scholarly journals Respiratory mechanics behavior after heart surgery: an experimental study

2021 ◽  
Vol 43 ◽  
pp. e55460
Author(s):  
Francisco José Nascimento Lima ◽  
Katia de Miranda Avena ◽  
Helder Brito Duarte ◽  
Kristine Menezes Barberino Mendes ◽  
Yasmin Silva Gomes ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Surgery ◽  
Minute Volume ◽  
Pulmonary Complications ◽  
Ventilatory Parameters ◽  
Significant Damage ◽  
Before And After ◽  
Recorded Data ◽  
Ventilatory Mechanics ◽  
The City

Changes in ventilatory mechanics and their consequent pulmonary complications are common after surgical procedures, particularly in cardiac surgery (CS), and may be associated with both preoperative history and surgical circumstances. This study aims to compare ventilatory mechanics in the moments before and after cardiac surgery (CS), describing how pulmonary complications occurred. An experimental, uncontrolled study was conducted, of the before-and-after type, and with a descriptive and analytical character. It was carried out in a private hospital in the city of Salvador, Bahia, Brazil, and involved 30 adult patients subjected to CS. In addition to clinical and epidemiological variables, minute volume (VE), respiratory rate (RR), tidal volume (VT), forced vital capacity (FVC), maximum inspiratory pressure (MIP), and peak expiratory flow (PEF) were also recorded. Data were collected in the following moments: preoperative (PRE-OP) period, immediate postoperative (IPO) period, and 1st postoperative day (1st POD). The sample was aged 48.1 ± 11.8 years old and had a body mass index of 25.5 ± 4.9 kg m-2; 60% of the patients remained on mechanical ventilation for less than 24 hours (17.5 [8.7-22.9] hours).  There was a significant reduction in VT, FVC, MIP and PEF when PRE-OP versus IPO, and PRE-OP versus 1st POD were compared (p < 0.05). There were no significant changes between IPO and the 1st POD. The highest incidence of pulmonary complications involved pleural effusion (50% of the patients). This study showed that patients subjected to CS present significant damage to ventilatory parameters after the surgery, especially in the IPO period and on the 1st POD. It is possible that the extension of this ventilatory impairment has led to the onset of postoperative pulmonary complications.

Intraoperative CARTO Mapping for Atrial Fibrillation Ablation in Patients Undergoing Cardiac Surgery

2021 ◽  
Author(s):  
Sara Rita Vacirca
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Pulmonary Veins ◽  
Open Heart Surgery ◽  
Atrial Fibrillation Ablation ◽  
Surgical Ablation ◽  
Before And After ◽  
The Mean ◽  
Exit Block

Objective: Intraoperative CARTO Mapping for Atrial Fibrillation ablation in cardiac surgery. Background: Surgical ablation of Atrial Fibrillation is usually performed without mapping. The study aims to determine if intraoperative CARTO can be useful to guide the ablating procedure. Methods and Findings: Fourteen patients with symptomatic and drug-refractory concomitant AF were operated on in 2003 and 2004. CARTO mapping was performed before and after surgical bipolar radio-frequency ablation. Application of energy was repeated when residual electrical activity was detected at the pulmonary veins-atrial junction. Pacing wires were applied on right and left pulmonary veins distally to the ablation line to confirm the exit block. The mapping protocol was completed in 12 patients. Acute left atrium-pulmonary vein isolation was achieved after single or double energy application in 2/12 (16.6%) and 9/12 (75%) patients, respectively. The mean duration of the mapping and ablation procedure was 67 minutes. At discharge, PV isolation persisted in 10 patients: exit block was confirmed by the absence of pacing through the pulmonary veins electrodes. After a mean follows up of 181 months, no further recurrent AF events were registered in 9/12 (69.2%) patients. Conclusions: CARTO system is useful during open-heart surgery to guide the ablating strategy.

