with insufficient retrograde pressure and/or presence of neurological deficit in the period of crossclamping of internal carotid — 18 patients. Results. The direct results of operation we estimated complex on the basis of degree of change of clinical status and presence of postoperative complications. At 43 patients in a postoperative period are not educed complications. At 8 patients an early postoperative period was complicated by bleeding from a patch, that demanded the repeated operative treatment. In two cases through 2 and 2,5 year, infecting of synthetic patch, that demanded urgent operative intervention as excision of synthetic patch and inseaming of autovein patch, was educed. To the patients control of passableness of carotids was executed through every 6 months Hemodynamically meaningful Restenilооm was observed in 3 cases at this group of patients. Conclusion. At hemodynamically meaningful extensive stenosises of carotids and insufficient level of retrograde arteriotony it is necessary to execute CEA with inseaming of synthetic patch. In case of the repeated interference on a carotid careful hemostasis and antibacterial therapy allows to bring down the level of infectious complications.

scholarly journals Cognitive disorders in patients after cardiac surgery

2021 ◽  
pp. 26-32
Author(s):  
A. V. Belinskyi ◽  
L. V. Rasputina ◽  
Y. M. Mostovoy ◽  
O. P. Mostova ◽  
T. D. Danilevych
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Period ◽  
Cognitive Functions ◽  
Heart Defects ◽  
Cognitive Disorders ◽  
Statistical Processing ◽  
Early Postoperative Period ◽  
Cognitive Test ◽  
Before And After ◽  
Prolonged Recovery

The occurrence of cognitive disorders is a common problem after surgery. The degree of worsening of cognitive functions after surgery and anesthesia has a significant impact on the patient's health and is significantly associated with prolonged recovery in the hospital, increased morbidity and delayed functional recovery. The aim of the study was to increase the effectiveness of the diagnosis of moderate cognitive impairment and to determine its gender and age characteristics in patients before and after cardiac surgery in the early postoperative period (3 and 7 days). We examined 56 patients who underwent cardiac surgery for coronary heart disease in 37 (66.1 %) and valvular heart defects in 19 (33.9 %) patients. Assessment of cognitive functions was performed before surgery, on the 3rd and 7th day of the postoperative period. Testing was performed using the Montreal Cognitive Test. Statistical processing of the obtained data was performed on a personal computer using the statistical software package SPSS 12.0 for Windows using parametric and non-parametric methods. It was found that presence of cognitive disorders before surgery was registered in 37 (66.1 %) patients, mostly among the age of group of 60-74 years and had no gender difference. It was found that in the early postoperative period there is a significant worsening of cognitive functions in patients after cardiac surgery on 3rd day – in 45 (80.4 %), on 7th day – in 44 (78.6 %) patients, respectively.

Frequency and structure of cardiac arrhythmias in the early postoperative period following cardiac surgery

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
TD Danilevych ◽  
LV Rasputina ◽  
YM Mostovoy ◽  
AV Belinskyi
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Period ◽  
Cardiac Arrhythmias ◽  
Heart Defects ◽  
Statistical Processing ◽  
Early Postoperative Period ◽  
Av Block ◽  
Paroxysmal Tachycardia ◽  
Anterior Branch ◽  
St Segment

Abstract Funding Acknowledgements Type of funding sources: None. Background. Cardiac arrhythmias occupy one of the key places in the structure of complications of the early postoperative period following cardiac surgery. According to various literature sources, they range from 10% to 40% and often determine the course of the postoperative period. Purpose. To determine the frequency and structure of cardiac arrhythmias in the early postoperative period in the patients following cardiac surgery (up to 7 days). Methods. 56 patients were examined, among them 19 (33.9%) men and 37 (66,1%) women (p = 0.02). The age of patients ranged from 31 to 79 years, averaging 60.86 ± 8.87 years. Cardiac surgery was performed for coronary heart disease in 37 (66.1%) and valvular heart defects in 19 (33.9%) patients (p = 0.02). The duration of the operation ranged from 240 to 600 minutes, averaging 371.94 ± 102.04 minutes. In 25 (44.6%) cases, the operations were performed in conditions of bypass, the average duration of which did not differ from operations without bypass (389.44 ± 116.88 vs. 355.47 ± 86.16, p = 0.34). Assessment of cardiac arrhythmias was performed during the first 7 days after cardiac surgery. Statistical processing was performed by SPSS 12.0 for Windows. Results. 27 (48.2%) patients have developed arrhythmias within first 7 days of the postoperative period, among them in 12 (63.2%) women and 15 (40.5%) men (p = 0.24). Analysis of age structure showed that the patients <45 years didn’t have arrhythmias, 45-59 years - 8 (14.2%), 60-74 - 17 (30.4%), 75-90 - 2 (3,6%) of the patients have rhythm disorders, respectively. Atrial fibrilation (AF) dominates in the structure of arrhythmias - 17 (30.4%) patients, among them – in 11 (64.7%) patients was paroxysmal,  in 6 (35.3%) – persistent form. The mean score of CHA2DS2VASc scale - 2.56 ± 0.89. Also registered atrial flutter –  in 3 (5.4%), atrial tachycardia –  in 2 (3.6%), supraventricular paroxysmal tachycardia –  in 1 (1.8%), frequent supraventricular premarute beats (PB) – in 11 (19.6%) ), ventricular PB – in 12 (21.4%), among them ventricular PB 1st Laun class  - 8 (66.7%), 2nd class - 2 (16.7%), 3rd class - 1 (8.3%), class 4A - 1 (8.3%) patients, respectively. Among the heart blocks were registered left bundle branch (LBB) block – in 4 (7.1%), anterior branch block of LBB – in 10 (17.9%), right bundle branch block – in 6 (10.7%), atrio-ventricular (AV) block 1 degree – in 4 (7.1%), complete AV block – in 8 (14.3%) patients, respectively. The implantation of the pacemaker was performed in 9 (16.1%) patients. Disorders of repolarization flattening / inversion of the T wave – in 31 (55.4%), elevation of the ST segment – in 5 (8.9%), depression of the ST segment – in 16 (28.6%), pathological Q wave – in 5 (8.9%) patients, respectively. Conclusions The prevalence of arrhythmias in the early postoperative period (7 days) following cardiac surgery is 48.2%, equally common in men and women. AF dominated in the structure of cardiac arrhythmias (30,4%).

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