scholarly journals dr Jovan Mijuskovic, precursor of cardiac surgery in Serbia

2020 ◽  
Vol 148 (1-2) ◽  
pp. 124-128
Author(s):  
Dusan Velimirovic
Keyword(s):  
Cardiac Surgery ◽  
World War Ii ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
City Hospital ◽  
Military Academy ◽  
School Of Medicine ◽  
Heart Lung Machine ◽  
History Of ◽  
The City

The beginnings of cardiac surgery in Serbia date back to the aftermath of World War II, when the first ?closed heart surgery? was performed in Belgrade. It was done by Professor Vojislav Stojanovic at the Second Surgical Clinic, and shortly afterwards, during the 1950s, by Professor Izidor Papo at the Medical Military Academy, also in Belgrade. ?Open heart surgery,? using heart-lung machine, was introduced in Serbia in 1960, and performed by the same cardiac surgery pioneers. Some of the very first heart operations in the world had been done before cardiac surgery was even officially recognized as a surgical discipline. Therefore, they were performed only as lifesaving procedures in patients with heart wounds. This article describes the first successful surgical treatment of heart wound in Serbia. It was a penetrating revolver wound, and the operation took place on April 7, 1928, at Valjevo City hospital, performed by Dr. Jovan Mijuskovic, who had received his degree from the School of Medicine in Vienna in 1917, and over the years worked as director and chief of surgical departments in various hospitals ? Cuprija, Valjevo, as well as in the City Hospital in Belgrade. He was elected Professor of History of Medicine at Belgrade School of Medicine in 1936. In 1941 he was appointed Minister of Health in the pre-war Serbian Government. Sadly, upon liberation of Belgrade in 1944, this surgical pioneer was arrested and executed.

scholarly journals Pulmonary function in preoperative, postoperative and post hospital discharge after heart surgery: controlled clinical study.

2020 ◽  
pp. 1-5
Author(s):  
Jully Wendy Soares Silva ◽  
Gabriela Xavier Santos ◽  
Monica Beatriz Ferreira ◽  
Bruno Bonfim Foresti ◽  
Danillo Barbosa ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Hospital Discharge ◽  
Respiratory Function ◽  
Respiratory Muscle ◽  
Heart Surgery ◽  
Regional Hospital ◽  
Maximal Inspiratory Pressure ◽  
Before And After ◽  
The Mean ◽  
Controlled Clinical Study

Background: Cardiac surgery may influence respiratory function at different times, such as before and after surgery, and after hospital discharge. Objective: The aim of the study was to evaluate the respiratory functionality (respiratory muscle strength and peak expiratory flow-PEF) of pre, postoperative and post-hospital discharge of cardiac surgery patients at a Regional Hospital in the south of Minas Gerais. Methods: The sample consisted of 11 subjects: 6 women (54.4%) and 5 men (45.46%), with mean age of ± 60 years. The mean height, weight and BMI were respectively: ±1.61m, ±71.08kg and ±26.89. Results: The values of the functional variables were lower than expected; men had the highest values of maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP) and PEF at the 3 moments; there was correlation rs < 1 p < 0.01 of PRE MIP and POS MIP; PRE MIP and POS MEP; third day MIP and PRE MIP; and POS MEP and PRE MEP. Conclusion: Given the above, it was concluded that men had the highest values of respiratory functional variables. The analysis of the variables at the 3 moments showed that after hospital discharge most of them reduced their values. The post hospital discharge should be a concern of professionals assisting cardiac surgery patients.

Abstract 313: Changes in Autophagic Flux in Patients Undergoing Cardiac Surgery

2012 ◽  
Vol 111 (suppl_1) ◽  
Author(s):  
Salik Jahania ◽  
David Sengstock ◽  
Peter Vaitkevicius ◽  
Redah Mahmood ◽  
Fahed Sabagh ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Surgery ◽  
Cardiac Tissue ◽  
Beclin 1 ◽  
Right Atrial ◽  
Autophagic Flux ◽  
Number Of Patients ◽  
Before And After ◽  
A Prospective Study ◽  
Ischemic Stress

Autophagy is an endogenous survival mechanism and adaptive response to cellular stress. We hypothesized that autophagy plays an important cardioprotective role in humans and would be accelerated during the ischemic stress of conventional heart surgery. In a prospective study to test this hypothesis, we measured key autophagy proteins (Beclin-1, Atg5-12, p62) in cardiac tissue from 5 patients undergoing cardiac surgery. Right atrial biopsies were obtained before and after cessation of cardiopulmonary bypass (CPB). In 4 of these patients, CPB was associated with a marked decrease in cardiac Beclin-1, Atg5-12, and p62. We believe that depletion of these factors, particularly p62, reflects a brisk increase in autophagic flux (Fig. 1). In one patient (#02), autophagic flux appeared to be impaired. This occurred in an aged patient with characteristics of metabolic syndrome (MetS) who had the highest predicted operative morbidity/mortality. While the number of patients studied is small and insufficient to reach any definitive conclusions, these preliminary data confirm the feasibility of studying autophagy in the human heart and suggest that ischemic stress during heart surgery is associated with a marked upregulation of autophagic flux. A better understanding of the role of autophagy could lead to the development of new cardioprotective strategies. [Figure 1: Changes in cardiac autophagy proteins in patients undergoing heart surgery before and after cross-clamping the aorta (after restoration of myocardial blood flow).]

scholarly journals Pulmonary function in preoperative, postoperative and post hospital discharge after heart surgery: controlled clinical study

2020 ◽  
Vol 18 ◽  
pp. 1-7
Author(s):  
Jully Wendy Soares ◽  
Gabriela Xavier Santos ◽  
Monica Beatriz Ferreira ◽  
Bruno Bonfim Foresti ◽  
Danillo Barbosa ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Hospital Discharge ◽  
Respiratory Function ◽  
Respiratory Muscle ◽  
Heart Surgery ◽  
Regional Hospital ◽  
Respiratory Muscle Strength ◽  
Before And After ◽  
The Mean ◽  
Controlled Clinical Study

Background: Cardiac surgery may influence respiratory function at different times, such as before and after surgery, and after hospitaldischarge. Objective: Evaluate the respiratory functionality (respiratory muscle strength and peak expiratory flow-PEF) of pre, postoperativeand post-hospital discharge of cardiac surgery patients at a Regional Hospital in the south of Minas Gerais. Methods: The sample consisted of11 subjects: 6 women (54.4%) and 5 men (45.46%), with mean age of ± 60 years. The mean height, weight and BMI were respectively: ±1.61m,±71.08kg and ±26.89. Results: The values of the functional variables were lower than expected; men had the highest values of maximalinspiratory pressure (MIP), maximal expiratory pressure (MEP) and PEF at the 3 moments; there was correlation rs < 1 p < 0.01 of PRE MIP andPOS MIP; PRE MIP and POS MEP; third day MIP and PRE MIP; and POS MEP and PRE MEP. Conclusion: men had the highest values ofrespiratory functional variables. The analysis of the variables at the 3 moments showed that after hospital discharge most of them reduced theirvalues. The post hospital discharge should be a concern of professionals assisting cardiac surgery patients.

scholarly journals Effect of High-Flow Nasal Oxygen on Respiratory Parameters and Pulmonary Complications After Early Extubation Following Pediatric Heart Surgery

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Farzaneh Enayati ◽  
Shahram Amini ◽  
Mohammad Gholizadeh Gerdrodbari ◽  
Lida Jarahi ◽  
Mojgan Ansari
Keyword(s):  
Cardiac Surgery ◽  
Respiratory Failure ◽  
Oxygen Therapy ◽  
Heart Surgery ◽  
Pulmonary Complications ◽  
High Flow ◽  
Control Group ◽  
Early Extubation ◽  
Respiratory Parameters ◽  
Length Of Icu Stay

Objectives: The aim of this study was to evaluate the effect of high-flow nasal cannula (HFNC) after early extubation on children undergoing cardiac surgery. Methods: This randomized controlled clinical trial was performed among 92 children aged 1 to 24 months undergoing cardiac surgery from March 5 to August 30, 2020, in a pediatric post-cardiac surgery intensive care unit (ICU). The patients were randomized to receive either HFNC or conventional oxygen therapy after extubation. Arterial blood samples were collected after anesthesia induction, after the end of the surgery, at the time of entering the ICU while they were intubated, 6 hours after entering the ICU, before removing the endotracheal tube, immediately after extubation, as well as 1, 6, 12, 24, and 36 hours after extubation. The patients were compared regarding PaCO2, PaO2/FiO2 ratios, respiratory failure, need for reintubation, development of atelectasis, pneumothorax, pleural effusion, and length of ICU stay. Results: The patients were similar regarding demographic characteristics, the duration of surgery, and mechanical ventilation (P > 0.05). On the first and second days after the surgery, the mean modified radiologic atelectasis score (m-RAS) was lower in the HFNC group compared to the conventional oxygen therapy group (P < 0.05). The frequency of respiratory failure did not differ in the groups before and after the surgery (P > 0.05). PaCO2 was lower in the HFNC group than in the control group after extubation (P < 0.001). PaO2/FIO2 ratio was significantly higher in the HFNC group one hour after extubation and afterward in comparison to the control group (P < 0.001). The need for re-intubation (P < 0.013) and the length of ICU stay (P < 0.001) were significantly lower in the HFNC group compared to the control group. Conclusions: It was found that HFNC could improve the respiratory parameters and reduce postoperative pulmonary complications in infants following a congenital heart surgery.

Abstracts from the #2 Heart Surgery Forum Meeting: Challenges and Solutions in Modern Cardiac Surgery

2014 ◽  
Vol 17 (2) ◽  
pp. 103
Author(s):  
Mark M. Levinson
Keyword(s):  
Cardiac Surgery ◽  
Heart Surgery

Heart Surgery Forum meeting: Challenges and Solutions in Modern Cardiac Surgery held in Split, Croatia.

Prophylactic Effects of Metoprolol on the Prevention of Atrial Fibrillation after Cardiac Surgery Are Dose Dependent

2014 ◽  
Vol 17 (1) ◽  
pp. 54 ◽  
Author(s):  
Nan Cheng ◽  
Changqing Gao
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Heart Surgery ◽  
Beta Blockers ◽  
Open Heart Surgery ◽  
Asian Patients ◽  
Different Response ◽  
Prolonged Hospital ◽  
Dose Dependent ◽  
Study Dose

Atrial fibrillation (AF) is one of the most common complications after cardiac surgery. Many studies have reported an incidence of 20%-40% in patients undergoing open heart surgery, and the peak incidence usually occurs between the postoperative days [Fuller 1989; Aranki 1996; Svedjeholm 2000; Maisel 2001]. AF is commonly self-limited and rarely results in postoperative death. However, postoperative AF (POAF) is often associated with complications, including stroke, heart failure, prolonged hospital stay, and increased costs [Maisel 2001; Bramer 2010]. Many pharmacological methods have been used to prevent this complication, and beta-blockers, which have been investigated in several studies, have demonstrated effectiveness [Ali 1997; Connolly 2003; Crystal 2004; Halonen 2006; Imren 2007]. There is currently a consensus in the use of beta-blockers for the prevention of POAF. However, whether the effect of beta-blockers on POAF is dose dependent has not been widely studied [Coleman 2004; Lucio 2004]. In addition, patients with different racial backgrounds have a different response to metoprolol based on body shape. In addition, the CYP2D6 genotypes are different among white and Asian patients. In this study dose-dependent prophylactic effects of beta-blockers, which were obtained in a single center.

The Use of Posterior Pericardiotomy Technique to Prevent Postoperative Pericardial Effusion in Cardiac Surgery

2012 ◽  
Vol 15 (2) ◽  
pp. 84 ◽  
Author(s):  
Canturk Cakalagaoglu ◽  
Cengiz Koksal ◽  
Ayse Baysal ◽  
Gokhan Alici ◽  
Birol Ozkan ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Heart Surgery ◽  
Artery Bypass ◽  
Pericardial Tamponade ◽  
Anxiety Level ◽  
Control Group ◽  
Echocardiographic Study ◽  
Number Of Patients ◽  
Hospital Stays

<p><b>Aim:</b> The goal was to determine the effectiveness of the posterior pericardiotomy technique in preventing the development of early and late pericardial effusions (PEs) and to determine the role of anxiety level for the detection of late pericardial tamponade (PT).</p><p><b>Materials and Methods:</b> We divided 100 patients randomly into 2 groups, the posterior pericardiotomy group (n = 50) and the control group (n = 50). All patients undergoing coronary artery bypass grafting surgery (CABG), valvular heart surgery, or combined valvular and CABG surgeries were included. The posterior pericardiotomy technique was performed in the first group of 50 patients. Evaluations completed preoperatively, postoperatively on day 1, before discharge, and on postoperative days 5 and 30 included electrocardiographic study, chest radiography, echocardiographic study, and evaluation of the patient's anxiety level. Postoperative causes of morbidity and durations of intensive care unit and hospital stays were recorded.</p><p><b>Results:</b> The 2 groups were not significantly different with respect to demographic and operative data (<i>P</i> > .05). Echocardiography evaluations revealed no significant differences between the groups preoperatively; however, before discharge the control group had a significantly higher number of patients with moderate, large, and very large PEs compared with the pericardiotomy group (<i>P</i> < .01). There were 6 cases of late PT in the control group, whereas there were none in the pericardiotomy group (<i>P</i> < .05). Before discharge and on postoperative day 15, the patients in the pericardiotomy group showed significant improvement in anxiety levels (<i>P</i> = .03 and .004, respectively). No differences in postoperative complications were observed between the 2 groups.</p><p><b>Conclusion:</b> Pericardiotomy is a simple, safe, and effective method for reducing the incidence of PE and late PT after cardiac surgery. It also has the potential to provide a better quality of life.</p>

EVALUATION OF THE EFFECTIVENESS OF NECK SHOULDER PAIN TREAMENT BY ACUPUNCTURE, MASSAGE AND TRADITIONAL MEDICINE REMEDY

2013 ◽  
pp. 110-117
Author(s):  
Thi Tan Nguyen
Keyword(s):  
Traditional Medicine ◽  
Shoulder Pain ◽  
Research Methodology ◽  
Pain Treatment ◽  
Central Hospital ◽  
Treatment Results ◽  
Good Account ◽  
Before And After ◽  
The City ◽  
Pain Patients

Objectives: To assess the effectiveness neck shoulder pain treatment by acupuncture, massage and traditional medicine remedy. Materials and Methods: 42 patients included in the inpatient and outpatient at the Department of Traditional Medicine, Hue Central Hospital and Traditional Medicine Hospital of Thua Thien Hue, was diagnosed as neck shoulder pain. Patients were treated with acupuncture, massage and medicine, according to the research methodology, assessing the results before and after treatment. Results: The age accounted for the highest proportion of 31-45 (42.49%), the second is between the ages of 46-60 (26.18%) and> 60 (26.18%). Incidence in the city (66.67%) than rural (33.33%) (p <0:05). Patients presented with neck shoulder pain (100%), together with the head pain, pain in the shoulder, arm numbness, movement restrictions tilted head bowed. Conclusion: good variety and accounted for 71.42% of which are quite good account of 14.28%, only 2.38% is poor. Results of good, high aged 31-45 (35.72%) and in patients with a course of treatment (66.66%). Key words: neck shoulder pain, acupuncture, massage, traditional medicine remedy.

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